China Insurance Regulatory Commission, Measures for the Administration of Health Insurance

Promulgated: August 7 2006
Effective: September 1 2006
Interpreting authority: China Insurance Regulatory Commission (CIRC)
Applicability: The term "health insurance" refers to a type of insurance for which insurance benefits are paid by insurance companies to cover losses caused by health problems, in forms such as sickness insurance, medical insurance, disability income protection insurance and healthcare insurance (Article 2). In the event of a conflict between these Measures and provisions promulgated by the CIRC prior to the implementation of these Measures, these Measures shall prevail (Article 50).

Main contents: Life insurance companies and health insurance companies established in accordance with the law may, subject to verification by the CIRC, engage in health insurance business. Insurance companies other than the aforementioned ones may, subject to verification by the CIRC, engage in short-term health insurance business (Article 7). Health insurance products with a guaranteed renewal clause shall expressly stipulate the effective date of the guaranteed renewal clause. Health insurance products with a guaranteed renewal clause shall not grant insurance companies the right to adjust insurance liability or the scope of exemption from liability at the time of renewing the insurance policy (Article 20). Insurance companies may stipulate in medical insurance products that insurance benefits are paid on the condition that the insured party receives medical treatment from the network of designated medical service institutions (Article 23). Insurance companies selling health insurance products may not sell them on the premises of medical institutions, nor may they commission medical institutions or medical practitioners to sell the products (Article 26). Insurance companies engaging in the health insurance business shall, in accordance with relevant provisions of the CIRC, submit an actuarial report or reserve assessment report for the preceding year, stating in detail the computation basis, methods and results for health insurance reserves and the impact on the company's insolvency. The report shall be signed and confirmed by the person-in-charge of actuary in line with the principle of prudence (Article 35). Except for branches and sub-branches of reinsurance companies and branches of foreign insurance companies, branches and sub-branches of insurance companies may not engage in the business of reinsurance of health insurance (Article 43).
Related legislation: PRC Insurance Law (Amended), Feb 28 2009, CLP 2009 No.3 p.35 and Provisions for the Administration of Reinsurance Business