Source: China Securities News
This article is transferred from: China Securities News
“Phenomenon -level” products bloom in many places
Huiminbao needs to take good inclusiveness and commercial “balance wood”
● Our reporter Huang Yiling
Urban customized commercial supplementary medical insurance (referred to as “Huimin Insurance”) will make another explosion.A few days ago, the Shanghai 2024 version of Huimin Insurance’s “Shanghai Hui Insurance” insured window was officially opened. The number of insureds in 2 hours was exceeded one million, which was 6 hours earlier than the same period last year.
A reporter from the China Securities Journal noticed that since 2020, Huiminbao has sprung up in the country. Most of them have been undergoing government guidance and underwriting commercial insurance companies., Yue has become the top of the insurance industry.After many years of operation, the price -priced and inclusive benefits have not suffered a large area of losses, and have received more attention from pharmaceutical companies and medical institutions, and the special medicine directory has continued to expand.As of 2023, more than 90%of Huiminbao products include special drug responsibilities. Tumor innovation drugs listed in China are the core drugs for Huiminbao.
At the time of development, “Internet celebrities” Huiming Bao also continued to face the test of “death spiral”.In the context of challenges such as unspeakable duration and relying on government support to a greater extent, it has achieved sustainable development into a must -answer.At the moment, how to take into account both inclusiveness and commerciality is the biggest test facing benefiting people’s insurance. Between the two, benefiting the people’s protection needs to take a good “balance wood” to ensure the scope of responsibility, the insured rate, the compensation rate, the insured person, the insured person.The sense of gain is the key indicators.
● Our reporter Huang Yiling
Promoting the responsibility upgrade in many places
On April 23, the 2024 version of Shanghai, Xiamen, and Dongguan was launched.Among them, the Shanghai 2024 edition of Huimin Insurance “Shanghai Huibu” performed hotly on the first day of launch. The number of insureds in the insurance window opened only one million in just 2 hours, which was 6 hours earlier than the same period last year.
In the 2024 version of Shanghai Huibao, on the one hand, it originated from the “expansion and increase” of guarantee responsibilities.It is reported that the amount of insured in Shanghai in 2024 remains unchanged, but the basic deductible amount has been reduced from 16,000 yuan/year in 2023 to 12,000 yuan/year in 2024. Customers who have been insured for two consecutive years or more are even more unreasonable.Low.At the same time, the types of special medicines at home and abroad are increased, and health rights are added to meet the needs of the daily mild medical care of the insured.
These changes do attract some consumers.Ms. Li, who worked in an Internet company in Shanghai, said, “Because I have allocated millions of medical insurance, I have never purchased Shanghai Hui Insurance.Decided to insure, just to ask for a doctor on the Internet and buy some medicine on the Internet. “
“After the settlement of medical insurance last year, I spent a little bit of my own expense, and there was no enough compensation line for 16,000. This year I did not intend to renew the insurance.Anyway, Mr. Luo Luo, another insurance consumer in Shanghai.
On the other hand, a number of insurance companies have jointly increased the promotion of Shanghai Huibao.The 2024 version of Shanghai Huibao still adopts the form of common insurance, which is underwritten by China Tai Bao Life Insurance.Home insurance company shall jointly underwriting.Generally speaking, insurance companies’ own traffic and sales capabilities can contribute more insured people to Huimin Bao products.On the first day of Shanghai Hui Insurance, the reporter found that the relevant staff of the insurance companies underwriting were “sip” in the circle of friends.”Our employees all have indicators to be completed, and the indicators of different personnel are different. Like my general indicator is three -digit, if it is not completed, the missing one will be deducted by a few yuan, and then a certain number will double.”Huhui Insurance’s joint insured unit insiders in the insurance company revealed.
As the largest Huimin insurance product in the country, Huhui Insurance’s “play” in recent years represents the industry trend to a certain extent.According to incomplete statistics, the new 2024 version of the 2024 version of Huimin Insurance has been upgraded in many places in the country, including reducing the amount of compensation, the types of extension of the special medicine, the increase in guarantee quota, increasing value -added services, etc. At the same time, it provides continuous insurance participation in insurance insurance.Preferential treatment and unreasonable claims and preferential treatment, improve the continuous insurance participation rate of healthy people.In terms of operation, most of the multi -factory products are adopted by the joint insurance underwriting model, that is, multiple insurance companies to form a co -insured body. On the one hand, this model can gather multi -party forces, and on the other hand, it can diversify risks.
Improving the insurance rate has become the main difficulty
Looking back at the road of Hui Minzhong’s development, it has gone through four stages: budding, exploration, outbreak and standardized development.According to the industry data obtained by the China Securities Journal reporter, as of 2023, my country has launched a total of 243 Hui Minfu products, with a total of 168 million people participating in insurance, with a premium of about 19 billion yuan.
From the perspective of overall operations, although most Hui Minzhong products are still operating healthy, since 2023, many benefit civilian products have gradually adjusted, optimized, and even withdrawn.This also means that as the market has entered a stable advancement period, Huimin Baozheng stood at the “crossroads” of transformation and upgrading, and the challenge of “death spiral” has become increasingly appearing.The so -called “death spiral” is a cycle that leads to the ultimate failure of insurance products. It is reflected in Huimin Insurance’s operating products. A major result is that it cannot pay for money.
The reason for the fact that the insurance fund pool is insufficient, and the insurance participation rate is not high enough.Insiders believe that if Huimin Bao wants to develop sustainable, the number of participants must be sufficient, and the scale of the capital pool needs to be large enough. It maintains a sufficient participation rate and renewal rate.mechanism.
Related data show that the participation rates of benefiting civilian insurance products in various places are very different. The first year’s insurance rate in some areas is between 1%and 15%, and there are even less than 5%in areas with low insurance participation rates.In addition to developed cities, most of the participation rates in Huiming’s products are limited.”In the process of practice, we have unwritten consensus within our practice. If the insurance participation rate is not higher than 30%, it is difficult to say that this is a inclusive project.” A person insiders who have participated in the people who benefit people in many places onceTell reporters.
Longge, deputy director of the Innovation and Risk Management Research Center of Foreign Economic and Trade University, holds similar views. He believes that the main difficulty of most provinces and cities Huimin insurance products lies in improving the participation rate. “At presentBelow 15%, there is still a lot of room for improvement.
Because of this, the longitudinal expansion of the existing benefits of Huimin Bao products is replacing the horizontal expansion of new Hui -private products, and rarely launched in new cities in new cities.It can be said that the core issues facing benefiting the Minzhong are no longer how to promote it to more regions, but how to really benefit more people.According to the “Connotation, Status, and Sustainable Development” released by China Shishou Insurance last year, “According to our observation of multiple projects, although the total number of participants is generally stable, there are still 20%-30%of each year.The crowd withdraws, which requires the bodies to pay more costs to get new customers to make up for the retreat. “
How to get new customers?Layered operations have become keywords.Sun Jie, deputy dean of the Insurance College of the University of Foreign Economics and Trade, said that he supports the upgrade of Huiminbao.On the basic model, in response to the development of high -guarantee upgrade products for different types of people, emphasizing “foreign coverage of medical insurance” to meet the multi -level guarantee needs of the insurance participants, and expand the special medicine directory.In addition, it is the top priority to attract health groups such as young people. The current general approach to the market is to improve the sense of gain of healthy people by providing health management services and related value -added services other than products.People from the one -life insurance company believe that in the future, behind the improvement of young people’s participation and activity, it is necessary to further build a digital empowerment and scientific and technological support.
Maintain a reasonable compensation rate
In addition to the participation rate, the compensation rate is also a major issue in the industry. Too low payment rate or too high will make the development of Huimin insurance products unsustainable.
It is reported that most of the compensation rates for benefiting civilian products are not high, which is less than 50%.Longge analyzed that “most of the projects are too low to announce the claims data because the compensation rate is too low, and the project with a high compensation rate is more willing to announce the relevant situation.70%.The China Securities Journal reporter learned that some regions have requirements for Huimin’s payout payable. If the payment rate is low, the responsibility adjustment and historical claims will be traced on the product, which will be traced on the “high” compensation rate.
But at the same time, the compensation rate of individual projects exceeds 100%.If the compensation rate has exceeded 100%for many years, insurance companies must face losses.What is the reason for the high compensation rate?According to Longge, if the previous symptoms and high -age groups (50 years of age or 60 years old) account for too high proportion, and the proportion of past symptoms and reimbursement is not appropriate, it is likely that the payout rate is too high, even more than 100%, direct directly, direct directly, directlyIt affects the enthusiasm of the Sports Company.
The relevant person in charge of a insurance company in East China bluntly said, “Insufficient compensation rate, the insurer’s sense of obtaining a significant reduction will be greatly reduced, which will affect the enthusiasm of continuous insurance.It will cause the unsustainable business. Therefore, how to balance this relationship is the key.The level, to protect the capital, and at the same time, we will also take out the balance of past products to support the insurance of some special groups (low -income groups, difficult groups) to ensure the sustainable development of inclusive insurance. “
In order to maintain a reasonable compensation rate, the relevant person in charge of Huimin Bao comprehensive service operator Magnesium Health Health believes that “what should be paid by the Huimin Insurance Insurance Fund Pool (delineate the scope of payment), how much (control payment price) and how to pay (control payment price) and how to payPayment (control payment behavior): for example, for medical services and drug consumables for medical insurance for foreign medical insurance, the management mechanism of the commercial insurance catalog should be established to enable the payment of Huimin Insurance Funds Pool to pay more clinical application value, excellent efficacy, price, price, priceReasonable drugs and medical services.Realize precision risk control, cost reduction and efficiency. “
Balance multi -party interests
Regardless of the responsibility for upgrading the guarantee or maintaining a reasonable compensation rate, the starting point is to improve the insurer’s sense of gain, and then realize the sustainable development of benefit of private private insurance.At the same time, the interests and demand of important participants in the private protection market in insurance companies also need to be guaranteed.
Generally speaking, there are many considerations for insurance companies to enter the field of Huimin Insurance: First, Huimin Bao is a new insurance type. The layout of insurance companies can seize the market share, and even use Huimin Bao to achieve “curve overtaking”; second,In the context of the government and supervision strongly, the participation of insurance companies can both bear social responsibility and increase premium revenue; third, insurance companies can obtain people including the Sinking market, the elderly, etc.Related data, and then “two -open” (second development) products.
“For small and medium -sized insurance companies, especially small and medium -sized property and insurance companies, Huimin Insurance is a good business type. Layout Huimin insurance existing premium income, can also maintain existing customers, and may also achieve micro -profit.”Grand blunt.However, because Huiminbao is a model of government and business integration, some products have a micro -commercial attribute.In this regard, the State Administration of Finance and Administration and the State Medical Security Bureau have solicited opinions on the “Notice on the Solid and Order of the Urban Customized Commercial Medical Insurance (Draft for Opinions)” (hereinafter referred to as the “Notice”) to various insurance companies.Clarify the functional positioning of Hui PICC, emphasize that Hui Minzi insurance should adhere to market operations, government guidance, and adhere to the independent operation of insurance companies and negatively profit and loss.
From the perspective of the market, this new regulations clarify that Huiminbao has strong business attributes and will enhance the enthusiasm and motivation of insurance companies to continue to participate.At the same time, the “Notice” also proposes solutions for multiple pain points of Huiminbao’s long -term healthy development. For example, for data acquisition difficulties, the “Notice” clearly clarifies that the local medical insurance departments should be explored under relevant premise and principles.During the design period of the plan, it provides some basic medical insurance presidential data to the insurance company to be involved in the application period to determine the insurance liability and determine the insurance rate.
