ACA Health Benefits Fund (ACA)
ACA Health is a restricted member Health Fund with the sole purpose of caring for the past and present Seventh-day Adventist Church employees, Local Church Officers and their families, with a range of health insurance products second-to-none.
Agreement Hospitals
This fund has agreements with some private hospitals or day surgeries to provide services at low or no out-of-pocket costs. You can see Agreement Hospitals for this insurer
Business Structure
This insurer is a mutual organisation that operates on a not-for-profit basis.
ACA Health Benefits Fund operates in all states and territories.
Membership restrictions
Membership with ACA Health is open to current and past employees of the Seventh-day Adventist Church and its associated companies in Australia – including Sanitarium Health Food Co, Sydney Adventist Hospital, Adventist Retirement Villages and Adventist Schools. Appointed Local Church Officers. Spouses or partners, children, siblings, parents and grandchildren of employees and past employees are also entitled to join. We consider children dependent until the age of 21 or if they are under 25 and unmarried full-time students earning less than $20,000pa. Once you’ve been employed by an Adventist Church company in Australia you, and your family members, are eligible to join for life. This means that you can still join ACA Health or stay with us after leaving Adventist Church employment. You are also always eligible to re-join if you ever choose to leave the Fund. If you are unsure of your eligibility to join ACA Health, please contact us for further information.
Performance
The Private Health Insurance Ombudsman prepares an annual report on the service delivery and performance of Australian health insurers. The following is a selection of statistics about this health insurer - the full report and an explanation of these figures is available from the Ombudsman's website. Please note information is not provided for some insurers in some states, as there are insufficient numbers reported to APRA for states in which the insurer does not have a large membership.
| Ombudsman complaints compared to market share | ||
|---|---|---|
| All complaints | 0% | 0.1% market share |
| Investigated complaints | 0% | |
| Health Insurer Retention and Finances | Industry result | |
|---|---|---|
| Member retention (hospital cover) | 91.9% | 88.6% |
| Benefits as % of contributions | 78.7% | 83.1% |
| Management expenses % of contribution income | 12.1% | 9.9% |
| Management expenses per average policy | $693 | $375 |
| Coverage | ACT | NSW | VIC | QLD | SA | WA | TAS | NT | Australia |
|---|---|---|---|---|---|---|---|---|---|
| Hospital Related Charges Covered | 89.6% | 94.3% | 95.4% | 94.5% | 94.1% | 92.6% | 93.4% | - | 94.4% |
| Industry Result | 82.9% | 89.4% | 91.5% | 89.7% | 93.4% | 92.7% | 92.9% | 89.3% | 90.6% |
| Medical Services with No Gaps | 81.7% | 92.9% | 92.4% | 93.8% | 89.1% | 88.2% | 92.1% | - | 92.8% |
| Industry Result | 76.9% | 89.7% | 88.0% | 88.8% | 89.7% | 88.5% | 91.4% | 87.5% | 88.8% |
| Medical Services with No or Known Gaps | 93.3% | 97.6% | 98.7% | 98.1% | 98.4% | 97.4% | 98.1% | - | 97.8% |
| Industry Result | 92.3% | 96.7% | 97.9% | 97.2% | 99.3% | 97.5% | 98.8% | 96.5% | 97.4% |
| General Treatment (extras) Covered | 58.4% | 55.1% | 56.0% | 58.3% | 61.0% | 58.6% | 50.6% | 65.7% | 56.2% |
| Industry Result | 47.0% | 49.1% | 50.8% | 52.5% | 56.4% | 56.6% | 52.6% | 58.4% | 52.0% |
| Private Hospital Agreements | 5 | 97 | 73 | 49 | 22 | 21 | 9 | 2 | - |
| Industry Maximum | 6 | 98 | 76 | 60 | 23 | 24 | 9 | 2 | - |
| Day Hospital Agreements | 8 | 86 | 69 | 48 | 24 | 20 | 5 | 1 | - |
| Industry Maximum | 9 | 103 | 79 | 57 | 30 | 24 | 8 | 2 | - |
Wahroonga
NSW 2076