普惠！金融监管总局：城市商业医疗险，要将创新药纳入责任，突出为民情怀，差异化定价，明确“六不得”...

Core Viewpoint - The new regulations issued by the Financial Regulatory Bureau aim to enhance the quality and sustainability of urban commercial health insurance, particularly focusing on the "Hui Min Bao" program, which has been updated after four years to better meet public health needs and expand coverage [3][8][9]. Group 1: New Regulations Overview - The new regulations emphasize the inclusive nature of "Hui Min Bao," aiming to optimize supply and include innovative drugs in the coverage [4][10]. - The regulations stress voluntary insurance participation and differentiated pricing based on health status and age, with higher payout ratios and lower deductibles for healthier individuals [20][21]. - Insurers are prohibited from adjusting the payout conditions of signed insurance contracts within the same year, ensuring stability for policyholders [39][40]. Group 2: Product Positioning and Consumer Satisfaction - The regulations highlight the need for urban commercial health insurance to maintain a public welfare focus while adhering to commercial principles [11][19]. - Insurers are encouraged to improve product offerings and customer service to enhance consumer satisfaction and retention [18][19]. - The regulations support the establishment of platforms for better communication among healthcare, insurance, and pharmaceutical sectors to facilitate claims processing [34][36]. Group 3: Risk Management and Pricing Strategies - Insurers are required to implement precise pricing strategies that reflect the risk profiles of different demographic groups, thereby enhancing fairness and adaptability in product offerings [23][25]. - The regulations address concerns about the sustainability of "Hui Min Bao" by promoting risk management practices and preventing adverse selection [22][24]. - The new rules also call for a clear distinction between commercial insurance and social insurance to avoid confusion among consumers [50]. Group 4: Market Order and Compliance - The regulations outline six prohibitions to maintain market order, including the requirement for insurers to avoid unfair competition and ensure transparent communication of product features [41][42]. - Insurers must clearly indicate the "customized" nature of their products and specify applicable regions in their offerings [51][53]. - The regulations encourage collaboration among insurers to share data and improve operational efficiency, thereby enhancing the overall ecosystem of urban commercial health insurance [38][49].