Hold the pen of finance, and draw a picture of the common prosperity of the river and the land

The country pioneered the "optional premium method" serious illness insurance system, with a maximum reimbursement of nearly 2.6 million yuan, and the number of people in difficulty such as the extremely poor, the subsistence allowance and low-income people, who paid more than 50,000 yuan for medical expenses, gradually decreased, and established a third-party supervision center to effectively build a new pattern of medical insurance fund supervision led by the government and with the participation of multiple subjects...... Looking back on the past, the Zhejiang Branch of Chinese Life Insurance Co., Ltd. (hereinafter referred to as "Chinese Life Insurance") is full of "new strength", highlighting the new pattern of high-quality development of Zhejiang's insurance industry.

As a large state-owned financial and insurance enterprise, Chinese Life Insurance Zhejiang Branch takes the initiative to undertake the responsibility mission of protecting people's livelihood and serving the society, continuously promotes the quality and expansion of inclusive insurance around the people's "urgent and difficult expectations", continuously improves the ability of inclusive financial services, integrates social responsibility into the whole process of enterprise development, effectively plays the functions of economic shock absorber and social stabilizer, and enhances the people's sense of gain, happiness and security.

Innovate the system and improve the quality and coverage of inclusive insurance

"In 2024, the number of people who choose to pay for 'Golden Benefit' will continue to increase by 80,000 at last year's high to 4.94 million, with an insurance participation rate of 93.5%. The relevant person in charge of Chinese Life Insurance Jinhua Branch said that the company focuses on "government promising, commercial insurance undertaking, and social co-governance", and pioneers the "optional premium method" serious illness insurance system in the country (renamed "Jinhuibao" in 2022), achieving 100% coverage of low-income personnel, people with special difficulties, students and other groups, and contributing to Jinhua's construction of a "national medical insurance city".

In the past, the basic medical insurance treatment of urban and rural residents in Jinhua was generally low, and the counties (cities) had different serious illness insurance policies, premiums, and treatments, and the synergy between the policy and the basic medical insurance was not strong, and the system design was relatively passive, and there were problems such as unbalanced and insufficient basic medical insurance treatment, ununified and insufficient protection of the serious illness insurance policy, weak policy synergy, and systematic system had not yet been established.

In 2018, Chinese Life Insurance Jinhua Branch and Jinhua Medical Security Bureau and other government departments gave full play to their respective advantages and added an "optional payment" module - 100 yuan per copy and up to 3 copies for residents on the basis of everyone paying the basic premium of serious illness insurance. According to the number of selected shares, the level of treatment and protection is different: if three copies have been selected and paid for three consecutive years, the starting line is 6,000 yuan, and the reimbursement amount is not capped, and the reimbursement ratio is 85%.

Mr. Chen, a citizen, is the beneficiary of the largest single reimbursement amount since the implementation of Jinhua Jinhuibao. Due to liver malignancy, he will incur a total medical expense of more than 3 million yuan for hospitalization in 2022, and finally reimbursed 2.569 million yuan after three consecutive years of selection and payment, superimposed on basic medical insurance and gold benefit. As of the end of December 2023, the system has reduced the burden of 7.584 billion yuan for 645,300 seriously ill patients in the city, and the number of voters has reached 4.94 million, with a vote rate of 93.5%, of which the three voters account for 80% of the voters.

The large coverage and high reimbursement ratio have attracted more and more Jinhua citizens to participate in the insurance and choose to pay 3 copies. There is more and more money in the fund pool, and the medical insurance department has more ability to optimize the scope of reimbursement, and the ability to resist risks continues to increase...... which forms a virtuous circle and allows the golden benefit insurance system to operate healthily and sustainably. The relevant person in charge of the Jinhua Medical Security Bureau said that everyone gathered firewood and the flame was high, "Under this system, it can be said that Jinhua people have helped each other to improve their medical security level." ”

Adhering to the original intention of "insurance for the people" with practical actions, establishing the service tenet of benefiting the people with financial services, and accelerating the development of inclusive financial business, the inclusive financial insurance products and services of Chinese Life Insurance Zhejiang Branch have continuously innovated, extended and expanded to farmers, urban low-income people, the elderly, new employment forms of employment and other people, and gradually built a diversified inclusive insurance product system.

Innovative services, intentions to deliver financial temperature

"I didn't expect to get such a high claim, thank you. Recently, Liu Jingfu (pseudonym) listened to the staff of Quzhou Ankang Insurance explain the claim plan, and thanked him again and again.

Lau King Fu is a flexible worker who is engaged in cargo delivery and handling. On January 31, Liu Jingfu was accidentally injured when transporting a batch of wooden doors to a villager's home in Ying'an Village, Fenglin Town. After an on-site visit by Chinese Life staff, it was confirmed that Liu Jingfu met the conditions for compensation and paid a total of 988.88 yuan in insurance benefits. "I have only been insured for 5 months, and the premium is only 90 yuan, but I didn't expect to have nearly 1,000 yuan of insurance money. Liu Jingfu said with emotion.

"Since the beginning of this year, nearly 13,000 people in our city have participated in the 'Quzhou Ankang Insurance'. According to the staff of Quzhou Human Resources and Social Security Bureau, Quzhou Ankang Insurance can disperse the economic risks of employers and flexible employees, reduce the probability of them falling into poverty due to injuries and returning to poverty due to injuries, which is of great significance for further weaving a dense social security safety net.

In the inclusive financial insurance security system, the "last mile" claims service is directly related to the people's sense of identity and sense of access to financial services and the guarantee yearning for a better life. Liu Jingfu's case is just a microcosm of the innovative service of Chinese Life Insurance Zhejiang Branch and the intention to convey financial temperature.

Li Dongzhao is the women's director of Yanglong Village, Dongyang City, and after being hired as the "Anxin Medical Insurance Commissioner" of China Life in 2023, she actively promoted "Jinhuibao" and rural inclusive insurance such as commercial health insurance and accident insurance to the villagers around her, and organized a total of 12 publicity activities, directly serving more than 200 people. In her opinion, inclusive insurance is very important for every family, "I also feel that my work is very meaningful".

Chinese Life Insurance Jinhua Branch, the Municipal Medical Insurance Bureau and the Municipal Service Management Office jointly issued a document to set up a safe medical insurance commissioner in the city. Relying on the company's township service platform, we have established a team of more than 1,000 "peace of mind medical insurance specialists" with "policy and grassroots", with the goal of "full coverage and no dead ends", to carry out services such as "entering the countryside" for political security services, "entering 10,000 homes" for policy publicity, "entering the grid" for fund supervision, and "entering the home" for care and condolences, so as to build a solid livelihood guarantee, narrow the gap between urban and rural areas, help rural revitalization, and strive to enhance the company's brand image and influence. The company also cooperated with the Jinhua Municipal Medical Insurance Bureau and the Municipal Management Office to launch the work of "peace of mind medical insurance into 10,000 homes". In 2023, a total of 812 medical insurance specialists will be recruited (selected from the existing government affairs agents), and after the company's unified training and guidance, the commissioners will hold more than 1,160 peace of mind medical insurance lectures and insurance policy publicity activities in the service area, serving more than 10,000 urban and rural residents on site.

Innovative measures to strengthen financial supervision

The medical security fund is the people's "money for medical treatment" and "life-saving money". Strengthening the normalized supervision of the use of medical insurance funds is of great significance to ensure the safe operation of the fund, improve the efficiency of fund use, standardize the behavior of medical services, and reduce the burden of medical treatment for the masses.

Guided by innovation, Chinese Life Insurance Zhejiang Branch optimizes the supervision method of medical insurance funds, implements normalized supervision, strengthens information intelligent monitoring and social supervision, and further weaves a dense medical insurance fund supervision network.

Improve the mechanism guarantee and build a solid foundation for smooth operation. Strengthen risk sharing, improve the profit and loss sharing mechanism, and clarify the sharing mechanism for the surplus or loss of commercial insurance companies after the expiration of liquidation in accordance with the principle of "balancing income and expenditure, and guaranteeing small profits" in premiums, and strive to achieve sustainable operation.

Strengthen the team guarantee and create a professional management model. Establish a service team for critical illness insurance projects. Set up a serious illness insurance management center at the city and county levels, and "co-office" with the two-level medical insurance institutions to improve the efficiency of handling and ensure the realization of "unified undertaker, unified fund management, and unified fund accounting". Establish a third-party supervision team. Establish a third-party supervision center for the medical insurance fund to assist the medical insurance department in carrying out on-site audits, on-site inspections and other work, and guard the "life-saving money" of the masses.

Optimize technical support and improve project service quality. In the policy design stage, the Chinese Life Insurance Headquarters, provincial and municipal companies jointly set up project service teams to carry out actuarial work such as rate calculation and treatment analysis, and established actuarial models based on the experience of underwriting commercial health insurance, which provided a reference for government departments to formulate policies. During the implementation of the policy, the company continued to do a good job in fund supervision and data analysis, comprehensively understood the actual effect of the project through data, and timely controlled the dynamic changes of fund income and expenditure, so as to provide a basis for policy adjustment.

"We have cooperated with government departments to carry out data collection and analysis, preset protection levels, measure per capita premiums, determine payment targets, and implement preferential policies to expand the scope of the system, closely focusing on the goal of smooth operation of the system, and successfully expanded the scale of financing in the first year. The relevant person in charge of the Zhejiang Branch of Chinese Life Insurance said that in addition, the company also regularly conducts operation analysis, timely grasps the income and expenditure, provides a reference basis for policy adjustment, greatly increases the initiative of project fund balance, and effectively builds a new pattern of medical insurance fund supervision led by the government and with the participation of multiple subjects.

With high-quality financial and insurance services, we can better solve the most direct and practical problems that the people are most concerned about, and continue to contribute to the high-quality development of the insurance industry in New Zhejiang. According to statistics, the Zhejiang Branch of Chinese Life Insurance serves more than 30 million customers, and will provide more than 30 trillion yuan of life insurance risk protection in 2023.

The country is picturesque, and the present is better than the past. In the future, Chinese Life Insurance Zhejiang Branch will implement the spirit of the Central Financial Work Conference and the Central Economic Work Conference, closely focus on the goal of building a financial power and the construction of "Healthy China", continue to promote the high-quality development of inclusive finance, help Zhejiang "two firsts" with the power of finance and insurance, and be a pioneer, leader and demonstration in Zhejiang's promotion of common prosperity and Chinese-style modernization.