(Source: Molecular Laboratory) Six years of tracking, decoding new trends in health and pension security. SHOUHUI GROUP, in collaboration with the Nankai University Finance Institute, released the sixth edition of the "Health and Pension Insurance Guarantee Index," marking their continued deep tracking of China's health and pension security system since 2019. From the popularization of health insurance to the implementation of the third pillar pension policy, and from product supply innovation to service system upgrades, this report not only records industry changes but also serves as a "scientific scale" for measuring guarantee levels and a "navigation map" for future guidance. The conference focused on "deepening multi-level guarantees, promoting the coordinated development of health insurance and the third pillar of pensions," bringing together regulatory bodies, universities, insurance companies, and industry capital. Key findings indicate that the total index for health and pension insurance guarantees in 2024 is 0.54, with the health insurance index at 0.62 and the pension guarantee index at only 0.47, highlighting pension protection as a notable shortcoming; commercial health insurance scale has surpassed 970 billion, with medical insurance and critical illness insurance being on par for the first time; the share of the third pillar of pensions is only 6.3%, significantly lower than the United States' 35%, indicating vast growth potential. Many guests reached consensus, emphasizing the need for collaborative efforts among politics, business, and academia to address aging populations and fill healthcare and pension gaps—pushing policies to enable data sharing between public and commercial insurance, innovating product models focused on dividends and longevity, building an "insurance + medical care" ecosystem in services, and leveraging technology to enhance efficiency, ultimately achieving a full-chain upgrade from payment to service. During the event, Professor Zhu Minglai, Director of the Health Economics and Medical Security Research Center at Nankai University, interpreted the report's core insights, revealing the state of the industry and future directions from four dimensions: "multi-level medical protection," "pension finance," "residents' needs," and "index results." The report's data covers the entire year of 2024 (macro data + micro research), providing the industry with dual value in "status analysis + future prediction".

1. Multi-Level Medical Guarantee System: Structural Transformation in Progress (1) Basic Health Insurance: Stable Enrollment but Pressure on Residents Enrollment Scale: By the end of 2024, the number of basic health insurance enrollees is projected to be 1.327 billion, with an overall enrollment rate stable but showing significant "structural divergence"—the number of employees enrolled in employee medical insurance steadily increases, while residents' medical insurance has declined annually for three years. The core reason: the "voluntary insurance" nature of resident's medical insurance, which affected some residents' participation due to "income pressure" from the economic downturn; coverage for the elderly and minors is insufficient, failing to meet high demand. Policy Response: The 2025 "Medical Security Law" will be introduced, transitioning from "voluntary participation" to "mandatory participation"; efforts to explore "personal account family mutual assistance" (allowing contributions from employee medical accounts to cover premiums for parents and children) began, with Hunan province already permitting "union dues to cover family members' medical insurance," which will gradually be promoted. (2) Commercial Health Insurance: Breaking Through the Scale, Structure Transformation Apparent Premium Scale: In 2024, commercial health insurance premiums are expected to reach 977.4 billion, with both life and property insurance companies actively contributing to sustained market expansion. Structural Change: For the first time, medical insurance and critical illness insurance are "on par"—previously, critical illness insurance accounted for 70%-80%, but the gap between the two is expected to be less than 10 billion in 2024 (in some statistical measures, medical insurance has already surpassed critical illness insurance), indicating a shift in "medical protection demand" from "one-time payouts" to "reimbursement-based coverage," matching residents' needs for "high-frequency medical expenses." Performance in niche areas: Inclusive health insurance: Over 170 such products nationwide, with a scale of 18-20 billion. Though limited, they serve as an entry point for commercial insurance—accumulating data through "low thresholds and broad coverage" for future product innovation (like "inclusive insurance + million medical insurance" combos); In August 2024, the financial regulator released "Standards for Urban Commercial Medical Insurance," further clarifying the supplemental role of inclusive health insurance, avoiding overlaps with basic health insurance. Critical illness insurance: Entering a "bottleneck period," with about 200 million enrollees, previously reliant on "savings and investment" selling logic which has been under pressure due to falling interest rates, the industry is exploring "dividend-type critical illness insurance" and "critical illness insurance + innovative drug add-ons" to remedy weaknesses in traditional products. Million yuan medical insurance: It needs to synchronize with the "commercial insurance directory"—in June 2024, the National Healthcare Security Administration and the National Health and Family Planning Commission jointly issued the "Commercial Health Insurance Directory," breaking basic health insurance payment restrictions (i.e., "three exclusions": commercial insurance directory drugs are not subject to the basic medical insurance payment scope, limited conditions, and reimbursement ratios), addressing the pain point of "hospitals being reluctant to use and customers unable to access" (e.g., in Heilongjiang, there were media issues where "commercial insurance reimbursed drugs could not be used due to basic medical insurance restrictions," which will be completely resolved through the "commercial insurance directory").

2. Pension Finance: A Breakthrough Needed for the Third Pillar (1) Imbalance of the Three Pillars: Significant Differences, Huge Space Comparing China's pension three pillars to the US (2024 data): (2) Three Major Directions of Pension Finance Pension Financial Products: Focus on coordinating the three pillars, exploring key connections between the second and third pillars—investments management model of corporate annuities (professional and long-term) can be replicated in individual annuities to address the pain points of uncertain investment returns; addressing the issue of small and medium enterprises without company annuities, researching integration of company annuity policies with third pillar policies to expand coverage. Pension Service Finance: Breaking through "single protection" by providing "financial management + services"—such as property split trusts for the elderly, fraud prevention consultations, and elderly home selection advice, addressing the pain points of "having money but no services" and "property safety"; collaboration between Nankai University and Tianjin State-Owned Assets Supervision and Administration Commission on "Intelligent Management of Pension Finance," utilizing AI to create "elderly customer profiles" for personalized service solutions. Pension Industry Finance: The financial sector supports the development of the pension industry, e.g., banks investing in pension institutions and insurance funds laying out pension communities (like Da Jia Insurance and Taikang), achieving a linkage between "heavy assets + light operations."

3. Resident Demand Survey: Upgrading from "Coverage Amount" to "Services" Professor Zhu Minglai's team, in collaboration with Xiao Yusan and Chuangxin Insurance, conducted online and offline surveys, identifying core needs for residents' health and pension security: (1) Demand for Health Insurance: Emphasizing "practicality," complementary roles of inclusive health insurance and million medical insurance. Core concerns: Consumers focus most on "deductibles (72%), reimbursement ratios (68%), and coverage scope (65%)," followed by the "amount of coverage," reflecting a "cost-effectiveness-first" decision-making process. Relationship between products: Inclusive health insurance and million medical insurance are not "replacement relationships," but rather "complementary relationships"—inclusive health insurance is "low-threshold, low-coverage," suitable for groups with "health issues, older age"; million medical insurance provides "high coverage, high deductible," ideal for "healthy populations"; together they cover different needs and will likely form a "tiered protection" system in the future. (2) Pension Demand: Those over 50 as the "weak link," with service needs outweighing monetary needs. Population differences: Pension security for those aged 25-50 is relatively high (stable income and strong purchasing power), while those under 25 (low income, weak awareness) and over 50 (high health risks, high premiums) are inadequately protected, especially the latter who strongly require care and assistance but have limited coverage from commercial insurance. Core demand: 68% of households expressed "willingness to pay for health management and medical care services," exceeding "pure monetary demands"—residents worry about being "wealthy but uncared for in old age"; the "care services" for the disabled or cognitively impaired elderly are the biggest pain point, necessitating a industry shift from the "payment side" to the "service side," creating a closed loop of "funds + services." (3) Awareness Differences: Education level correlates with guarantee awareness. Individuals with higher education levels have significantly better health and pension security than those with lower education levels. Cities like Shanghai rank highest in health insurance awareness nationwide (surpassing Beijing, Guangzhou, Shenzhen), making it the first choice for trials involving "collaboration between innovative drugs and commercial insurance," closely related to local economic status, education level, and healthcare resources.

4. Index Results: Pension Protection is a Notable Weakness, Requires Long-Term Optimization (1) Overall Index: 0.54, with health insurance outperforming pension insurance. The total health and pension insurance guarantee index in 2024 is 0.54 (top score 1), with the health insurance index at 0.62 and the pension guarantee index at 0.47, indicating that pension protection is a "notable shortcoming," illustrating "pension finance development lagging behind health protection." (2) Index Fluctuations: Normal phenomenon, requires long-term tracking. The index does not "continuously rise," experiencing slight fluctuations in recent years (e.g., 0.48 in 2022, 0.5 in 2023, and 0.54 in 2024), mainly influenced by policy adjustments (like "integrated reporting"), economic environment (growth rate of residents' incomes), and market changes (falling interest rates); this is a normal occurrence. Professor Zhu Minglai stressed: "The index requires over 10 years to validate long-term trends; as long as the overall trend is positive, short-term fluctuations should not be overly concerning." (3) Core Conclusion: The urgent need for the third pillar of pensions. The core reasons for low pension security levels: Firstly, the second and third pillars develop unevenly, with low coverage and significant differences in coverage amounts; secondly, marked differentiation among demographics, especially insufficient protection for those over 50 and those with lower education; thirdly, the residents' long-term security awareness is weak, with improved recognition of pension finance needed. Future developments require "policy guidance + product innovation + service integration" to accelerate the third pillar's growth.

Highlights from Guest Speeches: Tri-dimensional Breakthrough from Policy, Market, and Technology Fan Xiaoyun (Member of the National Committee of the Chinese People's Political Consultative Conference, Dean of Nankai University Finance Institute): Measurement is the starting point of management—academic support and industry responsibility behind the index. Dean Fan reviewed the six-year development of the index: "First released during Nankai's centennial celebration in 2019, it has become an industry 'navigation system.' Management guru Peter Drucker said, 'What cannot be measured cannot be managed.' The high-quality development of health and pension services must be grounded in scientific measurement." The institute has built a top domestic research team in health and pension insurance: the Nankai University Finance Institute has gathered the largest number of professionals in health and pension insurance in China, supporting over 20 national-level projects recognized by the State Council's Medical Reform Office and the National Healthcare Security Administration. Reinforcement of industry-academic-research integration: New master's programs in sci-tech insurance and technology transfer (financial support for the conversion of scientific achievements) have been introduced, promoting a closed loop of "academic research—policy advice—industry practice," particularly after the 2023 Central Financial Work Conference designated "pension finance" as a core direction supporting "five major financial initiatives." Industry Challenges and Breakthrough Strategies: The industry currently faces three major challenges: First, sustainability pressures on social security funds, requiring further consolidation of public confidence in pension insurance; second, a slowdown in residents' income growth impacting purchasing power for commercial insurance; third, regional development imbalances leading to significant discrepancies in protection levels. Breakthroughs need a collaborative effort involving "government, academia, and business": government to issue supportive policies, academia to provide theoretical backing, and financial institutions to innovate products and services to collectively tackle major issues.

Tian Hongzhen (Secretary of the Party Committee of Fosun Life): A "New Paradigm" in Pension Finance—Synergy of Products + Ecosystem. Tian Hongzhen's discussion centered on "The New Paradigm of Pension Finance in the Age of Longevity," combining Fosun's practice with proposed core ideas of combining "insurance products + ecosystem + services": "The third pillar in the US accounts for 30%, while China only stands at 6.3%, indicating vast space for growth." Market Trends and Customer Demands: Population structure drives transformation: By 2024, individuals aged 60 and above will exceed 1/5 of the population; family sizes decreased from 4.73 in 1973 to 2.6, with declining birth rates impacting traditional pension models; in 2020, urban employee pension insurance first recorded a "negative annual surplus," highlighting significant stress on the first pillar, necessitating urgent fortification from the second and third pillars. Evolving customer needs: Surveys indicate that residents’ demand for pension finance products has shifted from "capital protection and appreciation" to "cash flow + services"—both "regular pensions" and accompanying services, such as "health consultations, assister services, and nursing," with "having money without services" as the core anxiety. Renewal strategies: Empowering ecosystems with shareholder resources: Product innovation: Main offerings include "dividend-type pension annuities," providing floating returns while ensuring basic yields, tailored to downtrend interest rates; exploration of "critical illness insurance + innovative drug專項保障" to satisfy future demands of middle-aged and older adults relying on innovative medications. Ecosystem layout: Building five ecosystems anchored within Fosun Group’s three pillars of "health, happiness, and affluence": health sector providing caregiving and top doctor referral services; wellness sector with a national network of seven active eldercare communities; the travel sector linking with the Mediterranean Club and other global resources, offering "retirement + travel" services, creating a "unique" retirement experience.

Wang Xiuwen (General Manager of Beijing Life): The "three pivot points" to achieve high-quality development in health insurance—Inclusive, Unique, and Service. Focusing on health insurance, Wang Xiuwen shared Beijing Life's practices. Market Aspect: In recent years, the premium scale of commercial health insurance has hovered around 900 billion, with premiums accounting for less than 20%. Commercial insurance payments represent only about 4% of total healthcare expenditures, with less than 10% for innovative drug payments, indicating great potential for expansion in health insurance markets. New Policy Opportunities and Industry Pain Points: Clear regulatory guidance: The "Guiding Opinions on Promoting High-Quality Development of Health Insurance," issued at the end of the third quarter, explicitly advocate "full coverage for all populations and during all life stages, encouraging the development of dividend critical illness insurance and long-term medical insurance," aiming to make health insurance more inclusive, accessible, and sustainable. Promoting collaboration between health insurance and pharmaceuticals, allowing pricing for health management services by health insurance companies to break traditional constraints, providing broader space for industry innovation. Pain points in the industry await resolution: Medical and critical illness insurance, as major health insurance types, face developmental challenges. Medical insurance remains primarily short-term and unstable in renewals, with an industry claims ratio of around 40% considered low; the proportion of critical illness insurance dropped from over 60% in 2020 to around 40% by 2024, signifying a visible decline. Falling interest rates expose the disadvantage of long-term critical illness insurance "low leverage"; currently, disability and caregiving insurance premiums account for only about 10% of the health insurance market, revealing significant inadequacies in market supply and business scale. Practical Paths: The three pivot points address inclusivity first: In 2020, Beijing Life launched "Jinghui Insurance," initially covering 1.5 million people; it has year after year been the sole new company involved in the "Beijing Affordable Health Insurance Co-Insurance Scheme," which has recently surpassed 4.3 million total participants, necessitating ongoing focus on insuring "the elderly and children." Remarkable Differentiation: Collaborating with Xiao Yusan for "Big Yellow Bee Critical Illness Insurance," focusing on the child demographic with goals of providing early, thorough, and comprehensive coverage, currently, clients aged 0-4 years and with lifelong coverage represent over 80%, with average coverage exceeding 400,000, far surpassing industry averages; the company also partnered with the National Children's Medical Center and Beijing Children's Hospital on "Leukemia Recurrence Research," exploring critical illness insurance development in specialized areas. Service Integration: In 2022, the company established a Healthcare Technology subsidiary, investing in care centers, and developing "Jing Kang Suiyue" caregiving insurance providing care fund integration with eldercare community services; exploring new models for "health insurance data + commercial insurance direct compensation," launching the "Good Medicine Worry-Free Policy" covering 124 types of cancer specialty drugs and 428 brand-name original drugs, enabling "data direct access, rapid reimbursement." Wang Xiuwen concluded by emphasizing the proposed "Guiding Opinions on Promoting High-Quality Development of Health Insurance" is very advantageous for the health insurance sector. While enriching product supply, the industry must also focus on service system construction, critical for the high-quality development of health insurance. "Protecting people's health" has become a new mission for health insurance, making health insurance more accessible, affordable, and effective remains a steadfast goal for the industry, with an anticipated new model of high-quality development in health insurance characterized by "service warmth, guaranteed robustness, and resilient growth."

Zheng Changyong (Temporary Chief Financial Officer of Da Jia Insurance Group, Party Secretary of Pension Insurance): The "Scarce Value" of Urban Elderly Care—Practicing the Third Pillar of Pension. Zheng Changyong illustrated the path to establishing the third pillar of pensions through Da Jia Insurance's "Urban Elderly Care" model: "Elderly care shouldn't involve 'building communities in remote areas', but should be 'close to hospitals, near children, amidst human connections'—this reflects customers' genuine needs and our core advantages." Pension strategy: linkage of liabilities + investments + ecosystem: Ecosystem: Building three product lines—"urban medical and care + travel + homecare" across 16 urban communities in 14 cities, located near top-tier hospitals and children’s residences; community occupancy rates in Beijing and Tianjin exceed 95%, becoming "scarce resources"; in the future, secured residency rights will be available only to "qualified policyholders," encouraging long-term pension planning. Liabilities: By the first half of 2025, new pension premium income targets 20 billion, a year-on-year increase of 74%, with urban policies comprising 49% and a notable proportion of high-net-worth clients; the age of policyholders has increased to 80, with over 60% being female, reflecting "gender differences in pension planning." Investments: Maintaining a "conservative primary" approach, investing in long-term national bonds (30-year term) to cover liabilities, including high-dividend stocks and REITs; quantitative investment yields an annualized return of 32.64%, contributing to floating yields from dividend insurances, with comprehensive returns on investment at 4.6% in the first nine months of 2025, exceeding the industry average. The innovations in products and services for Da Jia's pension: Product Iterations: Partnering with Xiao Yusan on the "Yang Duoduo Series" (now in its 7th iteration), combining "fixed income + dividends"—fixed income products lock in long-term rates, while dividend products distribute over 70% of distributable profits. Service Extensions: Providing "health management + medical support," including green channels, appointment scheduling, and accompaniment services; connection to offshore medical, trusts, and study overseas planning, satisfying high-net-worth clients' diverse needs; leveraging the group’s 1 trillion asset management scale, ensuring "long-term stable returns" for pension funds, boosting client confidence.

Guangyao (Founder, Chairman, and CEO of SHOUHUI GROUP): From "Transaction" to "Service"—The Evolution of the Insurance Ecosystem and Industry Insights. As one of the index initiators, Guangyao shared SHOUHUI GROUP's practices and thoughts on the industry: "Beginning in 2019 solely focusing on health insurance research, transitioning in recent years to include pension insurance, we have witnessed an explosive demand—the gaps in medical and pension services present opportunities for commercial insurance." Core industry insights: Product structures adjust with interest rates: Throughout the downtrend in interest rates, life insurance products are migrating from "interest-based" to "dividend-based floating returns," and the industry must gradually adapt to this transition; the "integrated report" supervision initially pressures the sales side (bank insurance, agency, individual insurance), but is beneficial for long-term standardized development. Marked gaps in medical and pension needs: Constraints in basic healthcare and pension protections produce essential lacks, particularly as the policy benefits of the third pillar of pensions continue to be released; diseases correlated with age (such as cancer and Alzheimer's) necessitate both "financial reserves + service support" for dual protections, which are the industry's focal points. Corporate Practice: Establishing a closed loop of "sales + risk control + service": Service Upgrades: Creating "SHOUHUI Meichuang" risk control subsidiary, developing AI underwriting and claims settlement tools; introducing "Small Claims Fast Payment, Major Claims Cooperative Payment" services, enabling clients' small claim reimbursements through licensed assay surveyed by the insurance company upfront, resolving "slow claims processing" problems; further depth is anticipated in "post-service" sectors, shifting from "selling insurance" to "family risk management." Additionally, Huang Long, General Manager of Chuangxin Insurance Sales Co., announced the branding upgrade for the company—Chuangxin Insurance Sales Co. is set to rename itself "SHOUHUI Insurance Agency Co., Ltd." Huang Long indicated: "This name change not only revitalizes the image but also is a vital part of the group's overall strategic coordination. 'SHOUHUI' literally means 'skilled hands returning health,' symbolizing our commitment to safeguard every family's health and hope with professionalism and warmth. In the future, we aim to offer users superior products and services under the name 'SHOUHUI,' becoming a crucial part of SHOUHUI GROUP's strategic layout."

4. Consensus Among Guests: This conference saw various guests (regulators, universities, enterprises) share different perspectives yet come together in strong consensus on the future direction of the industry, summarizing into "Four Major Action Guidelines": 1. Policy Coordination: Breaking down "data + payment" barriers to release dividends. Data sharing: Fostering data synchronization between basic health insurance, commercial insurance, hospitals, and pharmaceutical entities utilizing the national healthcare insurance "1+3+N" system (1 major data platform + 3 major healthcare insurance modules + N kinds of supplementary guarantee), resolving commercial insurance's "difficult underwriting, slow claims" issues, providing supports for product pricing and risk control. Payment breakthroughs: Implementing the "three exclusions" principle under the commercial insurance directory, ensuring that drugs and services under the directory are not constrained by basic health insurance, allowing customers to "access and be reimbursed well"; expanding tax incentives to cover affordable pension health insurance and personal pension products with increased tax support, reducing residents' purchase costs. Regional Pilot Programs: Supporting cities like Shanghai and Tianjin in conducting trials for "synergies between commercial insurance and innovative drugs" and "pension finance," compiling lessons learned for national rollout while avoiding "one-size-fits-all" strategies. 2. Product Innovation: Focusing on "long-term + segmentation," adapting to changing needs. Health Insurance: Developing long-term medical insurance to address "renewal instability"; promoting dividend critical illness insurance to balance "protection and yield" against declining interest rates; creating "niche demographic products," such as medical insurance for the elderly, critical illness insurance for children, and health insurance for women, targeting "weak groups." Pension Insurance: Parallel development of fixed income and dividends: Fixed income products lock in long-term interest rates, applicable for risk-averse clientele; dividend products offer variability, fitting clients aiming for long-term growth; integrating service rights: pension annuity products linked with "entry rights to eldercare communities" and "nursing services," alleviating worries of "having money without services," illustrated by Da Jia Insurance’s "Urban Protection Plans" and Fosun's "Care Rights." Cross-Industry Integration: Exploring combinations like "health insurance + innovative drugs," "pension insurance + trusts," and "inclusive health insurance + million medical insurance," fulfilling diverse demands. 3. Service Integration: Building the "insurance + healthcare" ecosystem to fill service gaps. Medical service integration: Collaborating with hospitals, examination institutions, and pharmaceutical companies to deliver "preventive-treatment-rehabilitation" full-cycle services, as observed in Beijing Life's "leukemia recurrence research + insurance" and Fosun's "top doctor referrals"; in-home elderly care: developing home-care devices and on-site nursing services, addressing needs of the elderly unwilling to enter communities; seasonal retirement: linking global resources for "seasonal retirement" offerings like Fosun's Mediterranean Club collaboration project. Standardizing services: Establishing industry standards for health and elderly care services, covering caregiver qualifications, service processes, and fee standards, preventing inconsistent service quality. 4. Technological Empowerment: Enhancing efficiency and experience, reducing costs and increasing efficiency. Frontend: Developing AI underwriting tools, simplifying premium processes, such as SHOUHUI GROUP's intelligent underwriting system, lessening barriers for customers with health issues; Mid-end: Creating "customer profiles," employing big data analysis to meet client needs with personalized recommendations, like the "intelligent profile of pension finance" study by Nankai University and Tianjin’s State-Owned Assets Supervision and Administration Commission; Backend: Optimizing claims service, promoting "Fast Reimbursement" and "Direct Reimbursement," like SHOUHUI GROUP's "Small Claims Fast Reimbursement," and Beijing Life's "healthcare data direct reimbursement," addressing "claims difficulties and delays"; Risk Control: Employing big data to identify "insurance fraud" risks, lowering sector payout costs, ensuring market sustainability.

5. Conclusion: Building a New System for Health and Pension Guarantees. On May 30, 2025, SHOUHUI GROUP successfully listed on the Hong Kong Stock Exchange (stock code: 2621.HK), marking its formal entry into the international capital arena. Six years of diligence—from observers to builders, from data research to ecological practices, the "Health and Pension Insurance Guarantee Index" jointly developed by SHOUHUI GROUP and the Nankai University Finance Institute has become a benchmark in China's health and pension security landscape. As SHOUHUI GROUP's founder, Chairman, and CEO Guangyao articulated: "Six years of index research is not just about data accumulation; it extends responsibility. SHOUHUI aims to use technology and research to provide insights for the industry and create value for society." Currently, China is at a critical juncture of "deepening population aging," "policy dividend releases," and "rapidly upgrading demand;" building a health and pension guarantee system concerns the happiness of millions of families and the achievement of Chinese-style modernization. "Though paths may be obstructed and long, progress will be made if we persist." In the future, ongoing collaboration among regulatory bodies, universities, insurance companies, and industrial capital is essential for transitioning the guarantee system from "multi-level" to "high-quality," ultimately achieving the goal that "everyone enjoys health security and happily spends their golden years."