Private Health Insurance Premium Application Form

Private health insurers can use this form to apply for premium changes in 2020. It includes a guide to completing an application and 3 templates.

The approved form to apply for premium changes includes:

  • A written report
  • Template A — Product Information
  • Template B — Financial Forecasts
  • Template C — Snapshot.

Read the guide for:

  • what the written report must include
  • how to complete the templates.

Guide to Completing the 2020 Private Health Insurance Premium Application Form

Templates A, B and C (Product Information, Financial Forecasts, Snapshot)

About this resource

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Publication type:
Form
Language:
English

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