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监管要求“惠民保”基于年龄等定价,穗岁康未来费率会分层吗
Nan Fang Du Shi Bao·2025-08-01 11:00

Core Viewpoint - The recent notice from the National Financial Supervision Administration emphasizes the need for high-quality development of urban commercial medical insurance, particularly focusing on product management and precise pricing strategies [2][6]. Group 1: Market Overview - Urban commercial medical insurance, known as "惠民保," serves as a supplementary insurance for individuals with basic medical insurance, covering large medical expenses not reimbursed by basic insurance [3]. - The market for "惠民保" has seen a slowdown in growth over the past two years, with the number of operational products decreasing from 211 to 199 compared to 2023 [3]. Group 2: Regulatory Changes - The notice outlines six key requirements, including the need for differentiated pricing based on factors such as age, gender, and health status, moving away from the current uniform pricing model [2][8]. - The notice reinforces the commercial nature of "惠民保," urging insurance companies to operate independently and ensuring that consumers voluntarily choose to participate [6][12]. Group 3: Pricing and Product Management - The notice mandates that insurance companies utilize reliable historical data to determine insurance rates and implement differentiated pricing to enhance fairness and adaptability of products [8][9]. - Currently, many "惠民保" products use a uniform rate model, which may lead to issues such as adverse selection and imbalance in risk sharing [9]. Group 4: Market Conduct and Competition - The notice prohibits low-price, disorderly competition and emphasizes fair competition principles, ensuring that insurance companies do not engage in monopolistic practices [10][11]. - There is a growing concern regarding the sustainability and quality of "惠民保" products due to low pricing and similar coverage, prompting some regions to introduce upgraded versions with higher premiums [11]. Group 5: Future Directions - The notice encourages the exploration of differentiated pricing mechanisms, which could lead to improved product sustainability and better alignment with the needs of different demographic groups [9][12]. - It also highlights the importance of distinguishing between commercial insurance and social insurance to clarify responsibilities and optimize the insurance structure [12].