Core Insights - The report highlights the transition of China's "惠民保" market from "incremental expansion" to "stock optimization," indicating a shift towards high-quality development after ten years of rapid growth [1][2][6] Market Dynamics - As of July 31, 2025, a total of 313 local "惠民保" products have been launched, with 202 currently in stable operation, marking a significant evolution from non-existence to a well-established market [2] - The operational product ratio has seen a decline of approximately 7.5 percentage points from 2023 to 2024, which narrowed to 1.2 percentage points from 2024 to July 2025, indicating a maturing elimination mechanism within the industry [2] Product Development - New "惠民保" products are emerging with a "dual-driven" development approach, expanding coverage to broader regions while innovating existing products to enhance protection [3] - Traditional "惠民保" products dominate the market, accounting for over 80% of the share, while innovative products are increasingly being introduced to invigorate the market [2][3] Pricing and Responsibility - The pricing mechanism is evolving from a uniform pricing model to a more scientific and fair differentiated pricing model, with the average price of products rising from approximately 60 yuan in 2021 to 95 yuan currently [4] - The design of coverage responsibilities is becoming more personalized, with 70 products offering two versions and 7 products offering three versions, allowing consumers to tailor their coverage according to their needs [4] Special Drug Coverage - On average, each "惠民保" product covers 41 special drugs and 28 indications, with over 80% of basic traditional products including special drug responsibilities [5] - The report emphasizes the importance of addressing challenges such as rate determination, setting reasonable exclusions, and risk prevention for the sustainable operation of these products [5] Regulatory Environment - The recent guidelines from the financial regulatory authority stress the need for "惠民保" to maintain its inclusive positioning while adhering to commercial principles and insurance regulations, which will guide its high-quality development [5][6]

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].