Core Viewpoint - The new regulatory guidelines emphasize the importance of balancing the inclusive nature and commercial attributes of urban commercial health insurance (惠民保), aiming for sustainable development while adhering to market principles [1][5]. Group 1: Regulatory Guidelines - The Financial Regulatory Bureau issued a notification on July 31, requiring urban commercial health insurance to focus on inclusivity while maintaining its commercial nature [1]. - The notification mandates that insurance companies optimize product offerings to meet diverse health protection needs, ensuring broad coverage and reasonable premiums [2][5]. - Insurance companies are instructed to base pricing on reliable historical data, ensuring fair and differentiated pricing according to factors like age, gender, and health status [3][5]. Group 2: Market Competition - The notification prohibits "involution-style" competition, urging insurance companies to avoid chaotic price wars and maintain fair competition [4][5]. - Companies must enhance product diversity and adhere to internal control management during product development, sales, and claims processes [4]. - Sales practices must be transparent, with clear communication of product functions and obligations to prevent misleading information [4][5]. Group 3: Long-term Development - Experts believe the guidelines aim to curb unhealthy competition and ensure service quality, promoting the long-term health of 惠民保 [5]. - The focus is on transitioning from short-term expansion to long-term value creation, supporting a multi-tiered medical insurance system [5].

Core Viewpoint - The new regulatory guidelines aim to enhance the quality and accessibility of urban commercial health insurance (惠民保), emphasizing a balance between inclusivity and commercial viability [1][4]. Group 1: Regulatory Guidelines - The Financial Regulatory Bureau issued a notification on July 31, promoting high-quality development of urban commercial health insurance, focusing on inclusivity and adherence to insurance principles [1]. - The notification mandates that insurance companies implement differentiated pricing based on factors such as age, gender, and health status to improve fairness and adaptability of products [2][3]. - Insurance companies are required to base their pricing on reliable historical data regarding disease incidence, payout rates, and cost rates, ensuring scientific and accurate pricing [2]. Group 2: Market Conduct - The notification emphasizes the need for insurance companies to operate independently while ensuring voluntary participation from consumers, promoting a sustainable business model [2]. - Companies are instructed to avoid "involution" or cutthroat competition, ensuring fair competition and maintaining service quality [4]. - The guidelines also prohibit setting predetermined payout rates or creating discriminatory entry and exit conditions for insurance contracts [4]. Group 3: Industry Impact - The new regulations are expected to optimize the risk pool structure by implementing tiered pricing, which aligns costs with risk profiles [3]. - The guidelines aim to enhance consumer satisfaction and trust in the insurance industry by promoting transparency and ethical practices [2][4]. - The notification serves as a strategic framework for the sustainable development of urban commercial health insurance, contributing to a multi-tiered medical security system [4].

Core Viewpoint - The new regulatory guidelines emphasize the need for urban commercial health insurance (惠民保) to maintain its commercial nature while ensuring broad accessibility and compliance with market principles [1][2][5]. Group 1: Regulatory Guidelines - The Financial Regulatory Bureau issued a notification on July 31, requiring urban commercial health insurance to focus on inclusivity while adhering to commercial attributes and insurance principles [1]. - The notification mandates that insurance companies optimize product offerings to meet diverse healthcare needs, ensuring coverage of new medical technologies and treatments [2][5]. Group 2: Pricing and Risk Management - Insurance companies are instructed to set insurance responsibilities and exclusions based on target customer needs, utilizing reliable historical data to determine premium rates [3]. - The notification advocates for differentiated pricing based on factors such as age, gender, and health status to enhance fairness and adaptability in insurance products [3]. Group 3: Competition and Market Conduct - The notification prohibits "involution-style" competition, urging insurance companies to avoid price wars and ensure fair competition while enhancing product diversity [4][5]. - Companies are required to manage sales practices effectively, ensuring accurate communication of product features and preventing misleading sales tactics [4]. Group 4: Long-term Development Goals - The guidelines aim to balance inclusivity and commercial viability, promoting sustainable development of urban commercial health insurance while addressing public healthcare needs [5]. - The ultimate goal is to create a win-win ecosystem that is affordable for patients, manageable for hospitals, and sustainable for companies, thereby supporting a multi-tiered healthcare system [5].

在坚持普惠性同时，城市商业医疗险也应当遵循市场化、法治化原则。《通知》指出，坚持保险公司自主经营，人民群众自愿投保。各公司要按 照商业保险的基本原则和客观规律开展业务，坚持保费收取与保障程度相适配、扩面提质与商业可持续发展相结合，以规范经营和诚信服务促进 业务健康发展，不断提升保险消费者满意度。各地保险业协会要发挥自律组织作用，加强健康保险宣传和政策解读，塑造可信赖、能托付、有温 度的保险业良好形象。 在产品定价方面，《通知》提到，保险公司应当围绕目标客户需求，合理拟定城市商业医疗险的保险责任、责任免除等重要条款内容。要根据充 分可靠的疾病发生率、赔付率、费用率等历史数据，科学厘定保险费率，并在产品精算报告中详细列示。要遵循风险对价原则，实现差异化定 价，原则上应当基于不同群体的年龄、性别、健康状况等因素进行相应的责任分级或费率分组，不断提升产品和服务的公平性和适配性。对于首 次纳入保险合同的责任，应当基于历史经验数据和医疗、医保、医药等相关方提供的基础数据，科学准确定价。 在各地惠民保加速上新之际，监管新规出炉。7月31日，金融监管总局向各保险公司印发《关于推动城市商业医疗险高质量发展的通知》（以下简 称《 ...

Core Viewpoint - The Financial Regulatory Bureau has issued a notice aimed at promoting the high-quality development of urban commercial health insurance, emphasizing the need for improved product management and precise pricing [1] Group 1: Product Management - Insurance companies are required to align their products with the needs of target customers, ensuring that key terms such as insurance responsibilities and exclusions are well-defined [1] - There is a call for the use of reliable historical data on disease incidence, claim rates, and cost rates to scientifically determine insurance premiums [1] Group 2: Pricing Strategy - The notice emphasizes the principle of risk pricing, advocating for differentiated pricing based on factors such as age, gender, and health status of different groups [1] - Insurance companies should enhance the fairness and adaptability of their products and services through appropriate responsibility grading or premium grouping [1] Group 3: Data Utilization - For newly included responsibilities in insurance contracts, pricing should be based on historical experience data and foundational data provided by relevant parties in the medical and insurance sectors [1]