HEALTH INSURANCE ACT, 1994

• (v) if paragraph (b) of subsection (4A) is applicable, the period from 1 January of the first year of the applicable 3 year period to the end of the last year of the applicable 3 year period,]

• (6)
• (a) Where the Authority determines under subsection (5)(b) that there is a positive cumulative net financial impact on a registered undertaking or former registered undertaking in respect of a period, it shall make a determination as to whether the undertaking has or has not, in respect of that period, made a profit which is in excess of the reasonable profit F81[…] in respect of that period.

• (b) Where the Authority determines under paragraph (a) that a registered undertaking or former registered undertaking has made a profit which is in excess of a reasonable profit in respect of a period, it shall make a further determination as to the monetary equivalent amount of the profit which is in excess of the corresponding monetary equivalent amount of such reasonable profit in respect of that period.

• (7) Where, in respect of a period, the Authority has determined under subsection (5)(b) that the cumulative net financial impact of the relevant financial provisions on a registered undertaking or former registered undertaking was positive, and determined under subsection (6)(a) that the undertaking has made a profit which is F76[in excess of the reasonable profit], it shall prepare a report (in this Part referred to as the "draft report") setting out—

• (a) the reasonable profit, F81[…]

• (b) the amount determined under subsection (5)(b) to be the positive cumulative net financial impact on the undertaking,

• (c) the monetary equivalent amount determined under subsection (6)(b) to be the profit of the undertaking which is in excess of the corresponding monetary equivalent amount of F76[the reasonable profit],

• (d) the cumulative amount of overcompensation, being the lower of the amounts referred to in paragraphs (b) and (c),

• (e) the amount of overcompensation to be paid to F75[the Fund] by the undertaking, being the cumulative amount of overcompensation referred to in paragraph (d) reduced by the total amount of overcompensation paid or due to be paid to F75[the Fund] pursuant to the operation of subsection (10) in respect of all the periods prior to the first-mentioned period, and

• (f) the bases on which it made the determinations, and calculated the amounts, referred to in paragraphs (a) to (e).

• (8)
• (a) The Authority shall, as soon as may be after the preparation of the draft report—

• (i) furnish a copy of the draft report to the registered undertaking or former registered undertaking the subject of the report,

• (ii) invite the undertaking to make representations to the Authority in relation to the draft report before the expiration of 21 days (or such longer period as the Authority may permit in its discretion) from the day on which the undertaking received the report, and

• (iii) take into account any such representations made to it within that period before preparing the final report as soon as is practicable after the expiration of that period of 21 days (or, if applicable, the expiration of the longer period permitted pursuant to subparagraph (ii)).

• (b) The determinations of the Authority contained in its final report shall be final and conclusive (including for the purposes of any proceedings concerning the recovery of an amount referred to in subsection (11)).

• (c) The Authority shall furnish the final report to the Minister as soon as may be after it has been prepared.

• (9) Where the Minister is furnished with a report under subsection (8), the Minister shall, as soon as may be, furnish a copy of the report to the registered undertaking or former registered undertaking the subject of the report together with a copy of this section.

• (10) Where a registered undertaking or former registered undertaking is furnished with a copy of a report under subsection (9), it shall, not later than 2 months from the date on which it is given the report, pay to F75[the Fund] the amount set out in the report pursuant to paragraph (e) of subsection (7).

• (11) The Minister on behalf of the Minister for Finance may recover, as a simple contract debt in any court of competent jurisdiction, from the registered undertaking or former registered undertaking by which it is payable, any amount due and owing to F75[the Fund] pursuant to the operation of subsection (10).

• (12) Notwithstanding that the Authority may not, in respect of a particular year, or in respect of a particular registered undertaking or former registered undertaking, be required under subsection (8) to furnish a report to the Minister, the Minister may make a request in writing to the Authority to be furnished, within the period specified in the request (being a period reasonable in the circumstances), with such information relating to any determination it has made under subsection (5) or (6) in respect of a particular registered undertaking or former registered undertaking (including information relating to the basis on which such determination was made) as the Minister specifies in the request.

• (13) The Authority shall comply with a request made under subsection (12) by the Minister.]

• F83[(13A) For the purposes of this Act, a registered undertaking has not made a profit in excess of the reasonable profit in respect of its health insurance business in the State in respect of the 3 year period referred to in subsection (4)(b), or in respect of a relevant 3 year period, if its return on equity exceeds 12 per cent per annum in respect of that business for part of that period but not for all of that period.]

• F84[(14) In this section—

F78["applicable 3 year period" means—

• (a) the 3 year period from 1 January 2017 to the end of 2019, and

• (b) the 3 year period from 1 January 2018 to the end of 2020,

and so on for each succeeding 3 year period;]

F82["reasonable profit"—

• (a) shall be construed in accordance with subsection (4) in respect of a 3 year period referred to in paragraph (b) of that subsection and in respect of a relevant 3 year period, and

• (b) shall be construed in accordance with subsection (4A) in respect of a 3 year period referred to in paragraph (a) of that subsection and in respect of an applicable 3 year period;]

F76["relevant health insurance business in the State", in relation to a registered undertaking or former registered undertaking, means all of the undertaking’s health insurance business in the State;]

F82["relevant 3 year period" means—

• (a) the period from 1 January 2012 to the end of 2014;

• (b) the period from 1 January 2013 to the end of 2015.]]

F83["return on equity", in relation to a registered undertaking or former registered undertaking, not being a company established under the Companies Acts, and its relevant health insurance business in the State, includes the equivalent, as calculated using approved accounting standards, for such an undertaking, of a return on equity for a registered undertaking that is such a company.]

7G. F85[Disclosure of contents of information returns.

7G. — (1) The contents of information returns shall, in so far as they can be related to individual registered undertakings or former registered undertakings, be disclosed only where necessary for the purposes of the functions of the Minister or the Authority under this Act.

• (2) Subject to subsection (1), the Authority may, where it considers it appropriate to do so, disclose aggregate data derived from information returns.

• (3) Nothing in this section shall preclude the disclosure of information by means of a report furnished to the Minister pursuant to section 7E(1)(b) or 7F(8)(c).]

7H. F86[Registered undertaking to provide certain premium information to policy holders or certain other persons.

7H. — Where a registered undertaking effects a health insurance contract on or after the commencement of section 9 of the Health Insurance (Miscellaneous Provisions) Act 2009 (including any renewal of such a contract entered into before that commencement), it shall, at the same time as effecting the contract, or as soon as is practicable thereafter, give—

• (a) the policy holder, or

• (b) the person to whom the registered undertaking issues the request for payment of the premium due under the health insurance contract, where that person is not the policy holder,

a statement in writing setting out—

• (i) the premium payable under the contract in respect of each insured person before any deduction referred to in the definition of "net premium" in section 2 is made from the premium, and

• (ii) the net premium under the contract in respect of each insured person] F87[after deducting from the net premium the deduction to which such insured person is entitled, for the year of assessment concerned, by virtue of section 470 of the Taxes Consolidation Act 1997.]

8. Obligation to provide health insurance.

F88[8. — (1) A registered undertaking, other than a restricted membership undertaking, shall not refuse to effect a health insurance contract with or for a person of whatever age or such a person and his or her dependants except in such cases (if any) or in such circumstances (if any) as may be prescribed.

• (2) A restricted membership undertaking shall not—

• (a) impose as a condition of qualification for membership of the undertaking a requirement as to age,

• (b) refuse to admit to membership of the undertaking a person who is qualified for such membership and requests to be so admitted, or

• (c) refuse to effect a health insurance contract with or for such a person as aforesaid or with or for such a person and his or her dependants,

except in such cases (if any) or in such circumstances (if any) as may be prescribed.

• F89[(3) For the purposes of this Act, the Minister may prescribe the maximum waiting periods for eligibility for services or payments, or both, under a health insurance contract which a registered undertaking may impose in respect of the person effecting the contract or his or her dependents including, but without prejudice to the generality of the foregoing, in respect of a person who—

• (a) is of or under a prescribed age,

• (b) is of or over a prescribed age,

• (c) is suffering from a medical condition when the contract is effected,

• (d) effects a health insurance contract in the State without previously having effected a health insurance contract in the State,

• (e) effects a health insurance contract with the undertaking having previously effected a health insurance contract with that undertaking whether in respect of the same or different services or payments, or both, or

• (f) effects a health insurance contract with the undertaking having previously effected a health insurance contract with another registered undertaking whether in respect of the same or different services or payments, or both.]

(4)(a) Subject to paragraph (b), where a health insurance contract effected by a person with a registered undertaking ceases to be in force for any reason, that or any other registered undertaking shall not refuse to effect another health insurance contract with the person, irrespective of his or her age, in respect of the same services except in such cases (if any) or in such circumstances (if any) as may be prescribed.

• (b) A restricted membership undertaking may refuse to effect a health insurance contract with a person referred to in paragraph (a) if the person is not entitled to membership of the undertaking.

• F89[(5) Where a health insurance contract ("the first-mentioned contract") effected with a registered undertaking (including such undertaking which is a restricted membership undertaking) ceases to be in force and a person who was a party to or named in that contract effects, within such period after that cesser as may be prescribed, another health insurance contract with a registered undertaking ("the second-mentioned contract"), then insofar as the second-mentioned contract is in respect of such services or payments, or both, as would have been provided or payable, as appropriate, under the first-mentioned contract—

• (a) the waiting period for eligibility for the service or the payment, or both, under the second-mentioned contract to—

• (i) the person, or

• (ii) any other person who is named in the contract and was also a party to or named in the first-mentioned contract,

shall not be any longer than it would have been if the second-mentioned contract had been effected at the time the first-mentioned contract had been effected, and

• (b) there shall be deemed to be expired so much of that waiting period as is equal to so much of the like period under the first-mentioned contract as had expired at the time of the cesser aforesaid.]

• (6) F90[…]]

9. Prohibition of termination of, or refusal to renew, health insurance contracts.

F91[ 9. — (1) A registered undertaking shall not terminate or (irrespective of whether or not the contract provides for its renewal) refuse to renew a health insurance contract without the consent of the other party to the contract except—

• (a) where there has been fraudulent misrepresentation to the undertaking in relation to the contract which has, or could have, resulted in financial loss to the undertaking,

• (b) where the undertaking ceases to carry on health insurance business in the State, or

• (c) subject to subsections (2) to (5), where the undertaking has ceased to offer, in the State, health insurance contracts of the type of that contract.

• (2) Where a registered undertaking refuses to renew a health insurance contract ("non-renewed contract") on the ground referred to in subsection (1)(c) and that contract provides for benefits in respect of hospital in-patient services, it shall, at the same time as such refusal, offer, to the other party to the non-renewed contract, a replacement health insurance contract ("replacement contract") where—

• (a) subject to subsection (3), the hospital in-patient services for which the benefits are payable under the replacement contract are the same as, or more than, such services for which benefits are payable under the non-renewed contract, and

• (b) subject to subsection (4), the benefits payable in respect of hospital in-patient services under the replacement contract are the same as, or more than, the level of such benefits payable under the non-renewed contract.

• (3) Subsection (2)(a) shall not apply in the case of a hospital in-patient service—

• (a) which is no longer available in the State at the time of the refusal referred to in subsection (2), or

• (b) in respect of which the registered undertaking has ceased to offer (whether before such refusal or with effect on or after the time of such refusal), in the State, any health insurance contract under which benefits are payable in respect of such service.

• (4)
• (a) Paragraph (b) applies if—

• (i) the replacement contract provides that the insured person who makes a claim under the contract for payment of benefits in respect of hospital in-patient services provided to the person is liable to pay an amount (‘excess amount’) towards the provision of such services, and

• (ii) the excess amount—

• (I) is not greater than €100 where the non-renewed contract did not provide for an equivalent to the excess amount, or

• (II) is not greater than €100 more than the equivalent to the excess amount provided in the non-renewed contract.

• (b) The provision in the replacement contract for the payment of the excess amount shall be disregarded for the purposes of subsection (2)(b).

• (5) Without prejudice to the generality of section 8(5), where the second-mentioned contract referred to in that section is the replacement contract, it shall be presumed for the purposes of this section that the services or payment provided for in the replacement contract are the same as those provided for in the first-mentioned contract referred to in section 8(5).]

10. Minimum level of health insurance cover.

10. — (1) F93[Subject to subsection (3), a health insurance contract effected by a registered undertaking]

• (a) shall relate, at least, to such health services and F92[relevant] health services as may be prescribed, and

• (b) in so far as it relates to services prescribed under paragraph (a), shall provide for the payment by the undertaking in respect of those services of amounts that are not less than such amounts as may be prescribed.

(2)The Minister may engage a person whom he or she considers competent and qualified to do so to advise him or her in relation to the performance of the functions of the Minister under this section.

• F94[(3) Subsection (1) shall not apply to a health insurance contract—

• (a) where, and without prejudice to the generality of paragraphs (a) to (d) of the definition of "health insurance contract" (inserted by section 2 of the Act of 2001) in section 2(1), such a contract, either of itself or as construed with any linked or related other health insurance contract, makes no provision for the making of in-patient indemnity payments, or

• (b) relating solely to the public hospital daily in-patient charges made under the Health (In-patient Charges) Regulations 1987 (S.I. No. 116 of 1987).]

11. Prohibition of inducements by registered undertakings.

11. — A registered undertaking or a person acting on behalf of such an undertaking shall not—

• (a) make or offer to make a payment to a person,

• (b) forego or offer to forego a payment or part of a payment from a person,

• (c) give or offer to give any goods to a person,

• (d) provide or offer to provide any service for a person, or

• (e) give or provide or offer to give or provide any other thing of value to or for a person,

as an inducement to the person—

• (i) to terminate or not to effect or renew a health insurance contract with that undertaking, or

• (ii) (I) to forego a payment to or on behalf of the person in respect of a hospital in-patient service or F95[a relevant] health service under a health insurance contract effected between the undertaking and the person, and

• (II) to avail of his or her entitlements under Chapter II of Part IV of the Health Act, 1970, as respects the service.

11A. F96[Risk Equalisation Scheme.

11A. — This section and sections 11B to 11G, the regulations under section 11E, the regulations under section 11F, and Schedules 3 and 4, shall comprise a scheme (to be known as the "Risk Equalisation Scheme") for the purposes of assisting in the achievement of the principal objective.]

11B. F97[Application of Risk Equalisation Scheme.

11B. —(1) Subject to subsection (2), the Risk Equalisation Scheme shall apply to—

• (a) each registered undertaking, and

• (b) each undertaking that has ceased to be a registered undertaking but was a registered undertaking at any time when the Scheme was in force.

• (2) The Risk Equalisation Scheme shall not apply to a restricted membership undertaking.

• (3) The Risk Equalisation Scheme shall not apply to so much of the activities of a registered undertaking as consist of effecting health insurance contracts where such a contract—

• (a) either of itself or as construed with any linked or related other health insurance contract, makes no provision for the making of in-patient indemnity payments, or

• (b) relates solely to the public hospital daily in-patient charges made under the Health (In-patient Charges) Regulations 1987 (S.I. No. 116 of 1987).]

11C. F98[Payment from Fund of risk equalisation credits.

11C. — (1) (a) Where a registered undertaking effects, before 31 March 2013, a relevant contract for any period commencing on or after 1 January 2013, it shall, in respect of each insured person who falls within a class of insured person specified in column 1 of Table 1 set out in Schedule 4, not collect from the policy holder such part of the premium payable (or, if that premium is payable by instalments, not so collect pro rata from the instalments) in respect of the provision of health insurance cover under that contract to that person—

• (i) as is equal to the amount (if any) specified in column 2 of that Table opposite that class of insured person, and

• (ii) on the basis that that part of the premium payable is payable from the Fund.

• (b) Where a registered undertaking effects, on or after F99[1 April 2026], a relevant contract for any period commencing on or after that date, it shall, in respect of each insured person who falls within a class of insured person specified in column 1 of Table 2 set out in Schedule 4, not collect from the policy holder such part of the premium payable (or, if that premium is payable by instalments, not so collect pro rata from the instalments) in respect of the provision of health insurance cover under that contract to that person—

• (i) as is equal to the amount (if any) specified in column 2 of that Table opposite that class of insured person, and

• (ii) on the basis that that part of the premium payable is payable from the Fund.

• (2) F100[Subject to subsection (2A), a registered undertaking or former registered undertaking may] in accordance with the regulations under section 11F, make a claim to the Authority to be paid an amount equal to its risk equalisation credits for the period to which the claim relates.

• F101[(2A) A claim (or a part thereof) for a payment shall not be made to the Authority by a registered undertaking or former registered undertaking under subsection (2) if entitlement to the risk equalisation credits to which the claim (or a part thereof) relates arose more than 6 years before 31 March in the period of 12 months prior to the date of the making of the claim.]

• (3) Where the Authority receives a claim referred to in subsection (2) from a registered undertaking or former registered undertaking, it shall, in accordance with the regulations under section 11F, pay out of the Fund to the undertaking that amount that the Authority is satisfied is so payable, in accordance with the Risk Equalisation Scheme, in respect of the risk equalisation credits to which the claim relates.

• (4) Information concerning the amounts of stamp duty paid by registered undertakings or former registered undertakings pursuant to section 125A of the Stamp Duties Consolidation Act 1999 shall, at the request of the Authority, be disclosed to the Authority by the Revenue Commissioners or a Revenue officer (within the meaning of section 851A of the Taxes Consolidation Act 1997) for the purposes of assisting the Authority in performing its functions under this Act.]

11D. F102[Risk Equalisation Fund.

11D. — (1) The Authority shall establish, administer and maintain a fund to be known as the Risk Equalisation Fund (in this Act referred to as "the Fund").

• (2) The Authority shall open and maintain—

• (a) subject to paragraph (b), an account (in this Act referred to as a "current account") for all moneys paid into the Fund, and

• (b) an account (in this Act referred to as an "investment account") for such moneys (if any) that are not immediately required for the purposes of the current account.

• (3) The National Treasury Management Agency may, at the request of the Authority and on the Authority’s behalf, invest moneys (if any) in the investment account of the Fund and any income, capital or other benefit received in respect of moneys invested under this subsection shall be paid into the investment account or invested under this subsection as directed by the Authority.

• (4) Subject to subsection (5), the following shall be paid into the Fund:

• (a) all stamp duty paid, in respect of health insurance contracts effected to provide health insurance cover for any period commencing on or after 1 January 2013, by virtue of section 125A of the Stamp Duties Consolidation Act 1999; and

• (b) any other moneys which may belong to or accrue to the Fund or be received by the Authority in respect of it (including any amount referred to in section 7F(10) or subsection (7)).

• (5)
• (a) In this section "special account" means the account (if any) established under paragraph (d).

• (b) The Minister may, for the purpose of maintaining a sufficient amount of moneys in the current account of the Fund, having regard to the sums payable from the current account, request the Minister for Finance to advance moneys to the special account from the Central Fund.

• (c) A request under paragraph (b) shall be approved by the Minister for Finance, following consultation with the Minister for Public Expenditure and Reform, before any moneys are advanced to the special account pursuant to a request under that paragraph.

• (d) For the purposes of moneys advanced to the current account of the Fund pursuant to a request under paragraph (b), an account shall be established which shall be—

• (i) in the name of the Minister, and

• (ii) an account with the Paymaster General.

• (e) The Minister shall, subject to such conditions as the Minister for Finance considers appropriate, manage and control the special account for the purpose of maintaining an amount of moneys in the current account of the Fund that is sufficient to meet the sums payable from that current account.

• (f) Whenever the moneys in the current account of the Fund are insufficient to meet the sums payable from that account—

• (i) there shall be paid into that account from the investment account of the Fund the moneys necessary to meet those sums payable, and

• (ii) if there is still a shortfall in the current account of the Fund to meet those sums payable after the moneys in the investment account have been paid into it, there shall be paid into the current account from the special account the moneys necessary to meet the shortfall.

• (6) The following shall be paid out of the Fund:

• (a) amounts payable to registered undertakings by virtue of section 11C(3);

• (b) amounts payable to the Central Fund to repay moneys paid into the current account of the Fund from the special account;

• (c) costs, charges and expenses incurred in maintaining, protecting, administering and applying the Fund; and

• (d) other sums properly payable out of the Fund.

• (7) Where it comes to the knowledge of the Authority that, for whatever reason, there has been a payment (including any part thereof) from the Fund to a registered undertaking or former registered undertaking which is not in accordance with this Act, the Authority may recover the amount concerned—

• (a) as a simple contract debt in any court of competent jurisdiction from the registered undertaking or former registered undertaking concerned, or

• (b) by deducting that amount from any payment from the Fund otherwise due to the registered undertaking or former registered undertaking concerned.

• (8) The Authority shall keep all proper and usual accounts of all moneys paid into the Fund and disbursements from the Fund, including—

• (a) an income and expenditure account,

• (b) a cash-flow statement, and

• (c) a balance sheet.

• (9) As soon as may be after the end of each financial year of the Authority, the Authority shall submit—

• (a) the accounts of the Fund to the Comptroller and Auditor General for audit, and

• (b) a copy of an abstract of the accounts as so audited together with a copy of the report of the Comptroller and Auditor General thereon to the Minister.

• (10) The Minister shall cause copies of the 2 documents referred to in subsection (9)(b) to be laid before each House of the Oireachtas as soon as may be after the documents are submitted to him or her by the Authority.

• (11) There shall be included among the debts which, under section 285 of the Companies Act 1963 are, in the distribution of the assets of a registered undertaking or former registered undertaking which is a company being wound up, to be paid in priority to all other debts, all amounts payable to the Fund by virtue of section 7F(10) or subsection (7), and the Companies Act 1963 shall be construed accordingly.]

11E. F103[Specification by Authority of certain health insurance contracts as not providing for advanced cover.

11E. — (1) The Authority shall, before 1 January 2013—

• (a) first, evaluate and analyse each type of relevant contract on offer in the State in order to ascertain, to the Authority’s satisfaction, whether that type of relevant contract does not provide for advanced cover, and

• (b) second, if the Authority is satisfied that that type of relevant contract does not provide for advanced cover—

• (i) by regulations specify that the Authority is satisfied that that type of relevant contract does not provide for advanced cover, and

• (ii) after making such regulations, enter particulars in The Register of Health Insurance Contracts to indicate that that type of relevant contract has been so specified as not providing for advanced cover.

• (2) Where a sample of a new type of relevant contract is submitted to the Authority under section 7AB(1), the Authority shall, before the expiration of 30 days after the sample was so submitted—

• (a) first, evaluate and analyse the new type of relevant contract in order to ascertain, to the Authority’s satisfaction, whether that type of relevant contract does not provide for advanced cover, and

• (b) second, if the Authority is satisfied that that type of relevant contract does not provide for advanced cover—

• (i) by regulations specify that the Authority is satisfied that that type of relevant contract does not provide for advanced cover, and

• (ii) after making such regulations, enter particulars in The Register of Health Insurance Contracts to indicate that that type of relevant contract has been so specified as not providing for advanced cover.

• (3) Where a changed existing contract which is a relevant contract is submitted to the Authority under section 7AB(2), the Authority shall, before the expiration of 30 days after the changed existing contract was so submitted—

• (a) first, evaluate and analyse that type of relevant contract in order to ascertain, to the Authority’s satisfaction, whether that type of relevant contract does not provide for advanced cover, and

• F104[(b) second—

• (i) if the Authority is satisfied that that type of relevant contract does not provide for advanced cover where regulations do not presently specify that that type of relevant contract does not provide for advanced cover—

• (I) by regulations specify that the Authority is satisfied that that type of relevant contract does not provide for advanced cover, and

• (II) after making such regulations, enter particulars in The Register of Health Insurance Contracts to indicate that that type of relevant contract has been so specified as not providing for advanced cover,

• (ii) if the Authority is not satisfied as referred to in paragraph (a) in respect of that type of relevant contract where regulations ("the relevant regulations") presently specify ("relevant specification") that the Authority is satisfied that that type of relevant contract does not provide for advanced cover—

• (I) by regulations amend the relevant regulations to revoke the relevant specification with effect from the date on which the change concerned in a material particular of the benefits payable under that type of relevant contract is to be first made, and

• (II) after making such regulations, amend, with effect from the date referred to in clause (I), the particulars entered in The Register of Health Insurance Contracts in respect of the relevant specification.]

• F105[(3A) The Authority may at any time review any evaluation and analysis referred to in subsection (1), (2) or (3) that it has carried out and, if it is satisfied, after such review, that anything that resulted from such evaluation and analysis was not, or is no longer, correct, then the Authority may carry out a further evaluation and analysis referred to in subsection (1), (2) or (3), as the case may be, and its powers to make regulations referred to in this section and to enter particulars in, or amend particulars entered in, The Register of Health Insurance Contracts shall, with all necessary modifications, apply to any such further evaluation and analysis.]

• (4) For the purposes of this Act—

• (a) a relevant contract which provides health insurance cover for—

• (i) not more than 66 per cent of the full cost for hospital charges in a private hospital, or

• (ii) not more than the prescribed minimum payments within the meaning of the Health Insurance Act 1994 (Minimum Benefit) Regulations 1996 (S.I. No. 83 of 1996),

whichever is the greater, is a relevant contract which provides for non-advanced cover, and

• (b) any other relevant contract is a relevant contract which provides for advanced cover,

and references in this Act to "non-advanced cover" and "advanced cover" shall be construed accordingly.]

11F. F106[Scheme regulations.

11F. — The Minister may make regulations relating to the making and determination of claims referred to in section 11C(2), including, without prejudice to the generality of the foregoing—

• (a) the minimum or maximum periods, or both, to which the claims, or a class of the claims, may relate,

• (b) the information returns to be made by registered undertakings or former registered undertakings to the Authority in respect of relevant contracts, or a class of relevant contracts, offered or entered into by them,

• (c) the provision of other information by a registered undertaking or former registered undertaking required by the Authority in respect of a particular claim or class of claims, and

• (d) the making of enquiries by the Authority and the keeping of records by registered undertakings or former registered undertakings, in respect of claims or a class of claims.]

11G. F107[Power to specify form of documents for purposes of Risk Equalisation Scheme.

11G. — (1) The Authority may specify the form of documents (including the form of a claim referred to in section 11C(2)) required for the purposes of the Risk Equalisation Scheme as the Authority thinks appropriate.

• (2) The Authority’s power under subsection (1) may be exercised in such a way as to—

• (a) include in the specified form of any document referred to in that subsection a statutory declaration—

• (i) to be made by the person completing the form, and

• (ii) as to whether the particulars contained in the form are true and correct to the best of that person’s knowledge and belief,

and

• (b) specify 2 or more forms of any document referred to in that subsection, whether as alternatives, or to provide for particular circumstances or particular cases, as the Authority thinks appropriate.

• (3) The form of a document specified under this section shall be—

• (a) completed in accordance with such directions and instructions as are specified in the document,

• (b) accompanied by such other documents as are specified in the document, and

• (c) if the completed document is required to be provided to—

• (i) the Authority,

• (ii) another person on behalf of the Authority, or

• (iii) any other person, so provided in the manner (if any) specified in the document.]

12. Risk equalisation schemes.

12. — F108[…]

12A. F109[Risk equalisation schemes - further provisions.

12A. — F110[…]]

12B. F111[Limited exemption from requirement to make returns and otherwise comply with risk equalisation scheme.

12B. — F112[…]]

13. Advertising and promotion of health insurance business.

F113[13. — (1) Subject to subsection (3), if the Minister considers, after having consulted with the Authority, that it is in the interests of policy holders or potential policy holders of a type of health insurance contract that certain information should accompany the contract, the Minister may make regulations—

• (a) specifying the type of contract and the information,

• (b) requiring registered undertakings which supply the contract to ensure that the information accompanies the contract in the manner and form specified in the regulations,

• (c) regulating or prohibiting the supply by registered undertakings of the contract if any regulation made under paragraph (b) is not complied with in so far as the regulation applies to the contract, and

• (d) without prejudice to the generality of paragraph (a), requiring registered undertakings to include a statement in their offers to renew health insurance contracts, or a class of such offers, as to the rights (including open enrolment rights), or a class of such rights, of the policy holders concerned in respect of the contracts.

• (2) Subject to subsection (3), if the Minister considers, after having consulted with the Authority, that it is in the interests of policy holders or potential policy holders of a type of health insurance contract that certain information should accompany advertisements which relate (whether in whole or in part) to the contract, the Minister may make regulations—

• (a) specifying the type of contract and the information, and

• (b) requiring registered undertakings, the advertising of which relates (whether in whole or in part) to the contract, to ensure that the information accompanies the advertisements in the manner and form specified in the regulations.

• (3) The Minister shall not make a regulation under this section unless the Minister is of the opinion that—

• (a) the typical policy holder or potential policy holder of the type of health insurance contract concerned would need the information concerned in order to make an informed contract decision, and

• (b) if such information was withheld, omitted or concealed, it would be likely to cause the typical policy holder or potential policy holder of such a contract to make a contract decision that the policy holder or potential policy holder, as the case may be, would not otherwise make.

• (4) Nothing in this section shall be construed to preclude a regulation being made under this section which applies to all types of health insurance contract.

• (5) Regulations made under subsection (2) may be expressed to apply to a type of advertisement specified in the regulations.

• (6) In this section—

"accompanied"—

• (a) in relation to information to accompany a health insurance contract—

• (i) includes accompanied by way of being incorporated into or stamped on the contract, and

• (ii) in the case of an offer to renew the contract, includes accompanied by way of being incorporated into or stamped on the offer to renew the contract made prior to the issue of the contract where such offer is accepted,

and

• (b) in relation to information to accompany an advertisement which relates (whether in whole or in part) to a health insurance contract, includes accompanied by way of—

• (i) being incorporated into the advertisement, or

• (ii) there being a reference in the advertisement to the means by which the information may be readily obtained;

"advertisement" includes any form of advertising or marketing;

"contract decision", in relation to a type of health insurance contract, means—

• (a) a decision on whether or not to enter into a contract of health insurance of that type, or

• (b) if a contract of health insurance of that type has already been entered into, a decision on whether or not to—

• (i) cancel the contract,

• (ii) renew the contract, or

• (iii) exercise a contractual right under the contract;

"supply" in relation to a health insurance contract, includes furnish, offer or agree to supply and expose or display for supply.]

PART III Registration of Health Insurance Undertakings

14. The Register.

14. — (1) The Minister shall cause a register of undertakings to be established which shall be known as The Register of Health Benefits Undertakings and is referred to in this Act as “ the Register ”.

• (2) The Register shall be in such form and shall contain such particulars in relation to undertakings as may be prescribed.

• (3) Upon the establishment of the Register, the following undertakings shall be entered in it:

• (a) an undertaking duly authorised pursuant to the Council Directives to carry on health insurance business in the State, and

• (b) the Voluntary Health Insurance Board.

• (4) Upon application to the Minister or the Authority, as the case may be, in that behalf and upon furnishing to the Minister or the Authority, as the case may be, such information (if any) as the Minister or the Authority, as the case may be, may require, any other undertaking which was lawfully carrying on health insurance business in the State on the 30th day of June, 1994 and complies with the provisions of this Act shall be entered in the Register.

• (5) F114[Subject to subsection (5A), the Minister] may by regulations provide for the registration of undertakings (other than those specified in subsections (3) and (4)) of such classes as may be specified upon and subject to such terms and conditions as may be specified including (but without prejudice to the generality of the foregoing)—

• (a) in the case of a restricted membership undertaking, terms and conditions requiring it to satisfy specified financial criteria and to effect not less than a specified number of health insurance contracts within a specified period, and

• (b) in the case of any other undertaking, a term or condition requiring the undertaking to be the holder of an authorisation (within the meaning of the Insurance Act, 1989) for the time being in force to carry on non-life insurance business (within the meaning aforesaid).

• F115[(5A) The Minister shall not, on or after the commencement of section 12 of the Health Insurance (Miscellaneous Provisions) Act 2009, provide by regulations for the registration of any restricted membership undertaking which was not registered before that commencement.]

• (6) Upon the registration of an undertaking, the Minister or the Authority, as the case may be, shall cause a certificate containing such particulars of the registration as the Minister or the Authority, as the case may be, may determine and signed by an officer of the Minister or the Authority, as the case may be, authorised in that behalf by the Minister or the Authority, as the case may be, to be prepared and furnished to the undertaking and, if the undertaking is removed from the Register, it shall return the certificate to the Minister or the Authority, as the case may be.

• (7) The Register may be established and maintained in a form that is not legible if it is capable of being converted into a legible form.

• (8) A certificate issued by or on behalf of the Minister or the Authority, as the case may be, and stating that the undertaking specified in the certificate is or, as the case may be, is not registered shall, without proof of the signature of the person purporting to sign the certificate or that that person was the proper person so to sign, be evidence in any legal proceedings of the matters stated in the certificate, until the contrary is shown.

• (9) On the establishment day, subsections (4), (6) and (8) shall cease to have effect in so far as they relate to the Minister.

15. Removal from Register.

15. — (1) Where the authorisation of a registered undertaking under the Council Directives is withdrawn, pursuant to the Council Directives, the undertaking shall be removed from the Register.

• (2)
• (a) Where a registered undertaking—

• (i) is convicted on indictment in the State for an offence or is convicted outside the State for an offence consisting of acts or omissions which would constitute an offence triable on indictment in the State if done or made in the State, or

• (ii) contravenes a provision of this Act or of a regulation thereunder stated to be penal,

the undertaking shall be removed from the Register if the Minister or the Authority, as the case may be, so directs and the High Court so directs under subsection (3) or (4).

• (b) Where the Minister or the Authority, as the case may be, proposes to give a direction under this subsection, the Minister or the Authority, as the case may be, shall send by registered post to the undertaking concerned, at the address of the undertaking specified in the Register, a notice stating the proposal and the reasons therefor and, before deciding whether to give the direction, shall take into account any representations made in relation to the proposal by the undertaking within the period of 21 days from the giving of the notice.

• (3)
• (a) An undertaking to which a direction of the Minister or the Authority, as the case may be, under subsection (2) relates may, within the period of 21 days from the date of the direction, apply to the High Court for cancellation of the direction and on such an application—

• (i) that Court may—

• (I) cancel the direction, or

• (II) confirm the direction and direct that the undertaking be removed from the Register, or

• (III) give such other directions (if any) to the Minister or the Authority, as the case may be, as the Court thinks proper,

or

• (ii) if the Minister or the Authority, as the case may be, satisfies that Court that the undertaking has, without reasonable cause, delayed unduly in proceeding with the application, that Court shall, unless it is satisfied that there are good reasons for not doing so, confirm the direction and direct that the undertaking be removed from the Register.

• (b) The High Court may direct how, as between the parties to an application under paragraph (a), the costs of the application are to be borne.

• (4) Where an undertaking to whom a direction of the Minister or the Authority, as the case may be, under subsection (2) relates does not, within the period of 21 days beginning on the date of the direction, apply to the High Court for cancellation of the direction, that Court shall, on application to it ex parte in that behalf by the Minister or the Authority, as the case may be, unless it is satisfied that there are good reasons for not doing so, confirm the direction and direct that the undertaking be removed from the Register.

• (5) The decision of the High Court on an application under this section shall be final, save that, by leave of that Court or of the Supreme Court, an appeal, by the Minister or the Authority, as the case may be, or the undertaking concerned, from the decision shall lie to the Supreme Court on a question of law.

• (6) On the giving of a direction by the Minister or the Authority under subsection (2) in relation to an undertaking or upon the removal of an undertaking from the Register, the Minister or the Authority, as the case may be, shall forthwith send by registered post to the undertaking at the address of the undertaking specified in the Register a notice in writing stating, as may be appropriate—

• (a) that the direction has been given, the reasons for it and its date, or

• (b) that the undertaking has been removed from the Register.

• (7)
• (a) Upon application to the Minister or the Authority, as the case may be, in that behalf and upon furnishing to the Minister or the Authority, as the case may be, such information (if any) as the Minister or the Authority, as the case may be, may require, an undertaking that has been removed from the Register shall, if the Minister or the Authority, as the case may be, so thinks fit and so directs in writing, be entered in the Register and such entry shall be subject to such terms and conditions (if any) as the Minister or the Authority, as the case may be, determines and specifies in the direction.

• (b) A copy of a direction under this subsection shall be furnished to the undertaking concerned and it shall comply with any terms or conditions contained in it.

• (8) On the establishment day, subsections (2) to (7) shall cease to have effect in so far as they relate to the Minister.

16. Prohibition on carrying on of health insurance business by persons other than registered undertakings.

16. — A person other than a registered undertaking shall not carry on health insurance business.

17. Levy on registered undertakings.

17. — F116[(1) In this section,

"assessable amount", in relation to a quarter, means the gross amount received by a registered undertaking by way of premiums in that quarter in respect of the health insurance business of the undertaking in the State on or after the establishment day, but excluding any amount—

• (a) so received in the course of or by way of reinsurance, or

• (b) so paid in respect of a stamp duty under section 125A of the Stamp Duties Consolidation Act 1999.]

• (2) A registered undertaking shall, within 30 days from the end of the quarter following the establishment day and within 30 days from the end of each quarter thereafter, deliver to the Authority a statement in writing showing the assessable amount for that undertaking in respect of that quarter.

• (3) There shall be charged on every statement delivered in pursuance of subsection (2) a levy of an amount equal to such percentage of the assessable amount shown therein as may be prescribed having regard to the costs and expenses referred to in subsection (4).

• (4) The levy charged under subsection (3) on a statement delivered in pursuance of subsection (2) shall be paid by the undertaking concerned to the Authority upon delivery of the statement and the amount so paid shall be used by the Authority to defray the costs and expenses F117[…] incurred by it in the performance of its functions.

• (5) There shall be furnished to the Authority by a registered undertaking such particulars as the Authority may deem necessary in relation to a statement under this section delivered by it to the Authority.

• (6) In the case of failure by a registered undertaking to deliver a statement required under subsection (2) within the time specified in that subsection or of failure by a registered undertaking to pay any levy chargeable on such a statement on the delivery thereof, the undertaking shall be liable to pay, in addition to the levy, interest thereon at the rate of 15 per cent. per annum from the expiration of the quarter to which the statement relates until the day on which the levy is paid.

• (7) An amount payable to the Authority under subsection (4) or (6) may be recovered by the Authority from the registered undertaking concerned as a simple contract debt in any court of competent jurisdiction.

18. Records.

18. — (1) A registered undertaking—

• (a) shall maintain such records relating to its health insurance business as may be prescribed, and

• (b) shall furnish to the Minister or the Authority, as the case may be, such information regarding the health insurance business aforesaid carried on by it as the Minister or the Authority may require for the purposes of his or her or, as the case may be, its functions under this Act.

• (2) Upon the establishment day, subsection (1) shall cease to have effect in so far as it relates to the Minister.

F118[PART IIIA Enforcement Notices]

18A. F119[Interpretation of Part IIIA.

18A. — In this Part—

"enforcement notice" means a notice under section 18B(1);

"relevant provision" means—

• (a) a provision of this Act, or

• (b) a provision of a regulation under this Act.]

18B. F120[Issue of enforcement notices.

18B. — (1) Without prejudice to the generality of sections 4 and 15, where the Authority is of the opinion that a person—

• (a) is contravening a relevant provision, or

• (b) has contravened a relevant provision in circumstances that make it likely that the contravention will continue or be repeated,

then the Authority may serve on the person a notice in writing, accompanied by a copy of this Part—

• (i) stating that it is of that opinion,

• (ii) specifying the relevant provision as to which it is of that opinion and the reasons why it is of that opinion,

• (iii) directing the person to take such steps as are specified in the notice to remedy the contravention or, as the case may be, the matters occasioning it, and

• (iv) specifying a period (ending not earlier than the period specified in section 18C(1) within which an application under that section against any direction specified in the notice may be made) within which those steps must be taken, being a period reasonable in the circumstances.

• (2) The steps specified in an enforcement notice to remedy any contravention or matter to which the notice relates may be framed so as to afford the person on whom it is served a choice between different ways of remedying the contravention or matter, as the case may be.

• (3) Where a person on whom an enforcement notice has been served makes an application under section 18C(1) against any direction specified in the notice, the steps specified in the notice need not be taken by the person pending the determination, withdrawal or abandonment of the application.

• (4) The Authority may cancel an enforcement notice by notice in writing served on the person concerned.

• (5) Where a person fails to take the steps specified in an enforcement notice served on the person, the Authority may, on notice to that person, apply in a summary manner to the High Court for an order requiring the person to take those steps (or to take such varied or other steps for the like purpose as may be specified in the order), and the Court—

• (a) may—

• (i) make the order sought,

• (ii) make the order sought subject to such variations to those steps as may be specified in the order, or

• (iii) make the order sought subject to such other steps for the like purpose as may be specified in the order, or

• (b) may dismiss the application, and, whether paragraph (a) or (b) is applicable, may make such order as to costs as it thinks fit in respect of the application. Application for cancellation of direction specified in enforcement notice.]

18C. F121[Application for cancellation of direction specified in enforcement notice.

18C. — (1) A person on whom an enforcement notice has been served may, on notice to the Authority, not later than 45 days after being so served, apply to the High Court for the cancellation of any direction specified in the notice and, on such an application, the Court may—

• (a) cancel the direction,

• (b) confirm the direction, or

• (c) vary the direction,

and, whether paragraph (a), (b) or (c) is applicable, make such order as to costs as it thinks fit in respect of the application.

• (2) The decision of the High Court under this section on a direction specified in an enforcement notice shall be final save that, by leave of that Court or of the Supreme Court, an appeal by the Authority or the person concerned, as the case may be, from the decision shall lie to the Supreme Court on a question of law.]

18D. F122[Rules of Court.

18D. — Rules of Court may make provision for the expedition of the hearing of proceedings under this Part.]

F123[PART IIIB]

18E. F124[Authorised officers of Authority.

18E. — F125[(1) Where, in the opinion of the Authority, it is necessary to do so for the purposes referred to in section 18F(1)(a), the Authority may appoint, in writing—

• (a) any of its officers or employees, or

• (b) consultants or advisers engaged under section 23 who, in the opinion of the Authority, have qualifications and experience suitable to satisfactorily exercise the powers conferred upon authorised officers by or under this Act,

to be authorised officers to exercise the powers conferred upon authorised officers by or under this Act.]

• (2) Every authorised officer appointed under this section shall be furnished with a warrant of appointment and shall, when exercising any power conferred on him or her by or under this Act, if requested by a person affected, produce the warrant of appointment or copy of it to that person F126[together with a form of personal identification].

• F125[(3) A person’s appointment under subsection (1) as an authorised officer shall cease upon—

• (a) the revocation by the Authority of the appointment,

• (b) if the appointment was for a fixed period, the expiration of that period, or

• (c) if the person’s appointment was in his or her capacity as an officer or employee of the Authority, or as a consultant or adviser engaged under section 23, his or her ceasing, for whatever reason, to be such officer or employee, or such consultant or adviser, as the case may be,

whichever first occurs.]]

• F126[(4) Whenever requested to do so by the Authority, an authorised officer shall, as soon as is practicable after being so requested, give to the Authority a report on the exercise by the officer of all or any of the powers conferred upon authorised officers by or under this Act.

• (5) A person who is an authorised officer immediately before the commencement of section 4 of the Health Insurance (Amendment) Act 2022 shall, on that commencement, be deemed to be appointed under subsection (1) as an authorised officer on the same terms and conditions that applied to him or her immediately before that commencement (and, in the case of an appointment for a fixed period made before that commencement, for the unexpired portion of that period left to run after that commencement), and the other provisions of this section shall, with all necessary modifications, be construed accordingly.]

18F. F128[Powers of authorised officers.

18F. — F129[(1) (a) The powers conferred by this section may be exercised in respect of any person to whom this section applies for the purposes of—

• (i) securing the enforcement of the provisions of this Act (including any regulations made under this Act), or

• (ii) enabling or assisting the Minister or the Authority to perform any of their respective functions under this Act.

• (b) Subject to subsection (6), the following are persons to whom this section applies (whether they are within or outside the State):

• (i) a registered undertaking;

• (ii) a former registered undertaking;

• (iii) a person who has applied for registration in the Register;

• (iv) a person whom the Authority or an authorised officer reasonably believes is or has been acting as, or claiming or holding itself out to be, a registered undertaking;

• (v) a person who is or has been, or whom the Authority or an authorised officer reasonably believes is or has been, without being registered in the Register, effecting, or offering to effect, health insurance contracts in respect of which the person is required to be a registered undertaking;

• (vi) a related undertaking of any of the persons referred to in any of subparagraphs (i) to (v);

• (vii) a person whom the Authority or an authorised officer reasonably believes may possess or have control of information about a health insurance contract;

• (viii) any other person whom the Authority or an authorised officer reasonably believes may possess information about a person referred to in any of subparagraphs (i) to (vii);

• (ix) a person who is, in relation to a person referred to in any of subparagraphs (i) to (viii), a person specified in paragraph (c);

• (x) a person who is or has been an officer or employee or agent of a person referred to in any of subparagraphs (i) to (ix) or is, in relation to a person who is or has been such an officer, employee or agent, a person specified in paragraph (c).

• (c) The persons referred to in subsection (1)(b)(ix) and (x) are—

• (i) an administrator within the meaning of section 1 (1) of the Insurance (No. 2) Act 1983 ,

• (ii) an examiner, liquidator, receiver or official assignee, and

• (iii) a person with functions corresponding to those of any of the persons referred to in subparagraph (i) or (ii) under the law of a state other than the State.]

• (2) An authorised officer may do all or any of the following:

• (a) subject to subsection (3), at all reasonable times enter any premises, at which there are reasonable grounds for believing that any books, records or other documents in relation to the issue of any health insurance contract, or in relation to the acceptance of any premium in respect of a health insurance contract, are kept, and search and inspect the premises and such books, records or other documents on the premises;

• (b) secure for later inspection any premises or any part of a premises in which books, records or other documents are kept or there are reasonable grounds for believing that such books, records or other documents are kept;

• (c) require any person to whom this section applies F130[…] to produce to the authorised officer such books, records or other documents and in the case of information in a non-legible form to reproduce it in a legible form or to give to the officer such information or explanation as the officer may reasonably require in relation to any entries in such books, records or other documents;

• (d) inspect and take copies of or extracts from, or remove for a reasonable period for further examination, any books, records, F131[data (including data that constitutes personal data)] or other documents in whatever form kept (including, in the case of information in a non-legible form, a copy of or extract from such information in a permanent legible form) which the officer finds or which is produced to the officer in the course of inspection;

• (e) require any person to whom this section applies F130[…] to give to the authorised officer such information as the officer may reasonably require in relation to any entries in such books, records or other documents;

• (f) require any person to whom this section applies to give to the authorised officer any information which the authorised officer may require in regard to the business or activity concerned or in regard to the persons carrying on such business or activity or employed in connection therewith;

• (g) require any person by whom or on whose behalf data equipment is or has been used or any person having charge of, or otherwise concerned with the operation of, the data equipment or any associated apparatus or material, to afford the authorised officer reasonable assistance in relation thereto;

• (h) summon, at any reasonable time, any other person employed in connection with the business or activity concerned to give to the authorised officer any information which the officer may reasonably require in regard to such business or activity and to produce to the authorised officer any books, records or other documents which are in that person’s power or control;

• (i) require any person employed in the premises concerned to prepare a report on aspects of the business specified by the authorised officer or activities of a person to whom this section applies or to explain entries in any books, records, documents or other materials furnished.

• (3) An authorised officer shall not, other than with the consent of the occupier, enter a private dwelling unless he or she has obtained a warrant issued by a judge of the District Court under subsection (8) authorising such entry.

• (4) A person who has in his or her power, possession or procurement any books, records or other documents referred to in subsection (2) shall—

• (a) produce them at the request of an authorised officer and permit the authorised officer to inspect and take copies of, or extracts from, them,

• (b) at the request of an authorised officer, give any information which may be reasonably required with regard to them, and

• (c) give such other assistance and information to an authorised officer as is reasonable in the circumstances.

• (5) Where any person from whom production of a book, record or other document is required claims a lien thereon the production of it shall be without prejudice to the lien.

• (6) The duty to produce or provide any information, document, material or explanation extends to F129[any person (not being a person to whom this section applies)] who appears to the Minister, the Authority or the authorised officer to have the information, document, material or explanation in his or her possession or under his or her control.

• (7) An authorised officer, where he or she considers it necessary, may be accompanied by a member of the Garda Síochána when performing any powers conferred on an authorised officer by this Act.

• (8) If a judge of the District Court is satisfied on the sworn information of an authorised officer that there are reasonable grounds for suspecting that there is information required by an authorised officer under this section held on any premises or any part of any premises, the judge may issue a warrant authorising an authorised officer, accompanied by other authorised officers or by a member of the Garda Síochána, at any time or times within one month from the date of issue of the warrant, on production of the warrant if so requested, to enter the premises, if need be by reasonable force, and exercise all or any of the powers conferred on an authorised officer under this section.

• (9) A person shall not—

• (a) obstruct or impede an authorised officer in the exercise of a power under this section,

• (b) give to an authorised officer information which the person knows is false or misleading, or

• (c) without reasonable excuse, fail to comply with a request or requirement made by an authorised officer under this section.

• (10)
• (a) If any officer, employee, shareholder or agent of a person to whom this section applies refuses to produce to an authorised officer when requested to do so any book or document which it is his or her duty under this section to produce, or refuses to cooperate with an authorised officer when required to do so, or refuses to answer any question put to him or her by an authorised officer with respect to the affairs of the person to whom this section applies, the authorised officer may certify the refusal under his or her hand to the High Court.

• (b) Where a refusal is certified to the High Court, the High Court may enquire into the case and, after hearing any witnesses who may be produced against or on behalf of the officer, employee, shareholder or agent of the person to whom this section applies and any statement which may be offered in defence, make any order or direction as it thinks fit.

• (c) An order or direction made under paragraph (b) may include a direction to the person concerned to attend or re-attend before the authorised officer or produce particular books or documents or answer a particular question put to him or her by the authorised officer, or a direction that the person concerned need not produce a particular book or document or answer a particular question put to him or her by the authorised officer.

• (11) A person shall not falsely represent himself or herself as an authorised officer.

• F132[(11A) An authorised officer may require a person to provide him or her with the person’s name and address where—

• (a) the authorised officer has reasonable grounds for believing that the person—

• (i) is committing or has committed an offence under this Act, or

• (ii) has deliberately concealed or destroyed evidence, or is deliberately concealing or destroying evidence, or is likely to deliberately conceal or destroy evidence, of such an offence,

or

• (b) the authorised officer has reasonable grounds for requiring such information for the purpose of applying for a warrant under subsection (8).]

• (12) In this section—

"agent", in relation to a person to whom this section applies, includes past as well as present agents, and includes its bankers, accountants, solicitors, auditors and its financial and other advisers, whether or not those persons are officers or persons to whom this section applies;

F133["Data Protection Regulation" means Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 201618 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation);]

F129["person to whom this section applies" shall be construed in accordance with subsection (1)(b) and (c);]]

F133["personal data" means personal data within the meaning of—

• (a) the Data Protection Regulation, or

• (b) Part 5 of the Data Protection Act F129[2018;]]

F132["related undertaking", in relation to a person (in this definition referred to as the "first-mentioned person"), means—

• (a) if the first-mentioned person is a company, another company that is related within the meaning of section 2 (10) of the Companies Act 2014,

• (b) a partnership of which the first-mentioned person is a member,

• (c) if the business of the first-mentioned person and another person have been so carried on that the separate business of each of them, or a substantial part thereof, is not readily identifiable, that other person,

• (d) if the decision as to how and by whom the business of the first‑mentioned person and another person shall be managed can be made either by the same person or by the same group of persons acting in concert, that other person,

• (e) a person who performs a specific and limited purpose by or in connection with the business of the first-mentioned person, or

• (f) if provision is required to be made for the first-mentioned person and another person in any consolidated accounts compiled in accordance with the Seventh Council Directive 83/349/EEC of 13 June 1983¹, that other person.]

18G. F134[Privileged legal material.