Private health insurance report (PHIR) specification v3.0.1

The Final Private health insurance report version 3.0.1 electronic reporting specification (ERS) and the Final Private health insurance statement specification version, commencing from 1 July 2019 (Statement Specification) have been published.

Version 3.0.1 of the ERS must be used to report member information online directly to the ATO using the Business Portal for the 2019 and subsequent financial year reporting periods. Version 3.0.0 must still be used to report member information for the reporting periods 2015 to 2018 inclusive.

The final ERS and the final Statement Specification both incorporate updates to reflect that information statements need not be issued on a compulsory basis from January 2019.

The significant changes for software developed products are detailed in the draft ERS at:

• The following sections have been updated to reflect the changes in when funds are required to issue statements to members
  • Definitions section
  • Section 2 Legal requirements
  • Section 9 Amendment files.

Changes to definitions

• Informational changes to definitions Policy membership number (6.54), Your premiums eligible for Australian Government rebate (6.83) and Individual MLS record start date (6.86).

A detailed list of all changes to the ERS (as compared to the previous final version 3.0.0) can be found in the ‘Changes to this version of the specification’ section.

A tracked version of the final specification showing changes from the previous final version 3.0.0 is provided as well as a clean version.