Health insurance levy

Health insurance levy

The health insurance levy is paid by an organisation that carries on the business in New South Wales (NSW) of providing health benefits to contributors.

You carry on the business in NSW of providing health benefits to contributors if:

  • you enrol contributors or pay benefits to contributors:
    • using premises in NSW

    • using the services of an agent in NSW

  • any contributors to your health benefit fund are permanent residents in NSW.

Do I need to register?

If you provide health benefits to contributors in NSW, you must be registered.

To register, submit a Health Insurance and State Ambulance Insurance Plan registration form.

When are returns due?

You must lodge a return by the 15th day of the month and pay the appropriate levy.

What is the current prescribed rate?

The rates for the last 5 years are listed below:

Period Prescribed rate
1 April 2018 to 31 March 2019 $1.53
1 April 2017 to 31 March 2018 $1.49
1 April 2016 to 31 March 2017 $1.46
1 April 2015 to 31 March 2016 $1.43
1 April 2014 to 31 March 2015 $1.38

How is the levy calculated?

The following formula is used to calculate the levy:

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


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 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.

Are all contributors included when calculating the levy?

No, the following contributors are not included when calculating the levy:

  • people who permanently reside outside of NSW

  • people who contribute to an organisation for the purpose of claiming benefits other than basic health benefits

  • people 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

    • Social Security Card

  • people who are in receipt of a service pension under the Commonwealth Veteran's Entitlements Act 1986.

Last updated: 19 March 2018