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推动深化健康险改革!金融监管总局发布
Zheng Quan Shi Bao· 2025-09-30 13:13
Core Viewpoint - The Financial Regulatory Administration has issued guidelines to promote the high-quality development of health insurance, emphasizing the need for deep reforms, enhanced sustainability, and improved regulatory frameworks to support the Healthy China strategy [1] Group 1: Reform of Health Insurance - The guidelines specify reform requirements for key health insurance products, including commercial medical insurance, long-term care insurance, income loss insurance due to disability, and disease insurance [2] - As of the end of August, the original insurance premium income from health insurance in life insurance companies reached 578.4 billion, accounting for 16.16% of total premium income, while property insurance companies reported 181.5 billion, making up 14.88% of their total [2] Group 2: Product System and Coverage - The guidelines propose a comprehensive, multi-tiered commercial medical insurance product system, encouraging the inclusion of new medical technologies, drugs, and devices in insurance coverage [3] - Long-term medical insurance should adjust pricing based on risk categories and improve the matching of premium rates with underwriting risks [3] - The guidelines support the development of personal account-based long-term medical insurance and the expansion of coverage for income loss insurance due to disability [3] Group 3: Sustainable Development and Professional Capacity - The guidelines emphasize enhancing the sustainable development capabilities of health insurance companies through improved professional capacity, digital application levels, and core competitiveness [5] - Issues such as product homogeneity and insufficient operational capabilities in the health insurance sector have been identified as constraints on service improvement [5] Group 4: Regulatory Enhancements - The guidelines call for strengthened health insurance regulation, including monitoring and addressing illegal activities, and ensuring consumer protection [6] - Future efforts will focus on creating a favorable policy environment for health insurance development and expediting the introduction of supporting business details for floating income health insurance [6]
推动深化健康险改革!金融监管总局发布
证券时报· 2025-09-30 12:51
Core Viewpoint - The article discusses the release of the "Guiding Opinions on Promoting High-Quality Development of Health Insurance" by the Financial Regulatory Bureau, which outlines 15 measures aimed at enhancing the regulation and sustainable development of health insurance in China, aligning with the Healthy China strategy [2]. Group 1: Deepening Health Insurance Reform - The Opinions propose specific reform requirements for major health insurance types, including commercial medical insurance, long-term care insurance, disability income loss insurance, and disease insurance [4]. - As of the end of August, the original insurance premium income for health insurance from life insurance companies was 578.4 billion yuan, accounting for 16.16% of total premium income, while property insurance companies reported 181.5 billion yuan, making up 14.88% of their total [4]. Group 2: Product System and Service Enhancement - The Opinions aim to establish a comprehensive, multi-tiered commercial medical insurance product system, incorporating new medical technologies, drugs, and devices into coverage [5]. - It encourages long-term medical insurance to price according to risk categories and improve the matching of premium rates with underwriting risks [5]. - The document supports the development of personal account-style long-term medical insurance and the expansion of coverage for disability income loss insurance [5]. Group 3: Sustainable Development and Professional Capacity - The Opinions emphasize enhancing the sustainable development capacity of health insurance companies through professional capability building and digital application improvements [8]. - It identifies issues such as product homogeneity and insufficient industry operational capacity that hinder service quality [8]. - The document calls for strengthening the responsibilities of insurance companies and improving actuarial management mechanisms [8]. Group 4: Regulatory Strengthening - The Opinions stress the importance of regulatory oversight to maintain market order and address illegal activities, including financial misconduct and misleading sales practices [11]. - The Financial Regulatory Bureau plans to enhance communication with other departments to create a favorable policy environment for health insurance development [11]. - It also aims to expedite the research and implementation of supporting business details for floating income health insurance [11].
重磅!推动健康保险高质量发展指导意见出台,打通卡点堵点,明确未来发展方向
13个精算师· 2025-09-30 12:11
Core Viewpoint - The article discusses the issuance of the "Guiding Opinions on Promoting High-Quality Development of Health Insurance" by the Financial Regulatory Bureau, emphasizing the need to enhance the health insurance sector's service and guarantee levels in response to increasing health protection demands and the aging population [1][12]. Summary by Sections 1. Increasing Demand for Health Insurance - The demand for health insurance is rising due to an aging population and increasing life expectancy, with the average life expectancy in China reaching 79 years [5]. - There is a growing need for commercial health insurance products, particularly for quick settlement of medical expenses and coverage of more medications not included in basic medical insurance [7][8]. 2. Breaking Through Bottlenecks - The health insurance sector has seen rapid growth since 2014, with commercial health insurance premium income expected to reach 977.3 billion by the end of 2024, more than six times the amount a decade ago, with a compound annual growth rate of approximately 20% [11]. - Despite this growth, challenges such as product homogeneity and insufficient operational capabilities are emerging, which hinder service improvement [11][12]. 3. Deepening Health Insurance Reform - The opinions outline a focus on enhancing the health management service system and promoting collaboration between health insurance and the healthcare industry [15][22]. - Specific areas of development include commercial medical insurance, long-term care insurance, and disability income loss insurance, with a push for integrating new medical technologies and drugs into insurance coverage [16][20]. 4. Enhancing Sustainable Development Capabilities - The article emphasizes the need for insurance companies to strengthen their responsibilities and improve actuarial management, as well as to enhance the professional talent pool in health insurance [24][25]. - It also highlights the importance of digital transformation and the use of big data and AI to improve operational efficiency and customer satisfaction [25]. 5. Strengthening Health Insurance Regulation - The regulatory framework will be improved to ensure compliance and fair pricing in health insurance products, with a focus on enhancing the overall market order [27][28]. - Measures will be taken to combat malpractice and protect consumer rights, ensuring a more transparent and efficient health insurance market [28]. 6. Optimizing the Health Insurance Development Environment - The article calls for the establishment of standardized health insurance clauses and evaluation systems to improve service quality and consumer understanding [31][32]. - It also encourages collaboration between various stakeholders to promote the development of group health insurance and improve public awareness of health insurance [32]. 7. Future Arrangements - The Financial Regulatory Bureau plans to create a favorable policy environment for health insurance development and to enhance product offerings to meet public demand for high-quality health protection [35].