发展商业健康保险不仅是满足人民群众多样化医疗需求的民生工程，更是在老龄化背景下，有效应对人口年龄结构转变、分担基本医保支出压力、实现整 个医疗保障体系财务稳健与可持续发展的战略选择。老年人口是医疗资源消耗的主要群体，其慢性病高发、照护需求长期化等特点，在一定程度上加剧了 基本医保"保基本"的筹资与支出矛盾。在此形势下，构建以基本医保为主体、商业健康保险等共同发展的多层次医疗保障体系，通过商业健康保险的市场 机制有效承接超出"基本"范围的保障需求，能够显著增强医保制度应对老龄化冲击的韧性。 有基本医保，为什么还要大力发展商业健康保险？ 从学术定位上看，商业健康保险是以被保险人的身体为保险标的，保证被保险人因疾病或意外事故所致伤害产生的直接费用和间接损失获得补偿的保险。 在国家顶层设计中，其定位日益明晰且被赋予更高期望。《"健康中国2030"规划纲要》提出，"健全以基本医疗保障为主体、其他多种形式补充保险和商 业健康保险为补充的多层次医疗保障体系"；2020年发布的《关于促进社会服务领域商业保险发展的意见》设定了"力争到2025年，商业健康保险市场规模 超过2万亿元，成为中国特色医疗保障体系的重要组成部分"这一量 ...

Core 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]

此次论坛的成功举办，不仅为在华跨国企业应对人力资源转型挑战提供了宝贵的交流平台与实务指引， 也显著提升了百年人寿在企业福利与健康管理领域的专业品牌形象。作为积极的参与者和解决方案提供 方，百年人寿将持续致力于以创新的保险产品和专业的健康管理服务赋能企业高质量发展，与合作伙伴 共同构建更具韧性与温度的职场未来。（百年人寿供稿） 作为论坛的亮点环节，安顾方胜业务拓展总监胡涵之以 "企业创新员福方案的进阶实践" 为题发表专题 演讲，其中系统介绍了百年人寿为企业客户量身定制的团体保险及健康管理综合解决方案。演讲不仅涵 盖了百年团险的核心产品，更重点展示了覆盖"健康促进、疾病干预、便捷就医、全球医疗"的全周期健 康管理服务生态，并通过详实的成功案例，诠释了"保险+健康管理"如何为企业降本增效、提升员工归 属感与生产效率，赢得了现场嘉宾的广泛共鸣。 沉浸体验，彰显专业服务价值 论坛期间，百年人寿特别设置了专业健康筛查体验区，为参会嘉宾提供眼底健康、压力指数等快速检测 服务，让企业决策者亲身体验员工健康管理的实际价值。同时，百年精心编制的《企业健康福利解决方 案手册》也成为热门资料，为与会者提供了系统性的参考。 河北理财网 ...

Core Insights - The release of the "China Life Insurance Industry Experience Life Table (2025)" is a significant step for the insurance sector, set to be implemented on January 1, 2026, and reflects the profound changes in population structure and longevity trends [1] - The new life table indicates that China is entering an era of longevity, which brings challenges such as extended retirement payment periods and increased risks of chronic diseases and disabilities, necessitating scientific risk management and planning for health and retirement [1][2] - The insurance industry must innovate product offerings to cater to high-risk groups, including the elderly and those with pre-existing conditions, integrating health management and retirement services into comprehensive solutions [1][2] Company Initiatives - Aixin Life has focused on preventive healthcare management over the past two years, launching various health management plans aimed at providing effective coverage for underrepresented groups, particularly the elderly and those with chronic illnesses [2] - The company has introduced several key health management products, such as a comprehensive cancer prevention plan and specific medical coverage plans for high-risk groups, which have lower underwriting thresholds, allowing access for individuals over 75 and those with health issues [2] - Aixin Life's health management initiatives aim to shift the focus from disease treatment to health management, creating a closed-loop service that includes screening, expert consultations, and insurance coverage, thereby reducing the likelihood of disease occurrence [2][3] Industry Perspective - The arrival of the longevity era is prompting the insurance industry to redefine its role, emphasizing that insurance is not just about post-event compensation but also about comprehensive risk management throughout the life cycle [3] - The insurance sector is seen as a crucial support for the state in addressing aging populations, and companies must develop effective strategies to manage long-term payout risks [3] - Aixin Life is committed to meeting the genuine needs of the public by launching high-quality insurance products that transform the challenges of the longevity era into tangible benefits for the community [3]

Core Viewpoint - Company faces temporary revenue pressure in H1 2025, but adjusted net loss significantly narrows, indicating effective strategic restructuring [1] - Looking ahead, the strategic restructuring of low-margin specialty pharmacy business is expected to continue yielding positive results, while high-margin corporate health insurance business is anticipated to expand [1][3] Financial Performance - In H1 2025, the company achieved total revenue of 1.224 billion yuan, a year-on-year decrease of 48.2%, with a net loss of 81.14 million yuan, an increase in loss of 8.7% year-on-year; adjusted net loss was 12 million yuan, narrowing by 59.6% [1][2] - The decline in revenue and significant narrowing of adjusted net loss are primarily due to the strategic restructuring of the low-margin specialty pharmacy business, which has a gross margin of 5.4% [1][2] Business Segmentation - Commercial medical insurance service revenue was 83.12 million yuan, down 24.02% year-on-year, with a gross margin of 77.0%, up 6.2 percentage points; high-margin corporate health insurance revenue was 42.81 million yuan, up 10.2% year-on-year, while low-margin public insurance revenue was 40.31 million yuan, down 43.1% [2] - Doctor research assistance business revenue was 215 million yuan, up 14.8% year-on-year, with a gross margin of 28.8%, down 2.0 percentage points; specialty pharmacy business revenue was 926 million yuan, down 55.2%, with a gross margin of 5.4%, up 0.9 percentage points [2] Strategic Outlook - For H2 2025, the company expects continued positive effects from the strategic restructuring of the low-margin specialty pharmacy business and ongoing expansion of the high-margin corporate health insurance business [3] - The company aims to enhance network collaboration efficiency and deepen digital operations, which are expected to lead to effective cost control and sustained profit improvement [3] Profitability and Cost Control - In H1 2025, the overall gross margin was 14.39%, an increase of 4.70 percentage points, driven by increased revenue from high-margin corporate health insurance and the strategic restructuring of low-margin specialty pharmacy business [3] - The company has effectively controlled costs, with sales and marketing expenses of 80.89 million yuan, down 41.31% year-on-year, and administrative expenses of 151 million yuan, down 7.02% year-on-year [3] Future Earnings Forecast - The company is expected to benefit from its strong position in the corporate health insurance sector and the unique "insurance + health management" ecosystem, which is projected to drive growth in the commercial health insurance industry [4] - Revenue forecasts for 2025-2027 are 2.055 billion, 1.923 billion, and 2.003 billion yuan, with year-on-year changes of -54.98%, -6.44%, and +4.14% respectively; net profit forecasts are -100 million, -32 million, and 23 million yuan, with year-on-year growth of 69.10%, 67.82%, and 170.98% respectively [4]

Core Viewpoint - The insurance industry is shifting towards health management as a response to the "Healthy China" strategy and medical insurance cost control, driven by aging population and chronic diseases, moving from a reactive compensation model to proactive health management [1][3]. Group 1: Company Developments - China People's Health Insurance Company (PICC Health) has been approved to establish a wholly-owned health management subsidiary with an investment of 200 million yuan, marking a significant step in its "big health" strategy [1][2]. - The new subsidiary aims to create a nationwide health service network and upgrade the group's health management platform, enhancing services in medical care, rehabilitation, chronic disease management, and drug supply [2][3]. - PICC Health has been planning this health management company since 2021, with the formal application submitted in 2025 and approval received in August [2]. Group 2: Market Trends - The traditional "post-compensation" insurance model is inadequate for current needs, prompting insurers to intervene in health services to shift from "insuring healthy people" to "insuring people's health" [3][4]. - The increasing elderly population and chronic disease prevalence are escalating national medical expenditure, making health management participation by insurers crucial to alleviate financial pressures [3][4]. - Public awareness of health issues is rising, creating strong demand for health management services [3]. Group 3: Policy Environment - The "Healthy China 2030" plan encourages the development of health insurance products linked to health management services, promoting collaboration between commercial insurers and healthcare providers [4][5]. - Recent regulatory updates allow insurers to integrate health management services with health insurance products, enabling services like health risk assessments and chronic disease management [5][6]. Group 4: Industry Innovations - The integration of "insurance + health management" is becoming a trend, with many insurers establishing specialized health management subsidiaries [6][7]. - Insurers are exploring various models, including "managed care" and "insurance products + health service packages," to enhance customer engagement and improve health outcomes [9][10]. - Leading insurance groups are leveraging their resources to build proprietary health service networks, while smaller firms may partner with specialized health management organizations to differentiate their services [10].

Core Viewpoint - The health management sector is emerging as a significant opportunity for the insurance industry, with major companies actively investing in this area to create a comprehensive health service ecosystem [1][4]. Group 1: Company Developments - On September 17, the China Banking and Insurance Regulatory Commission approved China People's Health Insurance Co., Ltd. to invest 200 million yuan to establish a health management subsidiary, holding a 100% stake [2][3]. - Other leading insurance companies, such as Taikang Insurance Group and China Merchants Jinling Life, have also established health management subsidiaries, indicating a broader trend in the industry [3]. Group 2: Market Potential and Strategy - The health management market holds significant potential, supported by policies encouraging the integration of health insurance and health management services [4][5]. - Health management services can enhance customer loyalty and meet the demand for personalized and continuous health management, aligning with the "Healthy China" strategy [4]. - The shift from pure insurance payouts to comprehensive health service provision is seen as a key strategy for insurance companies to remain competitive [4][5]. Group 3: Challenges and Considerations - The transition to an ecosystem-based competition in health insurance faces challenges, including balancing data sharing with privacy protection, ensuring service standardization, and matching costs with benefits [6]. - The initial high investment costs and long return periods (typically 5-8 years) pose profitability pressures for insurance companies, which often face short-term performance evaluation challenges [6]. - Companies are encouraged to focus on core areas with high demand and clear benefits, such as chronic disease management, and to leverage partnerships with medical technology firms to reduce costs through digital solutions [6].

Group 1 - The core issue faced by millions of chronic disease patients in China is the inability to afford treatment and management, necessitating innovative solutions in the insurance system [1] - Zhonghui Mutual Insurance has developed a comprehensive insurance matrix covering 130 million kidney disease patients and a product specifically for 450 million chronic liver disease patients, addressing significant gaps in healthcare coverage [1][2] - The company has launched 16 insurance products tailored for chronic kidney disease (CKD) patients, with over 70% of policyholders being individuals with pre-existing conditions, demonstrating a commitment to inclusivity in insurance [2][3] Group 2 - The recent policy changes by the National Healthcare Security Administration and the National Health Commission mark a shift towards a dual-track system for innovative drug coverage, combining basic medical insurance with commercial insurance [2] - Zhonghui Mutual Insurance's model integrates health management with insurance, promoting proactive disease management and improving patient outcomes through personalized care and monitoring [3][4] - The mutual insurance model is positioned as a solution to the limitations of traditional commercial insurance, particularly for high-risk groups, by providing sustainable and community-focused healthcare solutions [4] Group 3 - The prevalence of chronic diseases in China, with over 300 million patients, highlights the urgent need for innovative insurance solutions to fill existing coverage gaps [4] - Zhonghui Mutual Insurance's "Hui Gan Bao" product aims to manage chronic liver disease, which is a significant contributor to liver cancer, thereby addressing both healthcare and social value [5][6] - The company's approach emphasizes risk reduction and health management, aiming to lower the incidence of severe diseases and enhance overall public health [6]

Core Viewpoint - The strategic partnership between Sipai Health Technology and Arthur J. Gallagher aims to enhance the corporate group health insurance market in China through customized insurance solutions and improved risk management capabilities [1][2]. Group 1: Strategic Partnership - Sipai Health Technology and Arthur J. Gallagher have signed a five-year strategic cooperation agreement focusing on corporate group health insurance and reinsurance [1]. - The collaboration will leverage Sipai's resources in China and Gallagher's global insurance product design capabilities to create data-driven health insurance development mechanisms [1]. Group 2: Market Opportunities - There is a growing demand for cross-border medical insurance as Chinese companies expand internationally, prompting the need for overseas health protection solutions [2]. - The partnership aims to address the health insurance needs of foreign enterprises investing in China, capturing market opportunities in the health insurance sector [2]. Group 3: Implementation and Innovation - A joint working group has been established to ensure efficient implementation of the partnership and resource collaboration, focusing on innovation and customer-centric solutions in the health insurance field [2].