Regulatory Alerts2025-05-19
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Implementation of Health Insurance Products
The Financial Services Authority (OJK) issued Circular Letter 7/SEOJK.05/2025 to establish prudential and risk management criteria for insurance companies offering health insurance lines. The regulation mandates that providers meet digital and medical capabilities, establish Medical Advisory Councils, and implement a mandatory 10% co-payment structure with specific out-of-pocket caps for outpatient and inpatient care. Additionally, insurers must utilize independent or collaborative information systems, conduct medical check-ups for individual policies, and actively promote health awareness campaigns.
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