“知识图谱”解读惠民保：“增量扩张”转向“存量优化”

Core Insights - The article discusses the evolution of urban customized commercial health insurance ("Hui Min Bao") over the past decade, highlighting a shift from "incremental expansion" to "stock optimization" with a focus on innovative special drug coverage [1][2]. Group 1: Market Development - The report indicates that by 2025, nine new products are expected to be launched, with a market growth rate of 2.96%. As of July 31, a total of 313 local Hui Min Bao products have been introduced nationwide [1]. - The current product landscape is characterized by a dominance of traditional products, which account for over 80% of those in normal operation. The proportion of operational products is expected to decline by approximately 7.5 percentage points from 2023 to 2024, and by about 1.2 percentage points from 2024 to 2025, indicating a stabilization of the market [1]. Group 2: Product Innovation - New products exhibit a "dual-driven" characteristic, focusing on expanding coverage to lower-tier markets while also innovating and upgrading existing products to meet diverse health insurance needs [2]. - Special drug coverage has become a key area of innovation, with an average of 41 special drugs covered per product, addressing 28 types of conditions. Over 80% of 169 basic traditional Hui Min Bao products include special drug responsibilities, primarily targeting malignant tumors and expanding to rare diseases and other medical fields [2]. Group 3: Pricing and Regulation - The pricing mechanism for Hui Min Bao products is transitioning from a uniform pricing model to a differentiated pricing model, with 141 products currently using a uniform pricing model averaging 95 yuan, an increase from approximately 60 yuan in 2021. Differentiated pricing considers factors such as age, health status, income, and group insurance [2]. - The National Financial Regulatory Administration has issued guidelines to promote high-quality development in urban commercial health insurance, emphasizing the need for regulated sales practices and encouraging product innovation and differentiated pricing [3].