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This is a Bill, not an Act. For current law, see the Acts databases.
1998-99
The Parliament of
the
Commonwealth of
Australia
HOUSE OF
REPRESENTATIVES
Presented and read a first
time
National
Health Amendment (Lifetime Health Cover) Bill
1999
No. ,
1999
(Health and Aged
Care)
A Bill for an Act to amend the
National Health Act 1953
ISBN: 0642 403597
Contents
A Bill for an Act to amend the National Health Act
1953
The Parliament of Australia enacts:
This Act may be cited as the National Health Amendment (Lifetime
Health Cover) Act 1999.
This Act commences on 1 July 2000.
Each Act that is specified in a Schedule to this Act is amended or
repealed as set out in the applicable items in the Schedule concerned, and any
other item in a Schedule to this Act has effect according to its
terms.
1 Subsection 4(1)
Insert:
adult beneficiary, in relation to hospital cover, means a
person covered by that hospital cover, other than a person who is under 31 years
of age and is a dependant of a contributor in respect of the hospital
cover.
2 Subsection 4(1)
Insert:
base rate, in relation to hospital cover, has the meaning
given in subclause 1(2) of Schedule 2.
3 Subsection 4(1)
Insert:
hospital cover has the meaning given in clause 4 of Schedule
2.
4 Subsection 4(1)
Insert:
joint hospital cover means hospital cover in respect of which
there is more than one adult beneficiary.
5 Subsection 4(1)
Insert:
permitted days without hospital cover has the meaning given
in clause 3 of Schedule 2.
6 Subsection 4(1)
Insert:
Schedule 2 application day has the meaning given in clause 5
of Schedule 2.
7 After section 73BA
Insert:
It is a condition of registration of a registered organization that it
must comply with Schedule 2.
8 At the end of section
105AB
Add:
(14) An application may be made to the Tribunal for the review of a
decision of the Minister refusing to make a determination under clause 10 of
Schedule 2.
9 Subparagraph (m)(v) of Schedule
1
Repeal the subparagraph, substitute:
(v) except as provided in Schedule 2, the age of the
contributor;
(va) the age of a dependant of a contributor;
10 Paragraph (q) of Schedule
1
Omit all the words from and including “unless,” to and
including “a contributor” (last occurring), substitute:
except to the extent (if any) that either or both of the following
apply:
(v) under the rules of the organization, a discounted rate of contribution
is payable by or in respect of such a contributor;
(vi) the amount of contributions payable by the contributor is increased
under Schedule 2.
11 After Schedule 1
Insert:
(1) The amount of the contributions payable for hospital cover in respect
of an adult beneficiary is increased if he or she did not have hospital cover on
his or her Schedule 2 application day.
(2) The amount of the increase is worked out as follows:
where:
age is the adult beneficiary’s age on the first day,
after his or her Schedule 2 application day, on which the adult beneficiary has
hospital cover.
base rate is the amount of contributions that would be
payable for that hospital cover in respect of an adult beneficiary in respect of
whom:
(a) contributions are not increased under this Schedule; and
(b) contributions are not decreased through providing financial benefits
under a loyalty bonus scheme implemented in accordance with paragraph (ma) of
Schedule 1; and
(c) a discounted rate of contribution is not payable in accordance with
paragraph (s) of Schedule 1.
Example: Bill turned 35 years of age on 1 September 2000. He
takes out hospital cover, for the first time, on 15 September 2000. If that
hospital cover has a base rate of $1,000 per year, the amount of the increase in
the base rate under this clause is as
follows:
(1) The amount of the contributions payable for hospital cover in respect
of an adult beneficiary is increased if:
(a) after his or her Schedule 2 application day, the adult beneficiary
ceased to have hospital cover; and
(b) on more than 364 days (other than permitted days without hospital
cover) after the first day on which paragraph (a) applied to the adult
beneficiary, he or she did not have hospital cover.
(2) The amount of the increase is worked out as follows:
where:
base rate is the base rate for the hospital cover in
question.
years without hospital cover is the number obtained
by:
(a) dividing by 365 the number of days (other than permitted days without
hospital cover), after the first day on which paragraph (1)(a) applied to the
adult beneficiary, on which he or she did not have hospital cover; and
(b) rounding down the result to the nearest whole number.
(3) Any increase under this clause in the amount of the contributions
payable for hospital cover is in addition to any increase under clause 1 in the
amount of the contributions payable for that hospital cover.
Example: Further to the example in clause 1, Bill, at age
37, ceases his hospital cover. He subsequently takes out hospital cover again
(at a base rate of $1,000 per year) after a period that included 800 days that
were not permitted days without hospital cover (see clause 3).
The number of years without hospital cover is 2 (rounded
down to the nearest whole number). The amount of the increase in the base rate
under this clause is therefore as follows:
This increase is added to the increase under clause 1,
giving a total increase of $140. Bill’s hospital cover (in the absence of
any loyalty bonus or discount) will therefore cost $1,140 per
year.
(1) Any of the following days that occur after an adult beneficiary
ceases, for the first time after his or her Schedule 2 application day, to have
hospital cover are permitted days without hospital cover in
respect of that adult beneficiary:
(a) the first 730 days during which the adult beneficiary did not have
hospital cover;
(b) days that are covered by circumstances of the kind specified in
regulations made for the purposes of this paragraph.
(2) However, the 730 days referred to in paragraph (1)(a) do not include
days to which paragraph (1)(b) applies.
(1) A person has hospital cover if the person is covered by
an applicable benefits arrangement of any registered organization, unless the
person is:
(a) under 31 years of age; and
(b) a dependant of a contributor for benefits in accordance with the
arrangement.
Note: For applicable benefits arrangements, see section
5A.
(2) A person is taken to have hospital cover if the person
is included in a class of persons specified in the regulations.
An adult beneficiary’s Schedule 2 application day
is:
(a) if the adult beneficiary turned 31 years of age on or before 1 July
2000—1 July 2000; or
(b) if the adult beneficiary turned 31 years of age after 1 July
2000—the day he or she turned 31 years of age.
The fact that the amount of contributions payable for hospital cover in
respect of an adult beneficiary is increased under this Schedule does not
prevent:
(a) contributions in respect of the adult beneficiary being decreased
through providing financial benefits under a loyalty bonus scheme implemented in
accordance with paragraph (ma) of Schedule 1; and
(b) any discounted rate of contribution being payable by or in respect of
the adult beneficiary in accordance with paragraph (s) of Schedule 1.
(1) The amount of the contributions payable for hospital cover in respect
of an adult beneficiary does not increase under this Schedule if he or she was
born on or before 1 July 1934.
(2) However, this clause does not prevent clause 9 applying to joint
hospital cover in respect of any adult beneficiaries who were born after 1 July
1934.
The maximum amount of any increase under this Schedule in the amount of
the contributions payable for hospital cover in respect of an adult beneficiary
is an amount equal to 70% of the base rate for the hospital cover.
(1) If:
(a) an adult beneficiary has joint hospital cover with a registered
organization; and
(b) the amount of the contributions payable for the hospital cover in
respect of the adult beneficiary is increased under this Schedule (other than
this clause);
the amount of the contributions payable for the hospital cover in respect
of all of the adult beneficiaries jointly is increased.
(2) The amount of the increase is worked out by:
(a) for each adult beneficiary, working out what would be the amount of
the increase under this Schedule in the amount of contributions payable in
respect of the adult beneficiary if:
(i) he or she had hospital cover in respect of which he or she was the
only adult beneficiary; and
(ii) the base rate for the hospital cover was an amount equal to the base
rate for the joint hospital cover divided by the total number of the adult
beneficiaries; and
(b) adding together the amounts worked out under paragraph (a).
Example: Further to the example in clauses 1 and 2, Bill, at
age 42, changes his hospital cover to a joint hospital cover with Maria, who had
hospital cover on 1 July 2000 and has maintained it ever since. The base rate
for the joint hospital cover is $1,500 per year.
The increase under this Schedule for Bill, on a base rate
of $750, is $105 (because he did not have hospital cover, after 1 July 2000,
until he turned 35, and because of the subsequent 800 days without hospital
cover).
There is no increase under this Schedule for
Maria.
The amount of the increase in the base rate, for Bill and
Maria jointly, is therefore $105.
(1) The Minister must determine that a person is to be treated, for the
purposes of this Schedule, as having had hospital cover on 1 July 2000
if:
(a) the person applies to the Minister, in accordance with subsection (2),
for the determination; and
(b) the Minister is satisfied that one or more of the circumstances
specified in the regulations apply to the person.
(2) The application must:
(a) be made before 1 July 2002; and
(b) be in the form approved by the Minister; and
(c) be lodged in the manner approved by the Minister.
(3) The determination takes effect on the day it is made. It does not
affect amounts of contributions, for hospital cover in respect of the person,
paid before that day.
(4) The Minister must notify the person in writing of the determination,
or of the Minister’s refusal to make a determination.
Note: A refusal to make a determination is
reviewable—see section 105AB.
The provisions of this Part override Part 1 of this Schedule to the
extent of any inconsistency.
(1) A registered organization must comply with any requirements specified
in the regulations relating to providing information to:
(a) adult beneficiaries in respect of hospital cover provided by the
registered organization; and
(b) other people who apply to become, or inquire about becoming, adult
beneficiaries in respect of that hospital cover;
about increases under this Schedule in the amounts of the contributions
payable for hospital cover in respect of those adult beneficiaries or other
people.
(2) A registered organization must comply with any requirements specified
in the regulations relating to providing information to other registered
organizations about increases under this Schedule in the amounts of the
contributions payable for hospital cover provided by the registered
organization.
(3) The regulations may require or permit a registered organization to
provide information of a kind referred to in this section in the form of an age
notionally attributed, to an adult beneficiary or other person, as the age from
which the adult beneficiary or other person will be treated as having had
continuous hospital cover.
A registered organization must comply with any requirements specified in
the regulations relating to whether, and in what circumstances, particular kinds
of evidence are to be accepted, for the purposes of this Schedule, as conclusive
evidence of:
(a) whether a person had hospital cover at a particular time, or during a
particular period; or
(b) a person’s age.