Nearly 100 million people have participated in the "Huimin Insurance" which has gone through a policy cycle. Some people think that it is very affordable, while others think that "the compensation is lower than expected".
How can the iteratively upgraded "Benefiting the People's Insurance" be more beneficial to the people?
Experts said that it is necessary to accurately meet the needs of the insured and ensure the sustainability of the operation
reading tips
As a kind of internet celebrity insurance that has swept across the country, "Huimin Insurance" has brought more expectations to the people in the process of upgrading from version 1.0 to version 2.0.
Does it perform as expected after one policy cycle?
How much do the people benefit?
The reporter's investigation found that to ensure the sustainable development of "Benefiting the People's Insurance" with low price, high quality and low profit, joint efforts of many parties are still needed.
"No age limit, no occupation limit, no need for physical examination" "49 yuan for a year, with a maximum reimbursement of 2 million yuan"... As a form of supplementary medical insurance, coupled with government support, it is known as a city of "Benefiting the People" The customized commercial medical insurance has been widely concerned and welcomed by the public as soon as it was launched, and the cumulative number of insured people has reached nearly 100 million.
Since the pilot launch of the first "Huiminbao" product in Shenzhen in 2015, there have been hundreds of products on the market.
Recently, many places have successively carried out iterative upgrades to the "Benefiting the People's Insurance" products, moving in the direction of being more beneficial to the people.
However, after experiencing the "honeymoon period" with the insured, problems such as the participation rate, loss rate and homogeneity of "Huimin Insurance" gradually emerged, and gradually entered the "run-in period" and "adjustment period".
Insureds look forward to product upgrades and improvements to better meet health protection needs.
Nearly 100 million people participated in the "Huimin Insurance"
"The elderly in their 80s can also participate in the insurance, and we will consider 'repurchase'." Ms. Wei from Beijing told reporters that in September last year, she purchased "Beijing Pratt & Whitney Health Insurance" for her whole family. The premium is 195 yuan per person per year, and the guarantee period is from January 1 to December 31, 2022.
Although there is no need to file a claim for the time being, she still thinks this product is very affordable.
"Huiminbao" refers to urban customized commercial medical insurance, which is mostly led or guided by local governments, underwritten by commercial insurance companies, and voluntarily participated by consumers.
"Beijing Pratt & Whitney Health Insurance" is the third "Benefiting People's Insurance" product in the Beijing area. Previously, there were "Beijing City Huibao" and "Beijing Jinghui Insurance".
In the past two years, "Huimin Insurance" has been rapidly rolled out in many places across the country, and the insurance fee ranges from 20 yuan to 200 yuan.
The data shows that as of December 2021, more than 200 prefecture-level cities in 27 provinces across the country have launched hundreds of people-benefiting insurance products, with a total of nearly 100 million people participating in the insurance.
"'Huimin Insurance' has no age requirements, no occupational requirements, and no health notification for the insured. Usually, as long as they have participated in the local medical insurance, they can participate in the insurance." Liu Ye, an insurance agent of AIA, introduced to the reporter. Said that this protection is very friendly to groups who are older, cannot participate in commercial medical insurance, and have pre-existing conditions.
The reporter combed and found that at the end of the year and the beginning of the year, the "Benefiting the People's Insurance" in many places is being advanced from version 1.0 to version 2.0.
After the iteration, the insurance coverage, deductible amount, and guarantee liability have been improved.
The upgraded version of "Guangzhou Huimin Insurance" has expanded the number of insured people, and those who have lived in Guangzhou for more than 30 days can also participate in the insurance; "Spring City Huimin Insurance" and "Changzhou Huimin Insurance" have reduced the deductible Amount; in many places, "Huiminbao" has increased the types of special medicines and provided value-added services. The types of special medicines in "Shaoguan People's Insurance" have increased to 36, and the types of special medicines in "Chuncheng Huiminbao" have increased by 17 and there are two types. Drugs for rare diseases.
Various compensation situations and different standards
At present, “Huimin Insurance” in many places has or is about to go through a complete policy cycle, and many insureds have experience in claim settlement.
Ms. Wu, 49, suffers from chronic cardiac insufficiency and hypertrophic cardiomyopathy. She was admitted to the hospital in July last year due to aggravation of her condition. During the hospitalization, she spent 188,500 yuan, and the medical insurance (including serious illness) reimbursed 122,700 yuan.
She participated in the "Hui Rong Insurance" and received another 37,000 yuan in compensation.
"Not only are the premiums affordable, but continuous participation in the insurance can pay more, and will continue to participate in the insurance in the future." Ms. Wu said.
But there are also many insureds who said that the amount of compensation is less than expected.
"I thought that all medical insurance reimbursements could be reimbursed, but in fact not all self-funded items can be reimbursed." "Pulmonary nodule surgery cost more than 100,000 yuan, and can only pay more than 7,000 yuan"... Some insureds are insured for a cycle Later, I think that the probability of getting a claim is very low, and the willingness to renew the insurance is not strong.
In response to the insured's questions, some people in the industry pointed out that the insured should have a correct understanding of "Benefiting the People".
Although "Benefiting the People's Insurance" has an inclusive nature, it is not an "all-in-one" guarantee.
It is a supplementary medical insurance that connects with the basic medical insurance. It is low in price and limited in cost. In order to maintain operations, it will set a certain deductible and a limited scope of liability, which cannot be compared with the coverage of commercial insurance.
The "Research Report on the Development Model of "Huiminbao" shows that the role of "Huiminbao" products is mainly reflected in the compensation for high medical expenses. The higher the medical expenses, the stronger the protection ability.
In order to ensure the loss rate, many places have carried out analysis and calculation in the design of the "Huiminbao" project, and have continued to improve it.
In October 2021, Zhejiang Provincial Medical Insurance Bureau and Zhejiang Banking and Insurance Regulatory Bureau jointly issued the "Notice on Further Promoting the Construction of Commercial Supplementary Medical Insurance to Promote Common Prosperity Demonstration Zones", requiring the actual capital compensation of "Huimin Insurance" to reach the agreed compensation rate. More than 90%, the treatment coverage must also reach a certain proportion, and the compensation liability and threshold line should be adjusted in time, which once again clarifies its business philosophy of "guaranteeing capital and small profits".
Stable and far-reaching, benefiting more insured
Low price, high quality and low profit "Huiminbao", its sustainable development has always been the focus of attention of all parties.
How to make good policies run steadily and benefit more insured people?
Experts believe that insurance is based on the law of large numbers, and risk diversification is more effective only when the "pool" is large enough.
To this end, the participation rate should be guaranteed first.
Sun Jie, a researcher at the National Institute of Openness and Economics at the University of International Business and Economics and the deputy dean of the School of Insurance, believes that if young healthy people lose their motivation to renew their insurance because they can't get compensation, they will always be actively renewing their insurance, which will lead to a constant loss rate. Climbing, affecting the long-term sustainable operation of the product.
To this end, she suggested that it is necessary to clarify the qualification standards of business participants, improve mechanisms such as break-even subsidies, cross-regional services and settlements, and performance evaluations to ensure the long-term sustainable operation of the "Huminin Insurance" project.
In order to encourage more people to buy "Huimin Insurance", in practice, many places have adopted the method of paying premiums with individual medical insurance accounts.
Zheng Bingwen, director of the World Social Security Research Center of the Chinese Academy of Social Sciences, found that the areas where individual accounts are opened have a higher participation rate, and the areas that have not opened the insurance coverage rate are relatively low, with the lowest being only 0.8%.
He suggested that policy support for "Huimin Insurance" should be increased, allowing and encouraging the use of employee medical insurance personal accounts to pay premiums and increasing the insurance participation rate.
In addition, Sun Jie reminded that while increasing the requirements for the loss rate and guarantee liability, the business enthusiasm of the insurance company must also be taken into account.
She suggested to build a data and information sharing platform to open up information exchange channels between traditional medical institutions, basic medical insurance and commercial insurance institutions, for the precise pricing and iterative evolution of "Huiminbao" products, as well as "Huiminbao" and other commercial The insurance protection optimization combination provides data support to better provide accurate protection for the insured.
Our reporter Zhao Chen