NZQA Expiring unit standard
25646 version 2
Page 1 of 4
Title
Demonstrate understanding of the health insurance market and
health insurance
Level
5
Credits
5
Purpose
People credited with this unit standard are able to demonstrate
understanding of:
–
the health insurance market;
–
types of health insurance relevant to clients of financial
advisers; and
–
implementation and claims processes for health
insurance.
Classification
Financial Services > Financial Advice
Available grade
Achieved
Entry information
Critical health and
safety prerequisites
Unit 25644, Demonstrate understanding of insurance
structures, principles, products; and risk principles used by
financial advisers, or demonstrate equivalent knowledge and
skills.
Explanatory notes
1
This unit standard may be assessed on job in the workplace using naturally occurring
evidence or in off job simulated work situations designed to draw upon similar
performance to that required in work in a financial services context, or a combination
of these.
2
References
AS/NZS 4360:2004 Risk Management;
Administration Act 1969;
Commerce Act 1986;
Companies Act 1993;
Consumer Guarantees Act 1993;
Credit Contracts and Consumer Finance Act 2003;
Electronic Transactions Act 2002;
Fair Trading Act 1986;
Family Protection Act 1955;
Financial Advisers Act 2008;
Financial Reporting Act 1993;
Financial Service Providers (Registration and Dispute Resolution) Act 2008;
Financial Transactions Reporting Act 1996;
The Skills Organisation
SSB Code 100401
 New Zealand Qualifications Authority 2016
NZQA Expiring unit standard
25646 version 2
Page 2 of 4
Health and Safety in Employment Act 1992;
Human Rights Act 1993;
Income Tax Act 2007;
KiwiSaver Act 2006;
Law Reform (Testamentary Promises) Act 1949;
New Zealand Bill of Rights Act 1990;
NZ IFRS (New Zealand Equivalents to International Financial Reporting Standards)
available from http://www.nzica.com;
Privacy Act 1993;
Property (Relationships) Act 1976;
Reserve Bank of New Zealand Act 1989;
Securities Act 1978;
Securities Markets Act 1988;
Superannuation Schemes Act 1989;
Trustee Act 1956;
industry codes of practice;
and all subsequent amendments and replacements.
3
All activities must comply with any policies, procedures, and requirements of the
organisations involved; the standards of relevant professional bodies including codes
of ethics; and any relevant legislative and/or regulatory requirements.
4
Definitions
Financial strategy – broad plan that accords with client’s stated goals, needs,
priorities, financial situation and risk profile, in a particular situation.
Financial situation – incorporates variables such as a client’s balance of assets,
liabilities, incomes, risks, needs and expectations.
Personal situation – incorporates variables such as a client’s personal relationships
and obligations, lifecycle stage, overall objectives, level of financial literacy.
Outcomes and evidence requirements
Outcome 1
Demonstrate understanding of the health insurance market.
Evidence requirements
1.1
The financial significance of health insurance is explained in relation to
insurable aspects of human health needs and the New Zealand health system.
1.2
The purpose, structures and roles of health insurance providers are explained in
relation to the roles and expectations of related parties.
Range
The Skills Organisation
SSB Code 100401
parties include but are not limited to – insured, insurer, beneficiary,
Ministry of Health, District Health Boards (DHBs), Primary
Healthcare Organisations (PHOs), Accident Compensation
Corporation (ACC), private health insurers, Health Funds
Association of New Zealand, shareholders, members, sales
consultants, other professional advisers.
 New Zealand Qualifications Authority 2016
NZQA Expiring unit standard
1.3
25646 version 2
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Factors affecting the health insurance sector market are explained in terms of
effect on products and services.
Range
factors include but are not limited to – medical technology change,
ageing population, obesity trends, adverse selection, antiselection.
Outcome 2
Demonstrate understanding of types of health insurance relevant to clients of financial
advisers.
Evidence requirements
2.1
Types of health insurance products are explained in terms of structures, events
covered, features and benefits, and terms and conditions.
Range
types include but are not limited to – comprehensive, modular,
hospital only, travel insurance for visitors in NZ, group health
insurance, cover type trends.
2.2
Types of health insurance products are evaluated in terms of suitability to
clients’ personal situations, financial situations and health situations.
2.3
Client tax planning considerations of health insurance premiums and payouts
are explained in the context of current tax regimes.
Range
2.4
tax considerations include but are not limited to – income tax,
Fringe Benefit Tax, Goods and Services Tax (GST).
Client considerations of policy ownership are explained in the context of current
client estate plans, personal situation and financial situation.
Outcome 3
Demonstrate understanding of implementation and claims processes for health insurance.
Evidence requirements
3.1
The health insurance application process is explained in accordance with
commonly accepted practices of product providers.
3.2
Relevant elements of the underwriting, implementation and claims processes
are identified and explained in terms of client responsibilities and insurer
requirements.
Range
The Skills Organisation
SSB Code 100401
relevant elements include but are not limited to – personal and
family medical history, other health related factors, access to
medical reports, specific duty of disclosure issues, recording
ownership, commencement dates, loadings, exclusions, preapproval of claims, payment of claims, declination of claims.
 New Zealand Qualifications Authority 2016
NZQA Expiring unit standard
25646 version 2
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This unit standard is expiring. Assessment against the standard must take place by
the last date for assessment set out below.
Status information and last date for assessment for superseded versions
Process
Version Date
Last Date for Assessment
Registration
1
20 February 2009
31 December 2017
Review
2
19 February 2015
31 December 2017
Consent and Moderation Requirements (CMR) reference
0003
This CMR can be accessed at http://www.nzqa.govt.nz/framework/search/index.do.
Please note
Providers must be granted consent to assess against standards (accredited) by NZQA,
before they can report credits from assessment against unit standards or deliver courses
of study leading to that assessment.
Industry Training Organisations must be granted consent to assess against standards by
NZQA before they can register credits from assessment against unit standards.
Providers and Industry Training Organisations, which have been granted consent and
which are assessing against unit standards must engage with the moderation system that
applies to those standards.
Requirements for consent to assess and an outline of the moderation system that applies
to this standard are outlined in the Consent and Moderation Requirements (CMR). The
CMR also includes useful information about special requirements for organisations wishing
to develop education and training programmes, such as minimum qualifications for tutors
and assessors, and special resource requirements.
The Skills Organisation
SSB Code 100401
 New Zealand Qualifications Authority 2016