OJK Permits Insurance Companies to Implement Resharing Schemes, Provided Certain Conditions are Met
The Executive Head of Insurance, Guarantee, and Pension Fund Supervision at the Financial Services Authority (OJK), Ogi Prastomiyono, stated that OJK Regulation (POJK) Number 36 of 2025 regarding the Strengthening of the Health Insurance Ecosystem was introduced to improve risk management in the provision of health insurance products. This includes regulations concerning resharing or risk-sharing/co-payment schemes.
According to Ogi, the resharing option has become a point of public interest within the POJK. However, he noted that co-payment practices are already common in the international health insurance industry.
“However, we understand the public’s concerns. Therefore, under the health insurance products offered in accordance with POJK 36/2025, every insurance company must offer a default, mandatory product without resharing or co-payment, as is the current practice,” Ogi explained during the Health Insurance Ecosystem Forum 2026 on Wednesday (3/6/2026).
On the other hand, Ogi explained that the OJK is opening the option for insurance companies to offer features involving resharing or co-payment. Nevertheless, he hopes that insurance providers will disclose these mechanisms more clearly to consumers.
“This must be offered to patients and health insurance purchasers. Insurers must explain what the premium is without resharing, and what the premium and resharing amounts would be if resharing is used. This way, the public has the choice to select their preferred insurance product,” Ogi emphasised.
Furthermore, Ogi asserted that the primary objective is to strengthen the health insurance ecosystem. He noted that medical capability, digitalisation, and the establishment of medical advisory boards are essential requirements for running a more sustainable, better, and more transparent health insurance service for participants. He added that the insurance process and provider services will also be significantly impacted.
“We are regulating the entire ecosystem, not just one part; we are regulating everything,” Ogi concluded.