Life dataresearch report

”Research Report on “2020 summary and 2021 prospect” of huiminbao From Development Research Institute of Fudan University

The following is the ”Research Report on “2020 summary and 2021 prospect” of huiminbao From Development Research Institute of Fudan University recommended by And this article belongs to the classification: Life data, research report.

China Insurance and social security research center of Development Research Institute of Fudan University, together with Shanzhen · Haiwei, jointly released the Research Report “huiminbao’s past life, present life and future -” huiminbao’s 2020 summary and 2021 prospect “, which systematically reviewed the development process of huiminbao, and discussed in detail the trend of rapid promotion and explosive growth of huiminbao in 2020, as well as its development status, development trend and future The business model, and further look forward to 2021 huiminbao whether it can continue to develop and will show what characteristics.

Background of the report

As a new health insurance mode jointly promoted by the government, insurance companies and the third-party platform, Huimin insurance integrates the attributes of inclusive and commercial. Since the first “supplementary medical insurance for serious diseases” was launched in Shenzhen in 2015, Huimin insurance products have been rapidly promoted in 2020.

The trend of its rapid development benefits from the joint action of national policies and social needs. Over the years, China has continuously promoted the reform of medical security system and promoted the construction of multi-level medical security system. The Central Committee of the Communist Party of China and the State Council issued a number of documents to put forward specific plans and detailed ideas for the construction and reform of the medical security system.

Reviewing the development of China’s commercial health insurance in recent years, it is found that although this kind of insurance presents a trend of rapid development, the role of its compensation amount in medical expenditure is still limited. Therefore, while developing the traditional commercial health insurance, we should develop the commercial health insurance to meet the medical needs of Chinese residents, and effectively solve the problem of “difficult to see a doctor, difficult to pay medical expenses” It is an inevitable trend for commercial health insurance to develop new health insurance products with the problem of “expensive medical service”.

As an important exploration of inclusive insurance in the field of health management, Huimin insurance is not only a typical model of social business integrated health insurance, but also a new exploration to meet the needs of the current development of China’s medical security system. At the same time, the product’s low price and loose underwriting greatly improve the product’s universality, and the additional health management services of most of the people benefiting insurance are more conducive to building a health management network for residents and effectively ensuring their health and safety.

01. The emergence and development of huiminbao

Since 2015, the development of Huimin insurance has experienced three periods: germination, exploration and outbreak.

(1) Germination period: 2015

In December 2015, Shenzhen launched the “supplementary medical insurance for serious diseases”, which is the first customized medical insurance for specific cities designed and launched by Ping’an endowment insurance company under the guidance of Shenzhen municipal government. It is the rudiment of Huimin insurance products. From 2015 to 2020, the number of insured persons of the project will reach 4.86 million, 5.04 million, 6.25 million, 7.05 million and 7.52 million respectively, with the highest coverage of 50.4% of the total number of insured persons of the city’s basic medical insurance.

(2) Exploration period: 2015-2020

In the two years since Shenzhen launched the “supplementary medical insurance for major and serious diseases”, there has not been the current explosive growth trend in the Huimin insurance market. On December 17, 2018, Ping An health insurance company launched the Huimin insurance product in Nanjing to compensate for the hospitalization expenses in the medical insurance. Since then, the Huimin insurance products have shown a trend of Point City exploration, which provides the possibility for the subsequent explosive growth of Huimin insurance products.

(3) Outbreak period: after 2020

At the beginning of 2020, the Huimin insurance market ushered in a period of rapid growth, showing a trend of “blooming in many places and gradually sinking”. As of December 31, 2020, there are 111 products on-line in 82 regions of 23 provinces in China, with a total of more than 40 million people participating in the insurance and a premium income of more than 5 billion yuan. Under the explosive growth of Huimin insurance products, there are some regularity in the way of overall planning, rate setting, guarantee responsibility and participants

02. The first year of benefiting the people – 2020

(1) Development background: “strategic choice + people’s needs”

The rapid development of huiminbao in 2020 is the result of strategic choice and people’s needs.

The medical security system requires:

In October 2016, the CPC Central Committee and the State Council issued the “healthy China 2030” planning outline, which shows that the party and the state have always attached great importance to people’s health, and require the whole society to enhance the sense of responsibility and mission, and strive to promote the construction of healthy China. In March 2020, the CPC Central Committee and the State Council issued the “opinions on deepening the reform of the medical security system”, comprehensively establishing a medical security system with Chinese characteristics, reducing the burden of medical treatment, improving people’s livelihood and maintaining social harmony and stability. As a new business type of commercial health insurance, Huimin insurance is a typical model of social business integrated health insurance, an important exploration of improving the medical security system, and in line with the national policy requirements of improving the multi-level medical security system.

People’s health awareness and medical demand increase

With the improvement of people’s living standards, the medical demand is increasing, mainly reflected in people’s attention to medical care consumption. The percentage of per capita health care consumption expenditure in per capita disposable income increased from 5.0% in 2013 to 6.2% in 2019. The people’s medical demand increased year by year, and the personal health expenditure continued to rise. In addition, the people’s hospitalization expenses are also rising, so it is urgent to alleviate the growing medical expenses.

With the deepening of aging in China, the demand for medical insurance is increasing. The health status of the elderly is the most prominent problem in the process of population aging. However, most of the current commercial health insurance has strict age restrictions and health notification restrictions. The elderly people often suffer from all kinds of chronic diseases. As a special group with high prevalence, they are often unable to participate in commercial health insurance. Therefore, there is an obvious gap between the demand and supply of health security for the elderly.

In novel coronavirus pneumonia, the public health emergency in 2020 showed a rise in people’s health consciousness. The outbreak of the epidemic has greatly enhanced people’s attention to public health and safety, strengthened the awareness of health management and health risk prevention, and more and more consumers expect to disperse health risks by purchasing insurance.

The compensation pressure of national medical insurance fund is increasing

According to the “statistical bulletin on the development of national medical security in 2019” issued by the National Medical Security Bureau, from 2012 to 2019, the balance ratio of residents’ medical insurance fund has a significant downward trend, the national medical insurance fund is facing great compensation pressure, and the whole national medical system is also at risk.

The entry of commercial health insurance can relieve the pressure of medical insurance to a certain extent. However, due to the high threshold and many restrictions, the coverage rate of general commercial health insurance is still insufficient. It can effectively and reasonably connect the basic medical insurance and commercial health insurance, and increase the participation of commercial medical insurance. At the same time, it can make up for the compensation gap of basic medical insurance and relieve the pressure of medical insurance fund.

Therefore, as a product to fill the gap between basic medical insurance and commercial insurance, Huimin insurance is an important exploration to build China’s multi-level medical security system, which can meet the needs of residents to expand the level of security, upgrade health management, and reduce the threshold of insurance, and is of great significance to reduce the level of residents’ medical payment.

(2) Development characteristics: “specific mode”

In 2020, huiminbao has developed a unique product model and main body model, and the development situation is gratifying.

Product model: “low price + low threshold + high guarantee + additional service”

(1) Low product pricing

One of the characteristics of Huimin insurance is its low premium. Insurance products are based on risk loss and use the law of large numbers to determine the premium rate. Due to the different ways of overall planning, there are differences in the rates of various products“ Under the policy of “one city, one policy”, most of the people’s welfare insurance products have a unified price for all the insured, and most of the product prices are below 100 yuan. However, based on the differences in the coverage and underwriting liability of the products in different cities, the rate level of each product fluctuates from 29 yuan to 190 yuan per year. There are also products in individual cities that are priced by age. However, pricing by age is more common in the products of “one province, one policy” and “national insurable”. Huiguibao divides the age of the insured into three intervals, and sets three differentiated prices of 46 yuan, 66 yuan and 96 yuan per year. The National City benefit insurance also divides the age of the insured into three ranges, setting the annual price of 19 yuan, 39 yuan and 199 yuan. Generally speaking, whether it is “one city, one policy”, or “one province, one policy” or “national overall planning”, the price of the products is relatively low, which can cover all income groups, reflecting its “benefiting people” attribute. As far as consumers are concerned, the very low threshold of Huimin insurance fills the gap between the basic medical insurance and commercial health insurance, which not only makes the medical insurance supply side more diversified, but also provides consumers with more comprehensive protection.

(2) Low threshold of insurance

The “inclusive” nature of huiminbao also shows a very low insurance threshold. There is no age limit, no occupation limit, no need for health information, and there are few types of past diseases. All local basic medical insurance participants can be insured. This is also the most significant difference between Huimin insurance and pure commercial health insurance in product form.

For the consumer groups who are not in line with the health information but refused to be insured by ordinary commercial health insurance, and who have medical insurance needs but limited premium budget, Huimin insurance with low insurance threshold provides them with an appropriate compromise protection option, which can reduce the worries of individuals and families in terms of medical expenses.

(3) High level of security

As a kind of medical insurance, Huimin insurance mainly compensates for hospitalization expenses and specific drug expenses. The figure below shows the general insurance liability of the products of PICC. Huimin insurance mainly supplements the individual part after reimbursement of medical insurance, that is, the general inpatient medical care within medical insurance, some products can also guarantee the inpatient medical care and general outpatient service outside medical insurance, and most Huimin insurance products are added with specific high-value drug insurance.

As of December 31, 2020, a total of 102 products have compensated for the hospitalization expenses in the medical insurance catalog, and the insurance amount of hospitalization expenses in the medical insurance catalog is mostly more than 1 million. At the same time, Zhuhai, Foshan, Zhuzhou and other places compensate for the high medical expenses in the medical insurance catalogue, which can alleviate the pain of low amount of basic medical insurance coverage and limited coverage to a certain extent. The items and expenses outside the medical insurance catalogue are also an important expenditure for residents to see a doctor. The Huimin insurance products include the hospitalization expenses outside the medical insurance catalogue, proton and heavy ion detection expenses, self financed items of malignant tumor, and specific high drug expenses (as shown in the figure below). As of December 31, 2020, a total of 34 products have compensated for hospitalization expenses out of the medical insurance catalogue, 83 products have guaranteed the specific high drug expenses, Nantong, Shenyang and Shandong Qilu love insurance products have compensated for proton heavy ion testing expenses, Zhuhai has compensated for malignant tumor self funded projects and self funded drugs, and has made fixed payment for 10 kinds of serious diseases. It is of great significance for Huimin insurance products to extend the scope of protection responsibility to the medical insurance catalogue, so as to alleviate the “expensive medical treatment” of residents. However, it can be seen that the liability of Huimin insurance products for hospitalization expenses outside the medical insurance catalogue is still limited. In the future, the liability of Huimin insurance products should pay more attention to the compensation of expenses outside the medical insurance catalogue, so as to effectively relieve the pressure of residents to see a doctor.

In terms of the level of security, Huimin insurance also set a certain threshold in the deductible and reimbursement ratio. Among them, the deductible of inpatient security items is usually between 10000 and 30000 yuan, while the deductible of specific high-value drugs is less than 20000 yuan. There are great differences in the proportion of compensation for different security items. The proportion of compensation for hospitalization within the medical insurance is between 50% – 100%, while that for hospitalization outside the medical insurance is relatively low, between 50% – 80%. It will be adjusted according to the situation of medical treatment in different places, previous diseases, group participation, etc. In terms of the amount of insurance, compared with the basic medical insurance, the amount of insurance of Huimin insurance products is relatively higher. The amount of insurance of hospitalization items in medical insurance is basically more than 300000, and some products even have no top line.

 ( 4) New additional services

The additional health management service of Huimin insurance products is another major feature of Huimin insurance. At present, the vast majority of Huimin insurance products online provide a number of health services, including providing value-added services such as drug service, serious disease service, chronic disease service and physical examination service to the insured, so as to provide as much help as possible to the insured before, during and after diagnosis. These health services are relatively convenient to obtain. Usually, the service pages will clearly indicate the relevant services, and provide access to services in the health management service manual. Usually, only the appointment is made in the WeChat official account and other channels. The increase of health management service is the embodiment of the change of insurance company’s concept from ex post compensation to ex ante risk management, which helps to reduce the insurance company’s compensation ratio. In the long run, it is conducive to the improvement of the health awareness of the whole society and the realization of “healthy China 2030”.

Main mode: “government + insurance company + platform company”

Compared with the general commercial medical insurance, one of the important characteristics of the people’s welfare insurance is the participation of governments at all levels. The participants of Huimin insurance include the government, insurance companies, insurance brokers, health management companies and other market players. All participants provide different degrees of help for the product design, risk protection, product publicity and value-added services of huiminbao. On the one hand, it is conducive to the healthy development of huiminbao products and the integration of different industries. On the other hand, it also promotes the information sharing and cooperation between the government and enterprises, which is an important attempt of government enterprise cooperation to promote the development of commercial health insurance.

(3) Development status: “guarantee + claim”

(1) Number of insured population

The number of people participating in the insurance reflects the popularity of huiminbao in various places, and also determines the subsequent development of huiminbao products.

(2) Claim case description

With the development of Huimin insurance products, various regions have successively released Huimin insurance claims reports and many claims cases“ According to the official claim report of Guangzhou huiminbao, 277 people applied for claim settlement in the first quarter of 2020, with the maximum single claim of 35000 yuan. It takes only 9 hours for online claim settlement from application submission to claim payment. It is worth noting that in the first quarter of 2020, a total of 1236 insured people used product health management services. The health services can respond within 24 hours, and the processing time is within 48 hours, which is conducive to the construction of insurance companies’ risk management front and residents’ health management network. According to the claim settlement data in the third quarter of 2020, the total number of summary cases of the product has reached 3777, with a single maximum claim of 88700 yuan, accounting for 96% of the online claims. The average settlement time of the overall claims is 5.37 days, with a total of 9238 users“ According to the official claim briefing of Ningbo yonghuibao, since September 1, 2020, the maximum amount of compensation cases is 32000 yuan. The age of compensation ranges from 93 to 15 years old, which fully reflects the nature of huiminbao and the nature of huiminbao, and effectively reduces the medical burden of the public.

03. Future prospects of huiminbao — Analysis of 2021 trend

(1) Recent trends

In 2020, huiminbao products show explosive growth. At the beginning of 2021, huiminbao market still maintains a good momentum of development, and more than ten new products have been listed nationwide. In 2021, the market is expected to show three characteristics. First, the growth trend is still “horizontal spread”. At present, huiminbao products cover 179 cities in 82 regions of 23 provinces, showing a trend of diffusion from the first and second tier cities to other cities. This trend will continue in 2021, and the coverage will sink to the third and fourth tier cities, benefiting more people. Second, the product form tends to be general health insurance products. With the development of the Huimin insurance market, there are many kinds of Huimin insurance products in some cities and provinces, or there are many types of Huimin insurance products to choose from. However, these products show certain price gradients and differences in protection liability. Product liability is no longer limited to the basic form of Huimin insurance, and Huimin insurance products will gradually become the customers of insurance companies, How to realize diversified premium income. Third, specific inclusive health insurance increased. Since the development of Huimin insurance, there have been some subdivided products, such as “Huimin serious diseases”, “Huimin special drugs”, which can provide more targeted protection for groups with specific needs.

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