PHI 76/14

This circular issued by the Private Health Insurance Branch contains information on Second-Tier Default Benefits Process Changes and Changes to the Private Health Insurance (Benefit Requirements) Rules 2011

Page last updated: 23 December 2014

Printable version of PHI 76/14 (PDF 137 KB)
23 December 2014

Second-Tier Default Benefits Process Changes and Changes to the Private Health Insurance (Benefit Requirements) Rules 2011

The purpose of this circular is to advise industry of minor administrative changes to the second-tier default benefits arrangements and that the Private Health Insurance (Benefit Requirements) Amendment Rules 2014 (No. 6) (the Amendment Rules) have been registered with the Federal Register of Legislative Instruments (FRLI) and will commence on 1 January 2015 (FRLI No: F2014L01775). The Amendment Rules amend Schedule 5 Second-Tier Default Benefits in the Private Health Insurance (Benefit Requirements) Rules 2011 (the Rules) and are outlined below.

Changes to the Second-tier process

In the interests of administrative simplicity, the Administrative Arrangements for the Second-Tier Default Benefits for Overnight and Day Only Treatment have been amended to provide that all applications for second-tier eligibility should be submitted to the Second Tier Advisory Committee (STAC) secretariat via the Second Tier Portal.

The new Administrative Arrangements for the Second-Tier Default Benefits for Overnight and Day Only Treatment are at Attachment A.

As advised in PHI 07/13, the Rules no longer contain a list of facilities eligible for second-tier default benefits. Rather, the Rules reference a list of eligible facilities maintained by the STAC.

The Amendment Rules

The Amendment Rules update the reference to the latest STAC-approved list of second-tier eligible facilities published in this circular. Nine additional facilities have been added to the previously approved STAC list. A list of the additional facilities has been provided at Attachment B.

The complete STAC-approved list of second-tier eligible facilities as of 1 January 2015 is at Attachment C.

Next Second Tier Advisory Committee Meeting

The next STAC meeting will be held on Friday, 20 February 2015.

The closing date for applications is Friday, 30 January 2015.

Information which must be included in applications is outlined in the Sample application 2014 (updated) located on the Australian Private Hospitals Association Website. Select Industry Resources.

For any enquiries regarding the STAC-approved list of second-tier eligible facilities, or for any further information, please email Australian Private Hospitals Association

If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch.

For more information visit 2014 Private Health Insurance (PHI) Circulars.

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