Mutual treasure stops texting.

It is worth mentioning that while "Huimin Insurance" is developing rapidly, its sustainability also faces multiple challenges, such as the overall age of the insured population is low. In addition, at present, the dividend-paying treasure of "Huimin Bao" products is facing a loss dilemma in some cities. Whether it can really rise needs further testing by the market.

Huimin Bao explosive growth

According to public information, one year after Mutual Treasure was launched at the end of 20 18, the membership scale quickly exceeded 1 100 million. Among them, nearly 60% members come from third-tier and below cities.

Since then, with the influence of changes in the industry environment and other factors, following the closure of platforms such as 202 1 Meituan Mutual Assistance, Water Drop Mutual Assistance and Easy Mutual Assistance, Mutual Treasure also announced on February 28th, 20021that it will be held on June 28th, 2022 after careful consideration and discussion.

According to the latest information shared, the number of members of Mutual Treasure is nearly 75 million, and 7 1 mutual assistance has been completed, helping more than 179000 sick members.

After the network mutual aid platform gradually withdrew from the historical stage, Huimin Bao was regarded as a "receiver" by the industry.

Huimin Baoquan is called customized commercial medical insurance in the city, which is an inclusive supplementary medical insurance led by local governments and underwritten by insurance companies. Its positioning is to provide the second guarantee after medical insurance, which is mainly used to transfer the large out-of-pocket expenses of serious illness in medical insurance.

On 20 19 and 12, "Guangzhou Huimin Insurance" officially opened the era of "Huimin Insurance", and 20 19 was also called "the first year of Huimin Insurance". Since then, the urban universal medical insurance business has been carried out in many places, and many attempts have been made in product design, security responsibility, and the connection between commercial insurance and social medical insurance.

Taking Chengdu Huirongbao as an example, after the release of "Opinions of the Central Committee of the Communist Party of China on Deepening the Reform of Medical Security System" in March 2020, Chengdu Medical Insurance Bureau officially defined this kind of products as "social-business integration health insurance", clarified the government's responsibility, and provided non-fund resources such as data, publicity and policy support without using medical insurance funds, guided market participants to develop and design products, and enhanced the credibility and attractiveness of products to the public.

In addition to government resources, Chengdu clearly put forward the operation mode of separating operation from underwriting for the first time, that is, the "N+ 1" mode, in which "N" is a number of commercial insurance companies and "1" is a platform company. A number of insurance companies form a consortium, integrate industry forces, and jointly promote the expansion of population size with platform companies, while platform companies play the role of market-oriented medical insurance agencies.

In May 2020, Chengdu Huirongbao was launched in the first year. During the 50-day insurance period, 365,438+10,000 people participated in the insurance, with a population coverage rate of nearly 20% and an urban population coverage rate of over 30%. Personal insurance exceeds 3 million, more than five years accumulated in Shenzhen. In the first year, the number of participants ranked first in all projects, and it was not until Shanghai and Hangzhou began to be surpassed in 20021year.

Since then, the Huimin insurance model has officially opened the road to national popularization.

According to the data, as of 20021and 65438+February, Huimin Insurance had a total of 139 city-level products, covering 108 cities, and 25 provincial-level products (excluding Huimin Insurance products with unlimited coverage in the whole country), with an overall enrollment of about 86 million and a premium scale exceeding 86 billion.

It is found that the rate level of Huimin insurance products basically fluctuates between 29 yuan-190 yuan/year; The registration conditions are also kept as loose as possible: there are no age restrictions, occupational restrictions, no need for health notice, and fewer types of previous diseases. As long as they are local medical insurance participants, they can participate in insurance.

The reason for the rapid development of Huimin insurance is that its design idea is to build a new commercial health insurance system that is highly connected with social basic medical insurance to make up for the gap between social basic medical insurance and commercial health insurance. Before the emergence of Huimin insurance, social insurance and commercial insurance were highly separated. Huimin insurance, which has both policy and market attributes, has become an intermediate form connecting traditional social insurance and commercial insurance.

In the eyes of the industry, with the rapid popularization of Huimin insurance project in China, Huimin insurance products will continue to evolve with the efforts of all parties. Future products will not stay at the basic level of tens of yuan forever. Future product development may develop in three directions at the same time:

First of all, expand the protection of self-funded expenses, connect with basic medical insurance more deeply, and provide a safety net for people with serious diseases;

Second, it extends from claims service to disease management and health service. Disease management and health management are no longer regarded as service costs, but as necessary protection contents, which are included in insurance compensation expenses;

Third, through the establishment of the catalogue management of commercial insurance drugs and materials, the ability to pay for drugs is established, and the ability of commercial insurance to control fees is increased. In the case of controllable risks, combined with Shangbao's product supply capacity and sales system, Shangbao can achieve rapid development and simultaneously benefit the pharmaceutical industry chain.

There are multiple challenges.

While Huimin insurance is developing rapidly, its sustainability is also facing multiple challenges, such as the overall age of the insured population.

Take Shanghai "Huhuibao" as an example. By the end of May last year, the number of participants had reached 5.8 million, of which people over 50 years old accounted for more than 48%. Similarly, the average age of the insured such as "Ji" and "Jin" is over 48 years old; The average age of participants in Jincheng Bao Hui and Banghuibao is over 46.

At the same time, payout ratio, which benefits the people, is also rising. Zheng Bingwen, member of Chinese People's Political Consultative Conference and director of the World Social Security Research Center of China Academy of Social Sciences, said that there may be two extremes: the income can't meet the expenditure and the income can't meet the expenditure.

"If you can't pay the fees, it will be difficult for medical insurance participants to participate, or those who participate will not feel the benefits of Huimin insurance. With the passage of time, the number of people participating in Huimin Insurance is getting less and less, and it is logical to gradually withdraw from the historical stage. At the other extreme, if you lose money, the final result is that the commercial insurance institution will gradually withdraw because it is not a non-profit organization. In either case, if it develops to the extreme, it will eventually escape the end of failure. " Zheng Bingwen said.

202 1 to 1 Ye Yinfei, director of the Policy Research Bureau of the Bank of China Insurance Regulatory Commission, said that in general, the customized medical insurance projects in most cities are still in their infancy and have not yet experienced a complete insurance period. In payout ratio, this business is greatly influenced by the setting of project compensation conditions, local basic medical insurance policies and participation rate. At present, the risk of compensation is not fully exposed, and it is not ruled out that losses may occur in some areas in the future.

"It is observed that at present, except for Huimin Insurance in Shanghai, Guangzhou and Zhejiang, other cities have not publicly disclosed the losses of Huimin Insurance." Chen Mingdong, deputy general manager of Sipai Health, believes that the analysis of loss cases shows that the main reason for the loss comes from excessive government intervention in product design, and the operating mechanism of commercial insurance is obviously different from that of social insurance. In essence, Huimin insurance still belongs to the category of commercial insurance. Under the strong intervention of some local governments, market players have basically lost a set of capabilities such as sales and claims management and control. Therefore, it is urgent to establish a mechanism to clarify the responsibilities of all parties and coordinate the work of all parties in order to maintain the long-term sustainable development of the project.

Up to now, domestic mainstream insurance companies have all participated in it, including property insurance companies and life insurance companies; There are both national insurance companies and regional insurance companies, and third-party service providers are also deeply involved in the product design, promotion, operation service and system service of Huimin insurance project.

After a number of insurance companies poured into Huimin insurance track one after another, the market competition was further intensified, and even a number of Huimin insurance products appeared in a city.

In this regard, Chen Mingdong believes that there is indeed a situation in which one city has many products and market players quickly open the market. However, personally, multiple products in a city are a manifestation of normal market competition. As long as it conforms to laws, regulations and market rules, market competition is benign. Market competition improves social efficiency, which is beneficial to the people. The choice of the people is the best answer.