Xin Lang Cai Jing·2026-01-05 10:10Core Insights - The establishment of the Ping An Health Management Company marks a significant step in the transformation of the health insurance sector, reflecting a shift towards a "managed care" model and the reconstruction of a new ecosystem in health insurance [1][16] - As of November 2025, the cumulative premium for commercial health insurance reached 943.9 billion yuan, with a year-on-year growth of 2.3%, indicating a stable market but falling short of the 2 trillion yuan target set for 2025 [1][16] - The Chinese commercial health insurance market is at a crossroads, focusing on high-quality development driven by regulatory guidance and innovation in health management and product offerings [1][16] Market Structure - The commercial health insurance market is maintaining stability amid slowing growth, with a shift in focus from scale expansion to quality improvement [3][18] - In the first 11 months of 2025, life insurance companies accounted for 76.8% of health insurance premiums, totaling 725.2 billion yuan, but their growth rate has stagnated, while property insurance companies saw a 10.2% increase in premiums [3][18] - The market's stability is evidenced by a monthly premium of 49.6 billion yuan in November 2025, with life insurance companies contributing 40.2 billion yuan and property insurance companies 9.4 billion yuan [3][18] Policy Support - Regulatory measures have been pivotal in driving the transformation of the health insurance industry, with multiple initiatives launched to enhance product standards and payment reforms [4][19] - The "Guiding Opinions on Promoting the High-Quality Development of Health Insurance" issued on September 30, 2025, outlines a vision for the role of health insurance in the national health security system by 2030 [4][19] - The policy emphasizes the integration of health insurance with health management, aiming to create a new health service guarantee system that combines prevention, management, and protection [4][19] Product Innovation - The health insurance sector is entering a phase of deep product innovation, with a focus on dual attributes of "protection + returns" in dividend insurance products [7][22] - Personal account-based long-term medical insurance is highlighted as a key area supported by policy, addressing the industry's challenges with traditional short-term medical insurance [7][22] - The mid-to-high-end medical insurance market is expanding, with major players enhancing their offerings to include comprehensive solutions beyond mere reimbursement [8][23] Ecosystem Reconstruction - The competition in the health insurance industry is shifting towards building an ecosystem, with a consensus on the "insurance + health management" model [10][26] - Major insurance companies are establishing health management firms to create a comprehensive health service system, moving from post-claim reimbursement to full-cycle health management [10][26] - The establishment of health management companies by leading insurers is seen as a localized innovation of the mature "managed care" model from developed markets, aiming to enhance service quality and sustainability [12][27] Technological Empowerment - The application of new technologies such as AI, big data, and blockchain is deepening in the health insurance sector, enhancing efficiency across product design, underwriting, and customer service [13][28] - Ping An has integrated AI into its health strategy, creating a comprehensive service system that covers various health service scenarios [13][28] - The focus on digitalization and the development of personalized health management platforms are expected to improve user experience and support dynamic pricing and risk control [13][28]