PHI premium round
This circular provides information about the 2027 private health insurance (PHI) premium round and Out-of-Round applications. Arrangements for the application process requesting PHI premium approvals have been determined in consultation with private health insurers and the Australian Prudential Regulation Authority (APRA).
The Department of Health, Disability, and Ageing (the department) coordinates the annual Premium Round and Out-of-Round process. The department will consult with APRA throughout this process. APRA’s role in relation to the Premium Round is to advise the department whether requested premiums from private health insurers would result in an adverse prudential outcome for individual insurers.
Private health insurance premium application form
Applications are to be submitted in the forms provided and consistent with the detailed guidance at Attachment 1A and 1B.
Timetable
Private health insurers requesting changes to premiums are to submit their application form no later than 3pm AEST on Wednesday 11 November 2026.
The timetable for the 2027 Premium Round is as follows:
| Friday, 18 September 2026 | PHI Circular released to inform industry of timeline and Ministerial Statement of Expectations. |
| Upon commencement of the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill | 2027 Premium Round premium application form and the Out-of-Round premium application form are both released. |
| Wednesday, 11 November 2026 | Applications due by 3pm. The Department of Health, Disability and Ageing and APRA’s assessment of applications commences. |
December 2026 to 31 January 2027 (Indicative only – subject to Minister’s consideration of applications) | Insurers notified of outcome outside business hours. |
| Thursday, 1 April 2027 | Premium approvals take effect. |
Out-of-Round Premium Applications
An Out-of-Round application is required where insurers seek premium approval for:
- A premium change or new product to take effect before or after 1 April 2027; or
A designated change to take effect from 2 April 2027.
Notify the department
Insurers should notify the department as early as possible if they intend to submit an Out-of-Round application, particularly where there is urgency in the requested date of effect.
Out-of-Round premium application form
Applications are to be submitted in the forms provided and consistent with the detailed guidance at Attachment 1C and 1D.
Submission of applications
All applications, regardless of whether a Premium Round or Out-of-Round should be submitted via the Health Data Portal, a cloud-based Department of Health, Disability and Ageing owned file transfer system.
Statement of Expectations
In the interest of providing insurers with greater clarity and transparency of the matters the Minister for Health and Ageing intends to pay particular regard to in his consideration of applications, he has issued a Statement of Expectations for the 2027 Premium Round.
Note: Each application is assessed on its individual merits and the Minister has broad discretion to consider any relevant matters in determining whether a requested premium is contrary to the public interest.