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Publications |
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Topics in this section Private Patients' Hospital Charter Insure? Not Sure? (pdf format) Operations Of The Private Health Insurers Annual Report Financial and Statistical tables of past Operations Annual Reports |
PublicationsPrivate Health Insurance Administration CouncilReport of Operations 2007-08Statutory Reporting InformationFreedom of InformationSection 8(1) of the Freedom of Information Act 1982 requires the publication of information concerning the functions and documents of agencies. The following information is supplied in accordance with that Act and is correct as at 30 June 2008. Information and Procedures for Freedom of Information RequestsRequests for information under the Freedom of Information Act 1982 should be made in writing and accompanied by a $30 administration fee as required by the Act, addressed to:
Initial enquiries about access to documents may be made in person, by telephone or by email. During the reporting period, PHIAC did not receive any requests under the Freedom of Information Act 1982. Risk Management Practices in the Private Health Insurance Industry, Managing Supervision and Intervention, PHIAC Reporting Requirements, Conversion to For Profit Status Practice Notes and Merger and Acquisition of Health Benefits Funds Practice Notes are documents which may be classified under section 9 of the Freedom of Information Act 1982. They are available from the PHIAC website and from the PHIAC office. PHIAC’s legislated functions are listed in full under enabling legislation at the beginning of this report on pages 5 and 6. PHIAC receives financial reporting information and private health industry statistics from PHIs. The majority of information held by PHIAC is made publicly available in the quarterly statistical releases and the annual report on the operations of the PHIs. Documents held by PHIACThe following documents are available from PHIAC:
The following industry statistics are available from PHIAC: Quarterly statistics hospital and general treatment statistics A quarterly publication which details by state, the number of persons covered by private health insurance for hospital treatment and general treatment cover and the proportion of the population these persons represent. The tables shown in these statistics are on both a quarterly and annual basis and include coverage by age cohort. Quarterly gap payment and medical benefit statistics A quarterly publication which details by state the in-hospital medical services. The proportion of services for which there was no gap or known gap and the average gap payment are shown for each state. A quarterly publication which details by state, the membership and benefits paid by health benefits funds for the period. A quarterly publication on PHIAC’s website which details by state prosthetic benefits paid by private health insurers by major prosthetic category. A quarterly publication on PHIAC’s website which details by state benefits paid and gap payments for medical services by major medical groups. Hospital and general treatment insurance: statistical trends in policies and insured persons A quarterly publication on PHIAC’s website which details by state trends in private health insurance membership for hospital and general treatment since 1997 Hospital and general treatment insurance: statistical trends in benefits paid A quarterly publication on PHIAC’s website which details by state trends in private health insurance benefits paid for hospital and general treatment since 1997. Annual private health insurance membership survey An annual publication which details the number of persons with private health insurance by age, gender and state or territory of residence, including the ACT. Other documents available:
The majority of these documents are available on the PHIAC website. Most published information is available free of charge. Certain types of information collected by PHIAC in the performance of its functions may be classified as exempt documents under section 38 of the Freedom of Information Act 1982.
Access to DocumentsDocuments held by PHIAC may be obtained as indicated below from the PHIAC office.
Ecologically Sustainable Development and Environmental PerformanceThe Environment Protection and Biodiversity Conservation Act 1999 (EPBC Act) requires Commonwealth agencies to report on ecologically sustainable development and environmental matters under section 516A. While PHIAC is a small reporting entity in terms of its location and staffing, it is mindful of its responsibilities under the EPBC Act. At all times PHIAC strives to ensure it subscribes to the principles of ecologically sustainable development and that its decision-making processes effectively integrate long-term and short-term economic, environmental, social and equitable considerations. All publicly available information can be obtained from the PHIAC website. Wherever possible, publications are printed double-sided, on recycled paper, and scrap paper is recycled. Occupational Health and Safety MattersPHIAC is required to comply with all Australian Government OH&S Acts and regulations relevant to an agency of its size and number of employees. PHIAC is committed to providing a safe working environment that supports the rights, responsibilities and interests of its staff by taking all reasonably practicable steps to ensure the health and safety of all employees. PHIAC’s occupational health and safety guidelines are included in the staff procedures manual to ensure all staff are aware of the potential hazards within the normal office environment and to provide such detail as information on optimum set-up of their immediate working environment and workstations. Within risk management measures and annual performance appraisals, staff take responsibility for safe working practices and maintaining a safe working environment. PHIAC has two appointed occupational health and safety officers, and agency policy specifies that a number of staff hold current first aid qualifications. Responsibility for the overall health and safety of all staff rests with the Chief Executive Officer. Ergonomic assessments of work practices and workstations are commissioned as a matter of course whenever new people commence work with PHIAC. The PHIAC Audit and Compliance Committee monitors occupational health and safety matters to ensure PHIAC is fully compliant with the Occupational Health and Safety (Commonwealth Employment) Amendment Act 2006 (OH&S Act) which commenced on 15 March 2007. Sections 16, 16A and 16B of the Occupational Health and Safety Act 1991 require all employers that are covered by this Act, to establish Health and Safety Matters Arrangements (HSMAs) with their employees by 15 September 2008. To continue to comply with OH&S Acts and regulations, PHIAC augmented its existing OH&S policy by developing a health and safety matters arrangement during March 2008. Legislation stipulated that this HSMA be developed in consultation with PHIAC employees. A draft of the HSMA was presented to the Audit and Compliance Committee, and once this committee approved the draft HSMA, a hard copy was provided to all staff members, together with an outline of:
The consultation process was effected by the use of emails to all staff, and discussion at staff meetings, inviting their comments and suggestions on the HSMA. These suggestions were incorporated in the final HSMA which was then distributed to all staff, and made available on the intranet. Under section 4 of the OHS and Safety and Rehabilitation Compensation (SRC) Legislation Amendment Act 2006, PHIAC as an employer, is generally taken to be a ‘rehabilitation provider’. Effective from 1 September 2005 and pursuant to subsection 41(2) of the SRC Act, a rehabilitation authority shall comply with these guidelines. As the rehabilitation authority, PHIAC has specific statutory powers and functions under Part III of the SRC Act. These include arranging for a rehabilitation assessment, determining that a rehabilitation program should be undertaken, arranging with an approved rehabilitation program provider for the provision of a suitable program and ensuring suitable employment is provided for employees who may be injured or become ill, in the course of their duties. In accordance with subsection 74(1) of the OH&S Act, PHIAC is required to include information relating to occupational health and safety in its annual report. PHIAC made no claims to Comcare during the year. Commonwealth Fraud Control GuidelinesAs an agency covered by the CAC Act that does not receive at least 50% of its funding for its operating costs from the Commonwealth or a Commonwealth Agency, the Commonwealth Fraud Control Guidelines do not apply directly to PHIAC. However, PHIAC has in place an anti-fraud plan and practices appropriate fraud prevention, detection, investigation, reporting and data collection procedures and processes that meet the specific needs of the agency. PHIAC also has in place an insider trading policy that outlines PHIAC’s policy regarding handling or receiving inside information, and trading in any shares of a company which incorporates a private health insurer. The guidelines also require relevant agencies to collect data on fraud within their organisation and report it annually to the Australian Institute of Criminology. PHIAC utilised the online questionnaire provided by the institute to report that there have been no instances of fraud within the agency. PHIAC will continue to comply with best practice standards as set out in the Commonwealth Fraud Control Guidelines. Commonwealth Disability StrategyPHIAC recognises and accepts its responsibilities under Australian legislation, including the Disability Discrimination Act 1992. As a prescribed agency, PHIAC adheres to the legal requirements and the principles of better practice of the strategy in all matters that have an impact on employees, especially those that may have a disability. To this end, PHIAC office premises, work practices and policies reflect the principles of the Commonwealth Disability Strategy. Within the limitations of a small entity, PHIAC reviews and updates its compliance with the Commonwealth Disability Strategy on an annual basis. Corporate Social ResponsibilityAll PHIAC staff have a commitment to operate in a way that takes account of not only the financial implications of business decisions PHIAC makes, but also the social, environmental and economic impacts. Corporate social responsibility issues are covered in the Staff Procedures and Chief Executive Officer’s Instructions provided to staff as part of their induction program. Particular corporate social responsibility issues relevant to PHIAC’s operations include aspects of: governance, compliance with the law with regard to employee wages and benefits, no discrimination against potential employees (employed on basis of skill as opposed to personal characteristics), and health and safety issues such as fire safety and emergency evacuation procedures. Environmental impact issues such as recycling of all appropriate materials are also considered. Access and EquityPHIAC provided contributions to the Department of Immigration and Citizenship’s ‘Accessible Government Services for All’ e-newsletter, and the Access and Equity Report 2006–2008 Report. The functions of PHIAC are listed at section 264–10 of the Private Health Insurance Act 2007. PHIAC is a small agency within the Health and Ageing Portfolio, with a staff of 24 people. Principal performance indicators and strategies that PHIAC reported against included: ResponsivenessOne of PHIAC’s key objectives is to ensure the interests of consumers, with regard to health fund restructures, mergers or acquisitions are protected through the monitoring and financial regulation of the private health insurance industry. In addition, PHIAC produces a brochure Insure? Not Sure? to provide consumers with information about private health insurance. Recently upon request, this brochure was translated and provided in Mandarin. This translated version was also made available on PHIAC’s website. CommunicationPHIAC maintains a website which incorporates a search facility. PHIAC’s publications may be made available in languages other than English upon request. AccountabilityOur customer service charter, which is reviewed regularly, is updated with input sought from PHIAC’s various stakeholders. LeadershipPHIAC collaborates fully with all relevant Government agencies and stakeholders. |
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Private Health Insurance Administration CouncilSuite 16, Level 1, 71 Leichhardt Street, KINGSTON ACT
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Last modified: 16 October, 2008 |