PHIAC is an independent Statutory Authority established in 1989, to regulate the private health insurance industry. PHIAC has a range of information collection, compliance and enforcement powers, including remedies in the Federal Court.

PHIAC is required to take all reasonable steps to perform its functions and exercise its powers with a view to achieving an appropriate balance between:

fostering an efficient and competitive health insurance industry
protecting the interests of consumers
ensuring the prudential safety of individual private health insurers.

The Council’s functions and powers are set out in section 264-10 of the Private Health Insurance Act 2007 and are listed in the PHIAC Customer Service Charter.

Where do I go if I have a complaint about a Fund?

The Private Health Insurance Ombudsman is an Australian Government agency but acts independently of the Government in dealing with complaints about private health insurers.

Complaints Hotline: 1800 640 695 (free call anywhere in Australia)

Email: info@phio.org.au

Website:www.phio.org.au/comp.html

Where do I find statistical information about my Fund?

PHIAC collects and distributes a number of statistical reports about theprivate health insurance industry. These publications provide aggregated data on a national and state basis.

The Report on the Operations of Private Health Insurers, is an annual report that provides information for each financial year on the financial performance of each fund and the industry as a whole. The report also provides membership, benefits and management expense data for each fund.

Where do I get information about my health insurance product?

All funds are required by legislation to provide a Standard Information Statement on each product that it offers. These statements are available at www.privatehealth.gov.au/

Where do I get Information on the Medicare Levy Surcharge?

In October 2008, legislation was passed raising the Medicare Levy Surcharge income thresholds and introducing transitional provisions. For more information please see Medicare Levy Surcharge Changes.

Where do I get Information on Lifetime Health Cover?

Lifetime Health Cover (LHC) is a Government initiative designed to encourage people to take out hospital insurance earlier in life and to maintain their cover. If you take out hospital cover earlier in life and maintain your hospital cover, you will pay lower premiums throughout your life compared to someone who joins when they're older. To avoid paying a LHC loading, you need to take out a private health insurance hospital policy by the 1st of July following your 31st birthday. For each year you delay, you will pay 2% more for your premium, up to a maximum of 70%.

If you were born before 1 July 1934, you are exempt from LHC.

Once you have paid a LHC loading on your private health insurance for 10 continuous years, the loading is removed as long as you retain your hospital cover. Some other special circumstances apply, which are described below.

More information on Lifetime Health Cover

What percentage of Australians are covered by private health insurance?

PHIAC publishes coverage information on a quarterly basis.

Where else can I get information regarding private health insurance?

Insure? Not Insure? – Your Guide to Private Health Insurance. This publication is produced by PHIAC. It is available online. Hard copies are also available from PHIAC. You may be able to obtain a copy of this publication from your private health insurer.

Where do I find a list of private health insurers and their contact details?

PHIAC maintains a list of all registered health insurers.

How are the boards of private health insurers regulated?

As of 1 January 2010 all private health insurers must comply with the PHIAC Governance Standard which sets out a minimum requirements for good governance. PHIAC is empowered under section 163-1 of the Private Health Insurance Act 2007 to make prudential standards which ensures that insurers conduct their affairs with intergrity, prudence and professional skill.

Annual Tax Statements – where should queries be directed?

Each private health insurer is required to provide taxpayers with an annual statement for income tax purposes.

If you have any queries regarding these statements you should contact your private health insurer.