聚力赋能精耕细作，重塑健康险新生态 ——多机构召开健康保险高质量发展工作座谈会点评 保险Ⅱ 证券研究报告/行业点评报告 2026 年 01 月 26 日 | | | 报告摘要 执业证书编号：S0740525040002 Email：geyx01@zts.com.cn 执业证书编号：S0740517090005 | 上市公司数 | 5 | | --- | --- | | 行业总市值(亿元) | 34,888.11 | | 行业流通市值(亿元) | 34,888.11 | 2026-01-21 充展望》2026-01-14 切换测算：OCI 选择权的两面性，税 务 追 溯 对 现 金 流 影 响 有 限 》 2026-01-06 请务必阅读正文之后的重要声明部分 分析师：葛玉翔 事件：为促进行业转型升级，积极服务健康中国战略。 1 月 22 日，中国保险行业协 会在京召开健康保险高质量发展工作座谈会，精算师协会、银行保险资管业协会、银 保信公司等应邀参加会议。 分析师：蒋峤 基本状况 在中国保险行业协会的牵头下，多家机构集体发声，体现高层重视度。四家行业机构 全方面围绕健康保险，从产品、条款、费率、数据、资金等方 ...

来源：金融时报 记者：孙榕 商业健康保险，正逐步成为创新药发展、医疗体系完善与普通家庭保障的重要支撑力量。 1月22日，健康保险高质量发展工作座谈会在北京召开。这场会议由中国保险行业协会牵头，中国精算 师协会、中国银行保险资产管理业协会、中国银行保险信息技术管理有限公司"（以下简称"中国银保 信"），相关医药卫生协会负责人、高校专家，以及部分医药企业、保险公司代表应邀参加。 中国保险行业协会披露了一组关键数据：近10年，商业健康险年均复合增长率超过20%，在售医疗保险 产品超过1.1万个，成为人民群众健康保障的坚实支撑。值得关注的是，商业健康险对创新药械的支持 力度显著提升。据初步估计，2025年，商业健康保险对创新药械的总赔付金额约为147亿元，连续四年 高速增长，年复合增长率达70%。 会议结束后，中国保险行业协会、中国精算师协会、中国银行保险资产管理业协会、中国银保信四家行 业机构集体发声，透露了商业健康保险在支持创新药发展、完善医疗体系、筑牢家庭健康保障方面的关 键作用与未来布局。 中国保险行业协会：商业健康险持续扩容 创新药赔付四年增长70% 下一步，中国保险行业协会将进一步加强行业自律，强化与健康 ...

刚刚 保险行业协会、资管协会 精算师协会、银保信等 齐发文 费率、数据、资金等 全方面聚焦 健康保险 高质量发展 ①从产品、条款、 ②保险行业协会 制定医疗险 示范 条款 和药品保障支付 清单 ③精算师协会： 编制 全国医保信息共享服务 ⑤资管协会 保险资金助力健康产业发展 1 健康保险未来发展重点 产品升级、费率更新、数据共享 当前，随着医疗技术的提升，人均预期寿命持续提升，根据监管部门披露的数据，我国 人均预期寿命达到7 9岁，每5年增长1岁。 如果，从购买保险人群的数据看，预期寿命还要更高！ 以现在保险业采用的第四套生命表中的CL1 ( 2 0 2 5 )表为例，男性预期寿命为8 5岁，提高 2岁，女性预期寿命为8 9岁，提高1岁。 详见《 第四套生命表2 0 2 6年启用 》 再加上，医保DRG/DIP支付方式改革的全面落地，大众对于健康管理的意识，以及商 业健康保险的需求也快速增长。 医疗险、惠民保的 净成本表 ④银保信：建设 其实，从百万医疗险的兴起到惠民保的全面发展，近年来，保险公司围绕健康保险，开 发了千余款产品，已经构建起多层次、全覆盖的产品体系。 | 分类 | | 2024年 | 2025 ...

原标题：积极开展商业医疗险净成本表编制工作 推动健康保险高质量发展 来源：中国精算师协会 为落实《国家金融监督管理总局关于推动健康保险高质量发展的指导意见》（金发〔2025〕34号），构 建全覆盖、多层次的商业医疗保险产品体系，提升保险费率与承保风险匹配度，精算师协会组织行业力 量开展商业医疗保险净成本表编制工作。一是有序推进商业医疗险净成本表编制工作。组织保险公司成 立项目组，根据行业实际情况进行商业医疗险经验分析，推进编制商业医疗险净成本表。二是积极开展 创新药品成本测算和分析工作。建立与医药行业常态化交流机制，加强沟通协作、互通联动，收集创新 药品信息，加强药品成本测算与分析，有利于推动保险公司科学合理定价，提升保险费率与承保风险匹 配度。三是稳妥推进惠民保净成本表编制工作。加强与外部机构的沟通协调，稳步开展惠民保净成本测 算与分析工作。 原标题：积极开展商业医疗险净成本表编制工作 推动健康保险高质量发展 来源：中国精算师协会 为落实《国家金融监督管理总局关于推动健康保险高质量发展的指导意见》（金发〔2025〕34号），构 建全覆盖、多层次的商业医疗保险产品体系，提升保险费率与承保风险匹配度，精算师协会 ...

Core Viewpoint - The article emphasizes the importance of health insurance in improving public health and supporting the aging population in China, highlighting the role of China People's Health Insurance Co., Ltd. in this context [1][2]. Group 1: Health Insurance Development - The company reported a risk coverage amount of 99 trillion yuan, a year-on-year increase of 6.2%, and a claims service participation of 16.096 million people, also up by 6.2% [1]. - The premium income reached 40.7 billion yuan in the first half of the year, marking a historical high with a year-on-year growth of 12.2% [1]. Group 2: Focus on Elderly Care - The company is actively participating in the construction of a long-term care insurance system, being the first to launch commercial long-term care insurance and engage in related pilot programs [2]. - It aims to develop a comprehensive care insurance system that includes both basic and supplementary coverage, enhancing services for the elderly [2]. Group 3: Innovation in Health Insurance - The company plans to include more new medical technologies and drugs in its coverage, exploring diverse payment methods to create a win-win situation for patients and the pharmaceutical industry [3]. - It will focus on providing flexible health insurance products and services tailored to various health risk characteristics of enterprises [3]. Group 4: Ecosystem Development - The company intends to establish a professional health management institution to enhance service capabilities and support the health industry [4]. - It aims to create a comprehensive service system that integrates health management into the insurance business, covering the entire health management cycle [4]. Group 5: Transformation to Health Management Partner - The company is shifting from being a traditional risk compensator to a health management partner, developing a product system that covers the entire health process [5]. - It focuses on proactive health management to reduce disease incidence and improve clients' quality of life [5].

Core Insights - The second China Financial Actuarial Forum focuses on the role of actuaries in the context of the "14th Five-Year Plan" and the integration of artificial intelligence in the insurance industry [1][9] - The forum emphasizes the need for actuaries to transition from passive risk managers to proactive drivers of high-quality industry development [2][9] Group 1: Forum Overview - The forum gathered over 170 participants, including industry experts and students, to discuss innovative development paths for the actuarial industry [1] - The event was supported by AIA Life Insurance and hosted by the Central University of Finance and Economics [1] Group 2: Keynote Speeches - Keynote speakers discussed various topics, including the evolution of health insurance, asset-liability management, and the role of actuaries [3][4] - Gong Xingfeng highlighted the need for health insurance to shift from scale pursuit to value cultivation and emphasized the importance of product innovation [3] - Peng Jihai pointed out the challenges faced by the insurance industry due to declining interest rates and the need for asset-liability rebalancing [3][4] Group 3: White Paper Release - A white paper on the high-quality development of pension finance in China was released, addressing issues such as insufficient total volume and structural imbalance [5] - The white paper proposes a "12345+10" implementation framework to guide the industry towards high-quality development [5] Group 4: Roundtable Discussions - The first roundtable focused on high-quality development paths under the "14th Five-Year Plan," with discussions on the role of actuaries in addressing longevity risk and supply shortages [6][7] - The second roundtable explored the collaboration between the insurance industry and artificial intelligence, highlighting the need for a systematic risk governance framework [8] Group 5: Future Directions - The forum serves as a practical implementation of the spirit of the 20th National Congress of the Communist Party of China, contributing to the construction of a financial power [9] - AIA Life Insurance will continue to support the development of actuarial education and research, fostering sustainable growth in the insurance industry [9]

Core Viewpoint - China Pacific Insurance has increased its insurance coverage for the 8th China International Import Expo to over 1.28 trillion yuan, marking its continuous support for the event over the past eight years [1] Group 1: Company Initiatives - China Pacific Insurance has entered the medical devices and healthcare exhibition area for the first time at this year's expo, aiming to showcase its contributions to the national health strategy and promote high-quality industry development [1] - The company plans to host a forum titled "Open Win-Win, Healthy Future - High-Quality Development of Group Commercial Health Insurance" during the expo, focusing on policy implications and development pathways [3] - A volunteer team from China Pacific Insurance, consisting of 40 members certified by the American Heart Association, is providing emergency services at the expo, ensuring safety for all participants [3] Group 2: Industry Trends - The importance of health insurance is increasing in line with the development of the health China strategy, with a new policy aiming for health insurance to play a more significant role in the national health security system by 2030 [2] - The policy emphasizes the collaborative development of group and individual health insurance, aiming to create a multi-tiered health security framework covering the entire population and lifecycle [2] - The policy encourages health insurance companies to explore differentiated development paths, focusing on health management and innovative business models to avoid homogenized competition [2] Group 3: Future Directions - China Pacific Insurance aims to continue its "open win-win" philosophy, collaborating with partners to deepen product innovation and service optimization, contributing to the high-quality development of China's health security [4]

Investment Rating - The report maintains an "Overweight" rating for the non-bank financial sector [1] Core Views - The insurance and brokerage stocks are expected to see valuation recovery driven by high earnings growth [1] - The non-bank financial sector has shown a mixed performance, with insurance leading in growth, followed by diversified finance and securities [8][9] Summary by Sections Non-Bank Financial Subsector Performance - In the recent five trading days (October 20-24, 2025), all non-bank financial subsectors underperformed the CSI 300 index, with insurance up by 2.99%, diversified finance by 2.70%, and securities by 2.02% [8] - Year-to-date performance shows insurance leading with a 14.47% increase, followed by diversified finance at 12.38%, and brokerage at 7.73% [9] Non-Bank Financial Subsector Insights Securities - Trading volume has increased year-on-year, with October's average daily stock trading volume at CNY 25,070 billion, up 12.07% from last year [13] - Margin financing balance reached CNY 24,510 billion, a year-on-year increase of 47.76% [13] - The average price-to-book (PB) ratio for the securities industry is projected at 1.3x for 2025 [23] Insurance - Major insurers like China Life and New China Life are expected to report significant profit increases for Q3, with China Life's net profit projected between CNY 156.8 billion and CNY 177.7 billion, reflecting a 50%-70% year-on-year growth [25] - The insurance sector is benefiting from regulatory support for high-quality health insurance development [31] Diversified Finance - The trust industry is experiencing a stable transition, with total trust assets expected to reach CNY 29.56 trillion by the end of 2024, a 23.58% year-on-year increase [34] - The futures market saw a trading volume of 770 million contracts in September, with a transaction value of CNY 71.50 trillion, reflecting a 33.16% year-on-year growth [38] Industry Ranking and Key Company Recommendations - The non-bank financial sector is currently undervalued, presenting a safety margin for investors [34] - The recommended ranking for investment is insurance > securities > diversified finance, with key companies including China Ping An, New China Life, China Pacific Insurance, CITIC Securities, and Tonghuashun [34]

Investment Rating - The report maintains a "Positive" investment rating for the investment banking and brokerage industry [7] Core Insights - Recent market enthusiasm remains high, with Q3 brokerage performance expected to continue its growth trend. The long-term ROE central tendency is anticipated to rise. In the insurance sector, the logic of deposit migration, increased equity allocation, and improved new policy costs is confirmed, leading to greater certainty in long-term ROE improvement and accelerated valuation recovery. Overall, the cost-performance ratio for investment is gradually increasing [2][4] Summary by Sections Industry Performance - The non-bank financial index increased by 2.7% last week, with an excess return of 0.7% relative to the CSI 300. Year-to-date, the non-bank financial index is up 6.9%, but underperforms the CSI 300 by 11.0% [5][17] Market Activity - Market activity has slightly declined, with an average daily trading volume of 21,876.96 billion yuan, down 5.43% week-on-week. The average turnover rate is 2.28%, a decrease of 17.11 basis points [5][39] Insurance Sector - In August 2025, cumulative insurance premium income reached 479.99 billion yuan, a year-on-year increase of 9.63%. Life insurance premiums grew by 14.05%, while property insurance premiums increased by 4.67% [21][25] Brokerage Recommendations - The report recommends stable dividend-paying stocks such as Jiangsu Jinzhong, China Ping An, and China Pacific Insurance, along with companies like New China Life, China Life, Hong Kong Exchanges, CITIC Securities, Dongfang Wealth, and Tonghuashun based on performance elasticity and valuation [4][6] Financing Activities - In September 2025, equity financing reached 41.634 billion yuan, a month-on-month increase of 86.6%, while bond financing totaled 8.11 trillion yuan, up 8.3% [50]

Core Viewpoint - The Financial Regulatory Bureau has issued guidelines to promote the high-quality development of health insurance, addressing the increasing demand for health protection and the need for industry reform [1][2]. Group 1: Background and Rationale - Health insurance is crucial for providing financial protection against health-related losses and is integral to the social security system, linking healthcare and economic stability [1]. - The growing demand for health insurance is driven by economic development and the Health China strategy, highlighting the need for improved service levels and product diversity [1]. - Existing challenges include a lack of product variety, insufficient industry capabilities, and inadequate collaboration with the healthcare sector, which hinder service enhancement [1]. Group 2: Drafting Approach - The guidelines aim to clarify requirements for different segments of health insurance, expand product offerings, and support the development of floating income health insurance [2]. - Emphasis is placed on strengthening the industry's foundation, enhancing digital transformation, and improving data utilization [2]. - The guidelines encourage specialized operations within health insurance companies and promote collaboration with the health industry to improve the accessibility of innovative medical products [2]. Group 3: Main Content - The guidelines consist of five main parts: overall requirements, deepening health insurance reform, enhancing sustainable development capabilities, strengthening regulatory oversight, and optimizing the development environment [3][4]. - Specific focus areas include commercial medical insurance, long-term care insurance, income loss insurance, and disease insurance, with plans for regulatory standardization [3]. Group 4: Future Work Arrangements - The Financial Regulatory Bureau will coordinate with other departments to create a favorable policy environment for health insurance development [5]. - There will be a focus on developing detailed regulations for floating income health insurance and ensuring compliance with the guidelines to meet public demand for quality health protection [5]. - Regulatory efforts will be intensified to combat illegal activities and protect consumer rights in the health insurance sector [5].