城市商业医疗险新规下发，六大维度推动“惠民保”高质量发展

Core Viewpoint - The issuance of the "Notice" by the National Financial Supervision and Administration aims to promote the high-quality development of urban commercial health insurance, emphasizing inclusivity, commercial attributes, product management, risk management, and market order [1][7]. Group 1: Regulatory Framework - The "Notice" serves as an implementation and extension of the State Council's opinions on strengthening regulation and preventing risks in the insurance industry, marking a new phase for urban customized commercial health insurance [1][7]. - The document emphasizes the need for insurance companies to operate autonomously while ensuring voluntary participation from the public, aligning premium collection with coverage levels [3][6]. Group 2: Product Development and Management - Insurance products must be optimized to meet the quality medical insurance needs of the public, incorporating new medical technologies and drugs into coverage [2][3]. - As of 2024, over 90% of "惠民保" products include specific high-cost drug claims, with the number of drugs covered increasing from 2021 to 2024, reaching 672 drugs [2][8]. - The "Notice" requires precise pricing and regular reviews to guide the industry back to its core function of providing long-term value [1][2]. Group 3: Market Sustainability and Consumer Protection - The document stresses the importance of maintaining market order and commercial sustainability, prohibiting low-price, disorderly competition among insurance companies [6][8]. - It mandates that insurance companies enhance product sales appropriateness management and protect consumer rights by accurately explaining product functions [6][7]. Group 4: Risk Management and Data Utilization - The "Notice" advocates for a data-driven pricing and underwriting mechanism to improve risk management across the entire insurance chain [8][9]. - The collaboration between Pacific Insurance and Swiss Re highlights the growth of commercial health insurance claims in China, indicating its increasing importance in the multi-tiered medical security system [8][9]. Group 5: Future Directions - The regulatory framework for inclusive health insurance is clear and continuous, focusing on accessibility while ensuring the profitability of commercial insurance [9]. - The core task of commercial health insurance is to work alongside basic medical insurance to achieve overall social security goals, requiring significant efforts from insurance institutions [8][9].