推动深化健康险改革！金融监管总局发布

Core Viewpoint - The Financial Regulatory Administration has issued guidelines to promote the high-quality development of health insurance, emphasizing the need for deep reforms, enhanced sustainability, and improved regulatory frameworks to support the Healthy China strategy [1] Group 1: Reform of Health Insurance - The guidelines specify reform requirements for key health insurance products, including commercial medical insurance, long-term care insurance, income loss insurance due to disability, and disease insurance [2] - As of the end of August, the original insurance premium income from health insurance in life insurance companies reached 578.4 billion, accounting for 16.16% of total premium income, while property insurance companies reported 181.5 billion, making up 14.88% of their total [2] Group 2: Product System and Coverage - The guidelines propose a comprehensive, multi-tiered commercial medical insurance product system, encouraging the inclusion of new medical technologies, drugs, and devices in insurance coverage [3] - Long-term medical insurance should adjust pricing based on risk categories and improve the matching of premium rates with underwriting risks [3] - The guidelines support the development of personal account-based long-term medical insurance and the expansion of coverage for income loss insurance due to disability [3] Group 3: Sustainable Development and Professional Capacity - The guidelines emphasize enhancing the sustainable development capabilities of health insurance companies through improved professional capacity, digital application levels, and core competitiveness [5] - Issues such as product homogeneity and insufficient operational capabilities in the health insurance sector have been identified as constraints on service improvement [5] Group 4: Regulatory Enhancements - The guidelines call for strengthened health insurance regulation, including monitoring and addressing illegal activities, and ensuring consumer protection [6] - Future efforts will focus on creating a favorable policy environment for health insurance development and expediting the introduction of supporting business details for floating income health insurance [6]