但在推行进程中，城市商业医疗险也暴露出诸多问题。一方面，产品定价不够精准。由于缺乏充分 可靠的疾病发生率、赔付率、费用率等历史数据支撑，部分产品定价难以实现风险与费率的有效匹配， 不仅影响了保险公司的可持续经营，还可能引发消费者对产品的信任度下降。另一方面，市场竞争秩序 混乱，部分保险公司为追求短期业绩，搞低价不正当竞争，甚至出现销售误导等不规范行为，扰乱了市 场环境，阻碍了城市商业医疗险的健康发展。 近日，金融监管总局发布《关于推动城市商业医疗险高质量发展的通知》，为城市定制型商业医疗 保险的经营行为立规矩，旨在确保其长期稳健发展。 与此同时，《通知》还着重强调维护市场秩序，明确规定保险公司应遵循公平竞争原则开展业务， 不得搞低价无序竞争，不得进行垄断性、排他性销售。这将促使保险公司从单纯的价格竞争转向提升产 品和服务的多样化水平，通过提供更优质、更个性化的保障方案与服务来吸引消费者，推动市场从粗放 式发展向精细化运营转变，营造健康有序的市场环境。 实现普惠保险的可持续发展，不能仅靠保险公司"让利"，还应完善建立考核评估机制与指标体系， 多方合力进一步激发市场活力。 城市商业医疗险作为普惠保险的典型代表，自 ...

近年来持续火爆的城市定制型商业医疗保险（俗称"惠民保"，以下简称"城市商业医疗险"）业务，迎来 新的监管规定。 7月31日，金融监管总局向各保险公司发布《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》）要求规范城市商业医疗险业务。《通知》从突出普惠定位，坚守商业属性，遵循保险规律， 强化产品管理，规范精准定价，维护市场秩序，提升服务能力、共建良好生态、注重统筹规划、加强监 督管理等多个角度全面规范城市商业医疗险业务。 业内专家普遍认为，城市商业医疗险在满足多样化医疗保障需求方面发挥了积极的作用，在一定程度上 缓解了人民群众面对高额医疗费用的负担。但在其快速扩张的过程中，这项业务也面临较大的可持续性 风险。此次《通知》出台强调遵循其专业规律和市场导向，有助于推动城市商业医疗险可持续健康发 展，保护保险消费者的合法权益。 北京大学应用经济学博士后朱俊生教授在接受《金融时报》记者采访时表示，《通知》首次以监管文件 形式对城市商业医疗险作出系统性定义和制度性引导，明确其作为基本医保的有益补充，在我国构建多 层次医疗保障体系中的功能定位。这不仅为同类产品的发展奠定政策基础，也为健康险行业的创新发展 提供了 ...

Regulatory Voice - The Financial Regulatory Bureau emphasizes the importance of disaster response and insurance claims services during the main flood season, urging relevant units to enhance resource investment and streamline claims processes to support affected areas like Beijing and Hebei [1] - The Financial Regulatory Bureau has issued guidelines for the sustainable development of urban commercial health insurance, focusing on inclusivity, product management, risk management, and market order [1] Industry Focus - The predetermined interest rate for traditional life insurance products has been lowered by 50 basis points to 2.0%, with the guaranteed interest rate cap for participating insurance reduced to 1.75% [3] - The insurance industry reported a total premium income of 3.74 trillion yuan in the first half of the year, a year-on-year increase of 5.04%, with life insurance premiums growing by 5.34% [4] - Property insurance companies reported a combined profit of 87.59 billion yuan in Q2 2025, a 68.08% increase year-on-year, with 63 companies profitable [5] Corporate Dynamics - Zhongyi Property Insurance has received approval to increase its registered capital from 1.3 billion yuan to 1.692 billion yuan [7] - China Ping An has appointed Wang Xiaohang as the Chief Technology Officer [10] - Qian Fang is temporarily assuming the role of chairman at Guolian Life Insurance pending regulatory approval [11]

Core Viewpoint - The National Financial Supervision Administration issued a notice aimed at promoting the high-quality development of urban commercial health insurance, emphasizing the importance of inclusivity, adherence to commercial principles, and compliance with insurance regulations [1] Group 1: Regulatory Guidelines - Urban commercial health insurance should highlight its inclusive positioning while maintaining its commercial nature and following insurance laws [1] - The notice mandates that insurance companies operate independently, with consumers voluntarily choosing to purchase insurance [1] - Companies are required to align premium collection with the level of coverage provided, ensuring a balance between expanding coverage and sustainable commercial development [1] Group 2: Consumer Protection and Product Management - Insurance companies must focus on the needs of target customers when defining insurance responsibilities and exclusions [1] - There is a requirement for enhanced management of product sales appropriateness, ensuring accurate communication of product functions and benefits to the public [1] - Companies must collaborate with sales channels to fulfill the obligation of explaining exclusion clauses, preventing misleading sales practices that exaggerate coverage or conceal exclusions [1]

国家金融监督管理总局31日向各金融监管局、保险业协会、各保险公司印发《关于推动城市商业医疗险 高质量发展的通知》，要求城市商业医疗险突出普惠定位，坚守商业属性，遵循保险规律，规范精准定 价。 据了解，城市商业医疗险即"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。近年来，城市商业医疗险在多地落地并快速 发展，满足人民群众多层次多样化的健康保障需求。 通知还要求城市商业医疗险规范精准定价。要遵循风险对价原则，实现差异化定价，原则上应当基于不 同群体的年龄、性别、健康状况等因素进行相应的责任分级或费率分组，不断提升产品和服务的公平性 和适配性。对于首次纳入保险合同的责任，应当基于历史经验数据和医疗、医保、医药等相关方提供的 基础数据，科学准确定价。 数据显示，2024年我国商业健康保险保费收入合计近万亿元，2025年上半年保费收入6223亿元，近10年 年均增速约20%，累计支付赔款2.6万亿元，目前还积累了超过2.5万亿元的长期责任准备金，将成为人 民群众未来健康保障的储备。 （文章来源：新华社） 通知明确城市商业医疗险应突出普惠定位。保 ...

Core Viewpoint - The issuance of the "Notice" by the National Financial Supervision and Administration aims to promote the high-quality development of urban commercial health insurance, emphasizing inclusivity, commercial attributes, product management, risk management, and market order [1][7][9] Group 1: Regulatory Framework - The "Notice" serves as an implementation and extension of the State Council's opinions on strengthening regulation and preventing risks in the insurance industry, marking a new phase for urban customized commercial health insurance [1][7] - It emphasizes the need for insurance companies to operate autonomously while ensuring that the insurance products meet the needs of the public for quality medical coverage [3][6] Group 2: Product Development and Management - The document highlights the importance of optimizing the supply of urban commercial health insurance products to include new medical technologies, drugs, and devices, ensuring broad coverage and reasonable premiums [2][4] - As of 2024, over 90% of "惠民保" products include specific high-cost drug claims, with the number of drugs covered increasing from 2021 to 2024, reaching 672 [2][8] Group 3: Pricing and Risk Management - The "Notice" mandates that insurance companies adopt precise pricing strategies based on historical data, ensuring that premium rates align with the level of coverage provided [3][5] - It encourages the establishment of a data-driven pricing and underwriting mechanism to enhance risk management capabilities across the insurance value chain [8][9] Group 4: Market Order and Consumer Protection - The document calls for improved sales practices, requiring clear communication of product functions and protections for consumer rights [6][7] - It stresses the need for fair competition among insurance companies, discouraging low-price, disorderly competition, and promoting diverse product offerings [6][7] Group 5: Industry Development and Future Outlook - The "Notice" is seen as a significant step towards refining the operational boundaries of urban commercial health insurance, transitioning from rapid growth to meticulous management [7][8] - It reinforces the role of commercial health insurance as a vital supplement to basic medical insurance, aiming to fill coverage gaps for high-cost medical expenses [2][7]

Core Viewpoint - The issuance of the "Notice" by the National Financial Supervision and Administration aims to promote the high-quality development of urban commercial health insurance, emphasizing inclusivity, commercial attributes, product management, risk management, and market order [1][7]. Group 1: Regulatory Framework - The "Notice" serves as an implementation and extension of the State Council's opinions on strengthening regulation and preventing risks in the insurance industry, marking a new phase for urban customized commercial health insurance [1][7]. - The document emphasizes the need for insurance companies to operate autonomously while ensuring voluntary participation from the public, aligning premium collection with coverage levels [3][6]. Group 2: Product Development and Management - Insurance products must be optimized to meet the quality medical insurance needs of the public, incorporating new medical technologies and drugs into coverage [2][3]. - As of 2024, over 90% of "惠民保" products include specific high-cost drug claims, with the number of drugs covered increasing from 2021 to 2024, reaching 672 drugs [2][8]. - The "Notice" requires precise pricing and regular reviews to guide the industry back to its core function of providing long-term value [1][2]. Group 3: Market Sustainability and Consumer Protection - The document stresses the importance of maintaining market order and commercial sustainability, prohibiting low-price, disorderly competition among insurance companies [6][8]. - It mandates that insurance companies enhance product sales appropriateness management and protect consumer rights by accurately explaining product functions [6][7]. Group 4: Risk Management and Data Utilization - The "Notice" advocates for a data-driven pricing and underwriting mechanism to improve risk management across the entire insurance chain [8][9]. - The collaboration between Pacific Insurance and Swiss Re highlights the growth of commercial health insurance claims in China, indicating its increasing importance in the multi-tiered medical security system [8][9]. Group 5: Future Directions - The regulatory framework for inclusive health insurance is clear and continuous, focusing on accessibility while ensuring the profitability of commercial insurance [9]. - The core task of commercial health insurance is to work alongside basic medical insurance to achieve overall social security goals, requiring significant efforts from insurance institutions [8][9].

《通知》提到，注重统筹规划，加强监督管理。各金融监管局要强化属地指导和监管责任，加强城市商 业医疗险可行性论证和风险评估，条件成熟的地区可探索推进并健全完善相关机制，条件不成熟的地区 不宜盲目跟风冒进。推动相关参与方准确把握商业保险与社会保险的区别，避免模糊或混淆二者的关 系，促进全社会形成合理保障预期。加强辖内城市商业医疗险项目统筹协调，推动业务经营及回溯分析 等信息共享，定期开展监测分析和业务总结，确保城市商业医疗险项目依法合规开展。保险公司违反监 管规定开展相关业务的，金融监管部门将依法采取监管措施，推动城市商业医疗险持续健康高质量发 展。 北京商报讯（记者 李秀梅）7月31日，金融监管总局办公厅发布《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》）。 ...

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]

Core Viewpoint - The notification emphasizes the importance of adhering to commercial attributes and insurance regulations in the development of urban commercial health insurance, promoting market-oriented and legal principles [1] Group 1: Principles and Guidelines - Urban commercial health insurance should follow market-oriented and legal principles, ensuring that insurance companies operate independently and that consumers voluntarily choose to purchase insurance [1] - Companies are encouraged to align premium collection with the level of coverage provided, balancing expansion and quality improvement with sustainable commercial development [1] Group 2: Industry Development and Consumer Satisfaction - The notification calls for standardized operations and honest services to promote healthy business development and enhance consumer satisfaction in the insurance sector [1] - Local insurance industry associations are urged to play a self-regulatory role, enhancing health insurance promotion and policy interpretation to build a trustworthy and warm image of the insurance industry [1]