Health Insurance Levy and State Ambulance Insurance Plan

Health Insurance Levy

The Health Insurance Levy is paid by organisations which provide health benefits to NSW contributors.

You are considered to provide health benefits to NSW contributors if:

  • you enrol contributors or pay benefits to contributors:
    • using premises in NSW, or
    • using the services of an agent in NSW, or
  • any contributors to your health benefit fund are permanent NSW residents.

Who should be registered?

Any organisation providing health benefits to contributors in NSW must be registered. To register, submit a Health Insurance and State Ambulance Insurance Plan registration form or by contacting Revenue NSW directly during business hours.

Returns

Registered health benefits providers must lodge a return by the 15th day of the month and pay the appropriate levy.

Calculation of the levy

The following formula is used to calculate the levy payable each month:

L = (S + 2F) x C x D x 1/7

where:

L is the monthly levy in dollars (the number of cents is to be disregarded)

S is the number of single contributors at the beginning of the month

F is the number of contributing families at the beginning of the month

C is the prescribed rate in force during the month

D is the number of days in the month.

Contributing family means a family, or group, whose members are contributors to a health benefits fund under a single policy of insurance.

Single contributor means a contributor who is not a member of a  contributing family.

Prescribed rate is normally adjusted annually and applies for the period 1 April to 31 March the following year. A full list of the prescribed rates can be found on the Health Insurance Levy page.

Exempt contributors

In determining the number of contributors to a health fund for the purposes of calculating the levy payable, persons permanently resident outside of NSW and certain classes of contributors are not included.

Exempt classes of contributors include:

  • persons who contribute to an organisation for the purpose of securing entitlement only to benefits other than basic health benefits
  • persons who hold one or more of the following cards issued to them by the Commonwealth:
    • Concession Card
    • Health Benefits Card
    • Pensioner Health Benefits and Transport Concession Card
    • Pharmaceutical Benefits Concession Card and Social Security Card.
  • persons who are in receipt of a service pension under Part III of the Veteran's Entitlements Act 1986 of the Commonwealth.

State Ambulance Insurance Plan

The State Ambulance Insurance Plan provides benefits to contributors for the payment of fees for the provision of ambulance services. The authorised agents pay contributions collected under the plan, less commission, to Revenue NSW.

Contributors

A contributor under the State Ambulance Insurance Plan is any person who is not:

  • a contributor to a health benefits fund, or
  • a person who is otherwise exempt from the payment of fees for the provision of ambulance services under the Ambulance Services Act 1976.

The amount of weekly contribution (including the authorised agent's commission) required to be paid for membership to the plan is regulated. Family memberships are required to pay an amount equal to twice the prescribed rate for a single membership.

Membership classes

There are two classes of membership:

  • single membership comprising a single person
  • family membership comprising a person and their dependents.

Authorised agents

The Minister of Health may appoint a prescribed organisation as an authorised agent for the purposes of collecting contributions and performing other functions under the plan. The following organisations are authorised agents:

  • the NIB Health Funds Limited
  • the Westfund Limited
  • the Australian Health Management Group Pty Limited
  • the Grand United Corporate Health Limited.

Returns

Authorised agents must lodge a return by the 15th day of the month and pay the appropriate amount.

Remittance of contributions by authorised agents

The following formula is used to calculate the amount payable each month:

A = (S + 2F) x C x D x 1/7 – E

where:

A is the amount in dollars to be paid to the Chief Commissioner

S is the number of contributors to single membership at the beginning of the month

F is the number of contributors to family membership at the beginning of the month

C is the prescribed rate in force during the month

D is the number of days in the month

E is the authorised agent's commission on contributions for the month.

Penalties

Failure to lodge payments on time will result in the imposition of interest and, in some cases, a further penalty. Interest and penalty tax is charged in accordance with the Taxation Administration Act 1996. Revenue NSW conducts random checks to ensure compliance.

For more information about health insurance levy and State ambulance insurance plan, contact us.

Contact

Phone
1300 139 814*
Email

Last updated: 30 July 2017