APRA Proposes New Capital Framework for Private Health Insurance
APRA launched a consultation on updating and strengthening the capital framework for the private health insurance (PHI) sector. The changes in the capital framework are aimed at improving the sensitivity of prudential capital requirements to the risks private health insurers face and improving the comparability of performance between insurers. The consultation will close on March 27, 2020, with APRA expected to release draft updated prudential standards in the second half of next year for further consultation. APRA intends to implement the finalized PHI capital framework from July 01, 2023 to align with its proposed adoption of Australian Accounting Standards Board (AASB) 17 on Insurance Contracts, for prudential purposes.
The discussion paper describes the proposed structure for the capital framework for private health insurers. The proposals aim to increase the risk-sensitivity of capital requirements to the activities of insurers and to improve the alignment of capital standards across the insurance industries it regulates. The proposals in the discussion paper are aimed to:
- Align the PHI capital framework with the framework applicable to life and general insurers, unless characteristics of the industry warrant a different approach
- Integrate changes stemming from AASB 17
- Apply the capital framework to the entire business of an insurer, rather than just the health benefits fund
APRA’s proposals have been developed from the basis of the existing capital standards applying to the life and general insurance industries (known as the LAGIC framework). The LAGIC framework reflects the overall approach of APRA to capital. By starting with the LAGIC framework, APRA aims to strengthen prudential outcomes for policy holders and improve the resilience of the PHI industry to financial stresses. Consistency of capital frameworks across the insurance sectors would allow for a common language for capital and support discussions (about capital) between APRA and insurers and within groups that contain multiple APRA-regulated insurers. This will also improve alignment with the international prudential regulation of insurance, as established through the Insurance Core Principles (ICPs) developed by IAIS.
The review of the PHI capital framework represents the third and final phase of the PHI Policy Roadmap, which was released in 2016. Phase 1 (risk management) and Phase 2 (governance) of the Roadmap are complete. Although these proposals are expected to increase minimum capital requirements for insurers once implemented, the current strong capital levels mean APRA does not expect a material need to raise additional capital across industry. The impact of these reforms on premiums is expected to be immaterial, given that capital requirements are not a material driver of PHI premiums.
Related Links
Comment Due Date: March 27, 2020
Effective Date: July 01, 2023 (proposed)
Keywords: Asia Pacific, Australia, Insurance, Private Health Insurers, Capital Requirements, PHI Roadmap, LAGIC, AASB 17, Insurance Contracts, IFRS 17, ICPs, APRA
Featured Experts

Nick Jessop
Scenario modeling expert; risk management specialist; quantitative financial modeler

María Cañamero
Skilled market researcher; growth strategist; successful go-to-market campaign developer

Gavin Conn
Experienced life actuary; background in economic capital modeling; ALM specialist; IFRS 17 researcher
Related Articles
NGFS Updates Address Short-Term Climate Scenarios and Transition Plans
The Network for Greening the Financial System (NGFS) is exploring the development of short-term climate scenarios to complement its existing scenario framework of long-term climate scenarios.
ISSB Updates Address ESG Issues while IASB Consults on Impairments
The International Sustainability Standards Board (ISSB) is seeking feedback, until August 09, 2023, on the exposure draft that sets out the methodology proposed by ISSB to amend the Sustainability Accounting Standards Board (SASB) Standards' metrics
OSFI to Review Liquidity Adequacy Guidelines and Policy Architecture
The Office of the Superintendent of Financial Institutions (OSFI) is consulting, until June 21, 2023, on a review of the liquidity treatment provided in the Liquidity Adequacy Requirements (LAR) Guideline for wholesale funding sources with retail-like characteristics.
ESRB Publishes Report on Cryptos and DeFi; ECB Updates on Digital Euro
The European Systemic Risk Board (ESRB) published a report that outlines the systemic implications of crypto markets and proposes policy options to address the risks stemming from crypto-assets and decentralized finance or DeFi.
EU Agencies Issue Updates on DORA, ESAP, and Crowdfunding Regulation
The European Supervisory Authorities (ESAs) published a discussion paper on their joint advice to the European Commission (EC) on proposals to specify criteria for critical information and communication technology (ICT) third-party service providers
ESAs Propose ESG Disclosure on STS Securitization, Issue Other Updates
The Joint Committee of the three European Supervisory Authorities (ESAs) proposed to amend the Implementing Regulation 2016/1799 on the mapping of External Credit Assessment Institutions' (ECAIs) credit assessments.
UK Authorities Issue Updates, Finalize Policy on Model Risk Management
The Prudential Regulation Authority (PRA) finalized the model risk management principles for banks, the policy statement PS5/23 on risks from contingent leverage, and PS4/23 on moving senior managers regime forms from the PRA Rulebook.
APRA Revises Implementation Timeline for Operational Risk Standard
The Australian Prudential Regulation Authority (APRA) updated the implementation date of the new cross-industry prudential standard CPS 230 on operational risk management
BCBS Consults on Basel FAQs and Amendments, Issues Other Updates
The Basel Committee on Banking Supervision (BCBS) published a report assessing implementation of the global Basel standards on net stable funding ratio (NSFR) and large exposures (LEX) in South Africa
EBA Announces Multiple Regulatory and Reporting Updates in April 2023
The European Banking Authority (EBA) published consultations on the amendments to the guidelines on risk-based anti-money laundering and countering the financing of terrorism (AML/CFT) supervision