Right 2: The insurance policy can be transferred to another company for free, without paying any fees. In order to facilitate users to choose products, the Measures stipulate that the insured can transfer the insurance policy to another insurance company free of charge after the end of the medical expenses risk protection responsibility period, and the insurance company shall not force or force the insured to change insurance companies in disguise. If the applicant surrenders his insurance, he shall pay preferential tax to the tax authorities, and the insurance company shall pay the tax for the withholding agent. Insurance companies can underwrite the re-insurance after surrender.
Right 3: The purchase of personal tax excellent commercial health insurance shall not be bundled with other commercial insurance products. According to the regulations, insurance companies should follow the principles of giving priority to protection, reasonable pricing and low-profit operation when designing such products. When promoting personal tax premium health insurance, the public shall not be misled, the scope of protection shall not be narrowed or exaggerated, and other commercial insurance products shall not be tied up by force. Instead, health management services should be provided for the purpose of improving the health level of the insured and reducing the incidence rate, and the contents and methods of health management services should be clearly defined in insurance products. The "Measures" also pointed out that medical examination expenses should not be included in health management expenditures.
Right 4: Individuals can log on to the commercial health insurance information platform to inquire about information. In order to facilitate management, the CIRC has organized and developed a unified commercial health insurance information platform for the whole industry, which is connected with the insurance company system and accepts the inquiry and audit of the tax authorities, so as to facilitate individuals to inquire about their policy status. Specifically, the platform has the following functions: supporting underwriting, claim settlement and transfer of personal tax-excellent health insurance business; Submit relevant statistical data to the insurance regulatory authorities; Support the tax authorities to test the authenticity of policies and preferential tax use quotas; Can provide self-service policy information and account information inquiry service for policyholders; Other duties as stipulated by China CIRC.
Followed by five considerations:
Note 1:
Including "mid-range medical care+personal account accumulation", with different purposes. According to the current product design, personal tax excellent health insurance products adopt universal insurance, including "mid-range medical care+personal account accumulation". Their compensation functions are different. Mid-range medical insurance will be connected with basic medical insurance and supplementary medical insurance, mainly used to compensate medical expenses, accounting for most of the premium; Personal account accumulation can be used to purchase commercial health insurance (such as long-term care insurance). ) when you retire.
Note 2:
A person can pay up to 6,543,800 yuan for life, so as to be aware of it. Specifically, there are many breakthroughs in mid-range medical insurance compared with basic medical insurance. First of all, the premium ratio of mid-range medical insurance is 20%, which should be regarded as health management expenditure and claims expenditure, and the compensation ratio should not be less than 80%. If the proportion of simple payment is less than 80%, the difference will be returned to the personal account on average. Secondly, the coverage of mid-range medical insurance is not less than 250,000 yuan, and the maximum cumulative compensation for one person for life is 6,543.8+0,000 yuan, and the out-of-pocket proportion of the insured's medical expenses is not higher than 654.38+00%. If the insured has not made a large claim for five consecutive policy anniversaries since the insurance, the lifetime cumulative compensation limit can be increased to 654.38 yuan +0.5 million yuan. At the same time, the mid-range medical insurance has annual deductibles, 16-40 years old insured 3000 yuan, 4 1-50 years old insured 5000 yuan, 5 1-65 years old insured 10000 yuan. Furthermore, the scope of medical expenses compensation for mid-range medical insurance is not limited by the basic medical insurance catalogue, but in theory, domestic drugs, medical devices and high-value consumables should be used as much as possible. Finally, medical hospitals with mid-range medical insurance are limited to the general wards of public hospitals.
Note 3:
Such products need to be marked with the words "personal tax excellent health insurance". Beware of counterfeiting regulations. Personal tax excellent health insurance products developed by insurance companies should be marked with the words "Personal tax excellent health insurance" to distinguish them from other types of health insurance. Therefore, individuals should pay attention to the above information when purchasing to prevent individual companies from inducing to buy counterfeit products.
Note 4:
Not every insurance company has this qualification. It must be noted that the CIRC also has strict regulations on insurance companies operating personal tax-preferential commercial health insurance because it involves major livelihood issues. For example, the company should be a professional health insurance company or have a special health insurance department. The solvency at the end of last year and the end of the latest quarter shall be no less than 150%, and it shall be equipped with a team of personnel with medical and other professional backgrounds, with good claims settlement ability and risk management ability.
Note 5:
The company shall not provide policy loan services for personal tax excellent health insurance. The "Measures" stipulate that an insurance company shall issue a special document for pre-tax deduction of personal income tax to the insured after confirming the receipt of the premium paid by the insured, and shall provide personal tax premium health insurance products in all pilot cities with branches. However, the policy of this product type has the nature of social security and does not have the function of pledge loan, so the company cannot provide policy loan services to the insured. The above are four rights and five precautions for purchasing personal tax-excellent commercial health insurance. You must know your rights and precautions when buying this insurance, so as not to affect your insurance planning.