Revised health insurance regulation takes effect on 1 Dec
Source: Asia Insurance Review | Dec 2019
The CBIRC has issued its revised health insurance regulation that for the first time provides for health management services. The guideline covers medical reimbursement, critical illness, accident and health and long-term care products.
The regulation, ‘Health Insurance Management Measures’, that takes effect on 1 December, encourages the development of long-term health insurance and big data applications. The measures, set out in nine chapters, also stipulate requirements for health insurance operations, development and design of health insurance products, filing approval, sales activities and claims management.
A CBIRC spokesman says that given the rapid growth of health insurance in China in recent years, there is a need to strengthen supervision and hence the related regulations have been updated as the last set of rules dated to 2006.
Long-term health insurance plans
Among the changes, the measures allow insurers to adjust premium rates for long-term medical insurance but they have to indicate clearly the conditions which would trigger rate adjustments. The CBIRC recognises that insurers have been reluctant to market long term health insurance products because of the risk that, over time, environmental, technological and other changes could affect costs. Incidence rates for diseases and illnesses could also change. Thus, allowing insurers to adjust rates means risk sharing between insurers and consumers.
The new rules also raise the cap of the net premium covering the cost of providing the non-insurance health management services – such as health checks and risk assessments – to 20% from 12%. This will effectively expand the scope of health management services that insurers can provide along with health insurance products. A
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