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上海团险版商保目录呼之欲出,新型团险产品预计下半年面市
第一财经·2025-08-31 14:27

Core Viewpoint - The article discusses the challenges and opportunities in promoting group insurance coverage for innovative drugs and medical devices in Shanghai, following the release of new policies aimed at enhancing the commercial health insurance market [3][4]. Group 1: Policy Initiatives - Shanghai has introduced measures to encourage the development of group health insurance products that cover innovative drug and device costs, allowing the use of employees' personal medical accounts for these products [3][17]. - The new policies aim to create a conducive environment for insurance companies to innovate and expand their offerings in the group insurance sector [4][17]. Group 2: Product Development - Several leading commercial health insurance companies are collaborating to develop new group insurance products, with some innovative products expected to launch in the second half of the year [3][6]. - The new group insurance products will include a group insurance version of the commercial insurance drug list, focusing on coverage outside of basic medical insurance [6][8]. Group 3: Market Dynamics - The new group insurance products are not intended to replace existing market products but to provide additional options that meet the diverse needs of enterprises and employees [4][12]. - There is a consensus that the new products should primarily focus on chronic and common diseases while also addressing high-cost medical risks [7][9]. Group 4: Pricing and Risk Management - Current pricing for ordinary group insurance products ranges from 1,000 to 2,000 yuan, and new products are expected to remain within this range while incorporating innovative drugs [10]. - Insurance companies are cautious about the potential increase in claims due to the inclusion of high-cost drugs and are considering strategies such as raising deductibles and adjusting coverage responsibilities [9][10]. Group 5: Market Demand and Challenges - Companies have expressed interest in new group insurance products, particularly regarding the accessibility of innovative drugs and support for purchasing original research drugs [13][15]. - The success of these new products will depend on whether companies are willing to allocate additional budgets for enhanced coverage and whether employees will accept changes in their insurance plans [14][15]. Group 6: Future Outlook - The potential market for group insurance in Shanghai is significant, with a large workforce and many companies yet to activate their insurance needs [15][17]. - The policies are expected to stimulate demand and enhance the diversity of products available in the market, positioning group insurance as a key player in supporting innovative drug payments [17].