Consultation on PHI Rules - October 2025 sunset

Overview

The Department of Health and Aged Care (department) and Australian Prudential Regulation Authority (APRA) are undertaking a review of private health insurance legislation in accordance with the Legislation Act 2003 to ensure it remains fit‑for‑purpose, is kept up to date and in force so long as it is needed.

This review applies to four Rules.

Three of these Rules are administered by the department:

• Private Health Insurance (Risk Equalisation Policy) Rules 2015
• Private Health Insurance (Health Benefits Fund Policy) Rules 2015
• Private Health Insurance (Levy Administration) Rules 2015

One Rule is administered by APRA.

• Private Health Insurance (Risk Equalisation Administration) Rules 2015

These Rules are due to cease (sunset) on 30 September 2025.

Why your views matter

The department and APRA seek responses from interested stakeholders on:

• whether the Rules are fit for purpose and still required
• whether the proposed updates are appropriate

This consultation is limited to administrative amendments to the four Rules for the purpose of replacement. Consideration of significant policy changes, including a review of the risk equalisation process, is not part of this process.

How we will use your responses

The purpose of this consultation is to seek stakeholder responses on the department’s and APRA’s proposal to retain the Rules with minor updates.

Your feedback will inform whether the Rules are remade and, if so, the minor updates to be made.

How to respond

Please submit your response via email to PHIconsultation@health.gov.au. Submissions are due by 31 March 2025.