Rates and calculation

Contributors

The health insurance levy is calculated each month by applying the prescribed rate to the number of single contributors and contributing families at the beginning of the month.

• A ‘contributor’ is a person who makes contributions to a health benefits fund.
• A ‘contributing family’ is a family or group whose members contribute to a health benefits fund via a single policy of insurance.
• A single contributor is a contributor who is not a member of a contributing family.

Exclusions

The following contributors to a fund are not included when calculating the levy.

Single or family contributors, all of whom:

• permanently reside outside NSW
• contribute to an organisation to claim benefits other than basic health benefits
• 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
  • Social Security Card.

Those who receive a service pension under the Veteran's Entitlements Act 1986 are also not included when calculating the levy.

Estimating the number of contributors

If you can’t determine the number of contributors, you can use an estimate to determine the levy.

Once you know the correct number, you must:

1. inform the Chief Commissioner of that number
2. assess the difference between the amount paid and the amount owed
3. pay any additional amount owed or apply for a refund if the amount paid exceeds the actual monthly levy.

Rates

Following are the prescribed rates for the past five years.

Calculation

The following formula is used to calculate the health insurance levy:

• L = (S + 2F) x C x D x 1/7

where:

• L is the monthly levy in dollars (the number of cents is disregarded).
• S is the number of single contributors at the beginning of the month.
• F is the number of contributing familes 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.

Family memberships are calculated at twice the prescribed rate for a single membership.

Objections and reviews

You can lodge an objection or request a reassessment if you’re dissatisfied with an assessment or decision we’ve made.