Core Viewpoint - The recent notification from the National Financial Supervision Administration emphasizes the need for high-quality development of urban commercial medical insurance, particularly focusing on the "Hui Min Bao" insurance, which serves as a bridge between social security and commercial insurance [1][2]. Group 1: Regulatory Changes - The notification outlines that urban customized commercial medical insurance should incorporate new medical technologies, drugs, and devices into its coverage [1][8]. - It stresses the importance of differentiating between commercial insurance and social insurance to avoid confusion and promote reasonable expectations for social security [1][2]. Group 2: Market Dynamics - Experts express concerns about the positioning of "Hui Min Bao" following the implementation of differentiated pricing, questioning whether it will still meet the needs of the public [2][5]. - The notification aims to prevent low-price, chaotic competition and monopolistic sales practices in the market [6][7]. Group 3: Pricing Strategies - Some regions are experimenting with differentiated pricing for "Hui Min Bao," with premiums set at 69 yuan for individuals aged 0-22, 99 yuan for those aged 23-50, and 149 yuan for individuals over 50 or with pre-existing conditions [2][3]. - The concept of differentiated pricing is seen as a way to balance risk and affordability, potentially stabilizing the market [3][4]. Group 4: Product Integration and Innovation - The upcoming commercial insurance innovation drug directory is expected to be integrated into "Hui Min Bao," enhancing its coverage of innovative drugs [1][9]. - The directory aims to include high-innovation, clinically valuable drugs that exceed basic medical insurance coverage, with a focus on reducing patient costs for expensive treatments [9][10]. Group 5: Challenges and Concerns - There are concerns regarding the effective implementation of the notification's requirements, particularly in terms of achieving consensus among various stakeholders [2][5]. - The high overlap of coverage between "Hui Min Bao" and basic medical insurance, estimated at 40%, indicates a need for better alignment and design of insurance products [10][11].

Core Viewpoint - The development pattern of "Hui Min Bao" products, as an important carrier for multi-level payment of innovative drugs and medical devices in China, is set to undergo significant adjustments [1][2]. Group 1: Regulatory Changes - The National Financial Supervision Administration issued a notice on July 31 to further standardize the business model of urban customized commercial health insurance, emphasizing scientific premium setting and differentiated pricing principles [2]. - Insurance companies are required to base premium rates on reliable historical data regarding disease incidence, payout rates, and cost rates, ensuring fairness and adaptability in products and services [2]. Group 2: Market Trends - The scale of medical insurance premiums has been growing, with the scale surpassing critical illness insurance in 2024, indicating a significant boost from "Hui Min Bao" for insurance companies in the medical sector [3]. - In 2024, there were 173 "Hui Min Bao" products operating across 30 provinces, with an average operational time of 3.6 years, and the premium scale reached 20 billion yuan [3]. Group 3: Industry Collaboration and Product Development - There is a need for better collaboration between pharmaceutical companies and insurance providers to develop specialized insurance products for innovative drugs and medical devices [5]. - The establishment of a selection mechanism for innovative drugs based on clinical value is essential, along with exploring innovative payment methods linked to clinical outcomes [5]. Group 4: Future Directions - The focus will be on designing insurance products for individuals with pre-existing conditions and enhancing patient service experiences [3][4]. - The integration of innovative drugs into insurance product directories should not lead to price competition but rather promote a fair distribution of benefits among stakeholders [4].

Core Viewpoint - The recent notice from the National Financial Supervision Administration emphasizes the need for high-quality development of urban commercial medical insurance, particularly focusing on product management and precise pricing strategies [2][6]. Group 1: Market Overview - Urban commercial medical insurance, known as "惠民保," serves as a supplementary insurance for individuals with basic medical insurance, covering large medical expenses not reimbursed by basic insurance [3]. - The market for "惠民保" has seen a slowdown in growth over the past two years, with the number of operational products decreasing from 211 to 199 compared to 2023 [3]. Group 2: Regulatory Changes - The notice outlines six key requirements, including the need for differentiated pricing based on factors such as age, gender, and health status, moving away from the current uniform pricing model [2][8]. - The notice reinforces the commercial nature of "惠民保," urging insurance companies to operate independently and ensuring that consumers voluntarily choose to participate [6][12]. Group 3: Pricing and Product Management - The notice mandates that insurance companies utilize reliable historical data to determine insurance rates and implement differentiated pricing to enhance fairness and adaptability of products [8][9]. - Currently, many "惠民保" products use a uniform rate model, which may lead to issues such as adverse selection and imbalance in risk sharing [9]. Group 4: Market Conduct and Competition - The notice prohibits low-price, disorderly competition and emphasizes fair competition principles, ensuring that insurance companies do not engage in monopolistic practices [10][11]. - There is a growing concern regarding the sustainability and quality of "惠民保" products due to low pricing and similar coverage, prompting some regions to introduce upgraded versions with higher premiums [11]. Group 5: Future Directions - The notice encourages the exploration of differentiated pricing mechanisms, which could lead to improved product sustainability and better alignment with the needs of different demographic groups [9][12]. - It also highlights the importance of distinguishing between commercial insurance and social insurance to clarify responsibilities and optimize the insurance structure [12].

城市定制型商业医疗保险(以下简称"城市商业医疗险")业务，迎来规范发展新阶段。 7月31日，金融监管总局向业内发布《关于推动城市商业医疗险高质量发展的通知》(以下简称《通知》)， 从突出普惠定位、坚守商业属性、规范精准定价、提升服务能力、共建良好生态、注重统筹规划六个维 度，全面规范城市商业医疗险业务，推动实现商业可持续发展，保护保险消费者合法权益。 回应社会关切 推动实现可持续发展 城市商业医疗险，即我们常说的"惠民保"，是由地方政府及相关部门指导、保险公司商业运作、与基本医 保衔接的商业保险，具有投保门槛低、保费低、保额高等特点。 一方面，要突出城市商业医疗险普惠定位。《通知》要求，保险业要坚持以人民为中心的发展思想，围绕 人民群众的优质医疗保障需求，优化城市商业医疗险产品供给，及时将医疗新技术、新药品、新器械应用 纳入责任范围，提供覆盖广泛、公平可得、保费合理、保障有效的保险服务。要努力扩大城市商业医疗险 的惠及面，推动商业医疗保险可及可信、可保可赔、可感可知。 另一方面，城市商业医疗险要坚守商业属性，遵循保险规律。《通知》指出，城市商业医疗险应当遵循市 场化、法治化原则，坚持保险公司自主经营，人民群众 ...

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].

Core Viewpoint - The new regulatory guidelines aim to promote the sustainable development of urban commercial medical insurance (惠民保) by emphasizing its commercial nature while ensuring it remains inclusive and accessible to the public [1][6][7] Group 1: Regulatory Guidelines - The Financial Regulatory Bureau issued a notification on July 31, requiring urban commercial medical insurance to adhere to its commercial attributes and market principles, ensuring precise pricing and avoiding excessive competition among insurance providers [1][3] - The notification emphasizes the importance of a people-centered approach, urging insurance companies to optimize product offerings to meet diverse healthcare needs and incorporate new medical technologies and treatments [3][6] 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 scientifically [4] - The notification advocates for differentiated pricing based on factors such as age, gender, and health status to enhance fairness and adaptability in insurance products, addressing previous issues of uniform pricing that led to adverse selection [4][5] Group 3: Competition and Sales Management - The guidelines prohibit "involution-style" competition, urging insurance companies to manage their branches effectively and ensure compliance with internal control requirements in product development, sales, and claims [5][6] - Insurance companies must enhance sales management practices, accurately communicate product functions, and prevent misleading sales tactics to protect consumer rights [5][6] Group 4: Long-term Goals - The notification aims to balance inclusivity and commercial viability, promoting sustainable development of urban commercial medical insurance while supporting the establishment of a multi-tiered healthcare security system [6][7] - The ultimate goal is to create a win-win ecosystem that is affordable for patients, manageable for hospitals, and sustainable for businesses, thereby strengthening the multi-tiered healthcare system [7]

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]