Who must comply with PHI Prudential Standards (APRA)?
The applicability test for PHI Prudential Standards (APRA) (APRA), computed across 35 industries, 9 business structures and 6 size bands.
Short answer: Some businesses
Applies when the business has industry: Private health insurers.
What the obligation is
Private health insurers must meet capital + governance standards.
Private Health Insurance (Prudential Supervision) Act 2015. APRA prudential standards covering capital, risk management, governance + outsourcing for private health insurers.
The applicability test
Applies when the business has industry: Private health insurers.
How the regulator frames it: Registered private health insurers.
What triggers it: PHI registration.
Jurisdiction: Commonwealth law, so the test is the same in every state and territory.
Which industries are in or out
Outcome across the 35 industries Rules Mate maps (1 of 35: yes; 34 of 35: no).
| Industry | Answer |
|---|---|
| Private health insurers | Yes |
| No | 34 other industries |
Business structure and size
Structure does not change the answer in private health insurers: for every structure the answer is "yes".
Size does not change the answer in private health insurers: at every size band the answer is "yes".
Worked examples
Each line is one run of the Rules Mate applicability engine for a single business profile, with the reason the engine gives:
- Pty Ltd company in private health insurers with 6–19 employees, turnover $1M–$3M: applies. Industry: Private health insurers.
- Pty Ltd company in real estate agents with 6–19 employees, turnover $1M–$3M: does not apply. Requires industry: Private health insurers.
What you must do, and when
- When due
- Ongoing.
- Frequency
- Annual
- Evidence to keep
- Annual returns + capital filings + board attestations.
- Status
- Current
- Priority
- High
Penalty for not complying
No maximum penalty is recorded for this obligation in the Rules Mate corpus; check the regulator source below.
Audit or assurance level
Rules Mate has not yet classified the audit or assurance level for this obligation. Any audit, review or certification requirement is set by the regulator source listed below.
Obligations with the same applicability test
If this obligation applies to you, so does this one: the engine uses the same rule for each.
What usually applies alongside it
Across the 1,890 business profiles Rules Mate evaluates, these obligations apply to most of the businesses this one applies to, and are far more common among them than among businesses generally:
- Design and Distribution Obligations (DDO) — RG 274: applies to 100% of the same businesses (11.7× the overall rate)
- Comply with APRA CPS 220 (Risk Management): applies to 100% of the same businesses (11.7× the overall rate)
- Comply with APRA CPS 230 (Operational Risk Management): applies to 100% of the same businesses (11.7× the overall rate)
- Comply with APRA CPS 234 (Information Security): applies to 100% of the same businesses (11.7× the overall rate)
- Comply with Design and Distribution Obligations (DDO): applies to 100% of the same businesses (11.7× the overall rate)
Where it sits in the corpus
Rules Mate tracks 8 published obligations tagged "insurance", 1 of them rated critical. For a professional services Pty Ltd company with 6–19 employees operating in every state, 0 of those apply outright. This obligation is rated high priority, and is a annual obligation.
Regulator, legislation and tools
Regulated by Australian Prudential Regulation Authority.
APRA: Prudential regulator of banks (ADIs), insurers (general, life, private health), and superannuation funds. Sets and enforces CPS standards including CPS 234 (information security) and CPS 230 (operational risk).
Free tools that help with this obligation:
Questions
- Who must comply with PHI Prudential Standards (APRA)?
- Applies when the business has industry: Private health insurers.
- Does PHI Prudential Standards (APRA) apply to sole traders?
- Yes. Looking in private health insurers and every size band, the engine's answer for a sole trader is: yes.
- Does PHI Prudential Standards (APRA) apply to businesses with 1–5 employees?
- Yes (1–5 employees, turnover $100K–$1M).
- When is "PHI Prudential Standards (APRA)" due?
- Ongoing.
Related
Sources
Computed by the Rules Mate applicability engine from the published obligation corpus; facts last checked 3 October 2026. Rules Mate is not a law firm and this is general information, not legal advice. Confirm your position with the regulator source or a qualified adviser before acting.