China life insuranceStudy, publicize and implement the 20th National Congress of the Communist Party of ChinaAs the primary political task and top priority at present and in the future, we must continue to strengthen the political and people-oriented nature of financial work, continuously improve the professionalism, and effectively shoulder the major mission of economic “shock absorber” and social “stabilizer” and lead the way. The industry actively serves national strategies and people’s livelihood protection. In order to vividly present the typical deeds and good style of front-line learning and implementation of the company, we launched “Study and implement the 20th National Congress of the Communist Party of China and embark on a new journey together“column gathers the strength of progress and encourages the whole system to contribute to China Life’s efforts to promote Chinese modernization with heart, emotion and effort.
“‘West Lake Yilianbao‘It’s great. I only spent 150 yuan and can be reimbursed so much. “Recently, Ms. Pang from Wushanqian Village, Cangqian Street, Yuhang District excitedly told the district medical insurance branch and the district medical insurance branch who came to visit her,”West Lake Yilianbao“Staff of the mutual insurance body.
Ms. Pang, 66, suffered a sudden acute cholecystitis in the first half of this year, which was later complicated by acute pancreatitis. She was hospitalized for nearly 4 months and the total medical expenses wereUp to 540,000 yuan.During discharge settlement, not only the medical insurance fund will be reimbursed300,000 yuanpreviously purchased “West Lake Yilianbao“A claim has been settled again.More than 150,000 yuanincluding the drug ceftazidime avibactam sodium, which was originally required to be paid for out-of-pocket, which reduced her out-of-pocket burden by more than half.
Similar stories have happened many times in Hangzhou over the past two years.
In recent years, the Party Central Committee and the State Council have promoted the implementation of “Healthy China“Strategic deployment, with the strong support of the former Zhejiang Banking and Insurance Regulatory Bureau, Zhejiang Provincial Medical Insurance Bureau and Hangzhou Municipal Medical Insurance Bureau, the Hangzhou Commercial Supplementary Medical Insurance was implemented by China Life Insurance Hangzhou Branch as the chief underwriting co-insurance body.”West Lake Yilianbao“The project was successfully launched. After nearly three years of development, it has initially formed”The government is promising,Market is efficient,People feel it“Huiminbao”Hangzhou model“.
Solve three major problems
Explore commercial medical insurance mutual wealth
“West Lake Yilianbao“Taking into account both the commercial attributes and the characteristics of benefiting the people, focusing on “Zero threshold,low premium,High insurance coverage,Excellent service”, focusing on solving three major problems.
Focusing on the connotation of common prosperity and inclusiveness,crack“Not allowed“”Can’t afford it“problem. “West Lake Yilianbao“There are no insurance conditions such as age, past medical history, health status, etc.; individual medical insurance accounts are allowed to pay premiums for themselves and their spouses, parents, and children. The premium for teenagers is per person per year.100 yuanother personnel are150 yuan; People in need are funded by the government to purchase insurance. In the three years from 2021 to 2023, a total of people with difficulties in purchasing insurance will be funded.More than 300,000 visitorsthe amount of government subsidiesReaching more than 46 million yuanlaying a good foundation for attracting citizens to participate in insurance extensively.
Adapt to the diverse health protection needs of common prosperity,crack“Incomplete protection“problem. “West Lake Yilianbao“Covering four-fold guarantee responsibilities such as supplementary insurance for serious diseases in the medical insurance catalog for hospitalization and prescribed outpatient medical insurance, supplementary medical insurance for self-paid drugs, diagnosis and treatment items and medical materials, medical insurance for specific tumors and critical illness, and insurance for rare disease drugs and drugs necessary for diagnosis and treatment. Medical insurance will be connected and supplemented. At the same time, “West Lake Yilianbao“We also insist on dynamic optimization based on the compensation situation, and with the support of regulatory agencies and medical insurance experts, we include urgent, difficult and anxious reasonable expense items that are concentrated among citizens into the guarantee, and continue to improve the level of product protection.
Practice the concept of common prosperity and convenient services,crack“Personal advance“”Claims legwork“problem. “West Lake Yilianbao“In terms of medical expenses for the first and second items of liability protection, it has been achieved at the medical institution end.”one stop shop“Claim settlement, projects covered by guarantee liability three and four can be done through “West Lake Yilianbao“WeChat official account, choose two methods to make claims: direct payment for scheduled drug purchase and subsequent reimbursement. 2021 and 2022”West Lake Yilianbao“Reduce the cumulative burden of medical expenses for people in need.About 80 million yuan.
Government-security cooperation continues to deepen
Realize administrative mechanism and market mechanism
Integration and linkage
“West Lake Yilianbao“The promotion and operation work is carried out under the guidance of the Hangzhou Municipal Medical Insurance Bureau, adhering to government guidance and market operation. Government departments play the role of guidance, support and supervision, and strengthen the construction of multi-level medical insurance systems and subsidize insurance participation from policy, business and Provide support to underwriting companies in terms of publicity and share data, “one stop shop“Provide service support in settlement and other aspects. And as”West Lake Yilianbao“China Life Insurance Hangzhou Branch, a member of the mutual insurance companies, takes the lead in implementing the main responsibilities in terms of product design, insurance mobilization, cost supervision, handling services, etc., and assumes risks for its own profits and losses, highlighting the role of the market mechanism.
In addition, China Life Insurance Hangzhou Branch actively participates in the daily publicity activities of the Hangzhou Municipal Medical Insurance Bureau, enriches the promotion model of health insurance products, strengthens the popularization of health insurance knowledge, and strengthens communication and collaboration with regulatory agencies and the Medical Insurance Bureau. At the same time, the branch has made great efforts in health management education, and has effectively enhanced the people’s awareness of medical security, risk prevention awareness and insurance purchase concepts through publicity activities such as claim settlement case introduction, knowledge popularization, service experience, and visits to enterprises and villages.
Compensation exceeded one million people in two years
Citizens’ burden of medical expenses for serious illnesses
With “Zero threshold,low premium,Wide coverage,Full treatment,Easy claims settlement“Innovative features such as these have been launched for more than two years,”West Lake Yilianbao“It has played an important role in building a multi-level medical security system in Hangzhou, preventing people from becoming poor due to illness and returning to poverty due to illness, and building a defense line for people’s livelihood security.
2021-2022,”West Lake Yilianbao“Total compensationMore than 1.2 million visitorsamountMore than 1.26 billion yuanthe number of direct beneficiariesMore than 150,000 peopleaverage loss ratioMore than 90%. It has effectively supplemented the scope of protection that is not covered by medical insurance, and gradually reduced the medical burden of patients with serious and serious diseases, which is in line with the needs of society, what Hangzhou can do, what the people hope for, and what the future direction is.
In 2021, Mr. Xu incurred total medical expenses due to liver cirrhosis.3.7645 million yuanmedical insurance and commercial insurance will reimburse itReaching 2.2809 million yuan,in”West Lake Yilianbao“to reimburse1.4207 million yuan; In the same year, multiple media reports aroused public concern about a certain twin brother suffering from a family disease.West Lake Yilianbao“Cumulative reimbursement for it2.4 million yuaneasing the financial burden on families.
More beneficiaries are citizens like Ms. Pang. The compensation amount may not be high, but it has truly reduced their medical burden. For example, Mr. Gong, an 86-year-old retired employee, needs high-cost innovative targeted drugs to treat leukemia, which “needs to eat a refrigerator a day.”West Lake Yilianbao“It reduces the medical burden by half; Ms. Wang, an employee in her 40s in Chun’an County, suffered a sudden cerebral infarction in 2022, and the total medical expenses during hospitalization were320,000 yuanmedical insurance reimbursement120,000 yuan,”West Lake Yilianbao“Reimbursement again50,000 yuanallowing her to receive treatment with peace of mind and be protected.
Enhance people’s “sense of gain”
Create the “golden business card” of Zhejiang Huimin Insurance
After more than two years of development, “West Lake Yilianbao“The project has received great attention and recognition from Hangzhou citizens and all walks of life. From 2021 to 2023, the number of insured persons in the project will beReached 4.7 million people,4.96 million people,5.17 million peopleannual premium scaleMore than 700 million yuaninsurance participation rateMore than 42%.
In addition to citizens actively taking out insurance, many companies and groups also take out group insurance.West Lake Yilianbao” to enhance protection for employees. Fuchunjiang Group, one of the top 500 private enterprises in China, has provided services for several consecutive years.More than 5,000 peopleLocal employees and their families in Hangzhou are insured”West Lake Yilianbao”, as an important part of building a community of shared future for enterprises and employees.
also,”West Lake Yilianbao“Since its launch, it has been recognized by the industry many times. In 2021 and 2022, it was selected for the “”Collection of excellent cases of multi-level medical security“; won the City Express Future Life Festival”Common prosperity Innovation guarantee” and other honors and hot media reviews; in 2022, it will be awarded with “Accurate guarantee,Improve the multi-level medical insurance system“Rated as Hangzhou City”The people call me“Best Practice Cases;” initiated by Sina FinanceNational Benefit Insurance Selection“In the activity, won the “Annual word-of-mouth Huiminbao product“; “”” jointly launched by China Banking and Insurance News, China Insurance and Social Security Research Center of Fudan University and Fubao Technology Co., Ltd.Golden word of mouth“Insurance product evaluation under review”West Lake Yilianbao“Won again”2022–2023 Golden Word of Mouth“Insurance product title.
As an inclusive commercial supplementary medical insurance product for the citizens of Hangzhou——”West Lake Yilianbao“With the joint promotion of the government, mutual insurance bodies, society and other aspects, the “Help each other,Poverty prevention and alleviation,Let’s get rich together“The new protection mechanism has effectively reduced the burden of major diseases on the masses and created a win-win insurance project with Hangzhou characteristics for the benefit of the people.”gold business card“.