Definitions used in this report

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DAC

Deferred Acquisition Costs
 

Episode

The period of admitted patient care between an admission and separation (eg. discharge) characterised by only one care type.
 

Family policy

A policy under which more than one person is insured including: two parents and children; single parent and children; two or more children and no adults; three or more adults.
 

FITBS

Future Income Tax Benefits
 

General treatment

Treatment that is intended to manage or prevent a disease, injury or condition and is not hospital treatment.*
 

General treatment services

Ancillary services such as dental and optical.

Gross margin

The difference between total premium revenue and total cost of benefits (inclusive of state levies) expressed as a percentage of premium revenue.
 

HIB

Health Insurance Business: the business of undertaking liability, by way of insurance or an employee health benefits scheme, that relates to hospital treatment and general treatment.*
 

Hospital treatment

Treatment that is intended to manage a disease, injury or condition provided to a person at a hospital or arranged with the direct involvement of a hospital.*
 

Hospital-substitute treatment

General treatment that substitutes for an episode of hospital treatment.*
 

HRB

Health Related Business* includes one or more of:

Providing goods and/or services to manage or prevent disease, injuries or conditions (may include dental or optical centres)

Undertaking liability, by way of insurance, to indemnify people who are ineligible for Medicare

Providing a financial service to assist people meet the costs associated with treatment, goods or services that are provided to manage or prevent diseases, injuries or conditions.
 

Medical service

Medical specialist services such as the anaesthetist or obstetrician. A hospital episode may involve several medical services.
 

Net margin

Gross margin less management expenses expressed as a percentage of premium revenue.
 

Out-of-pocket

Refers to the amount paid by the policy holder for a service after private health insurance benefits and medicare benefits are paid. Out-of-pocket includes medical gap, excess or copayments for hospital or hospital-substitute episodes, and copayments for ancillary services.
 

Persons

Refer to the number of persons covered by private health insurance policies.
 

Policies

Refer to the number of private health insurance policies referable to private health insurance funds. Each policy may cover one or more persons.*
 

Single policy

A policy under which only one person is insured.
 

State ambulance levy

Amounts payable to the New South Wales and Australian Capital Territory governments in respect of levies on policy holders of insurers with hospital treatment cover, for ambulance cover.