The Indonesia Financial Services Authority (OJK) issued two regulations to strengthen oversight of the insurance, guarantee and pension fund sector and to reinforce Indonesia’s health insurance ecosystem. The package introduces a more structured, risk-based methodology for assessing the health of insurers, guarantee institutions and pension funds, and sets new operating, product design and risk-management requirements for companies offering health insurance, including rules intended to curb overutilisation of healthcare services. POJK 33/2025 sets a risk-based supervision approach for health assessments covering performance, risk profile, issues faced and development prospects, with assessment factors spanning corporate governance, risk profile, profitability and capital or funding. The framework applies on both an individual basis and, where control over subsidiaries exists, on a consolidated basis, and requires entities to submit self-assessment results through OJK’s reporting system, with administrative sanctions for non-compliance; transitional provisions are included, particularly for guarantee institutions licensed before the regulation took effect. POJK 36/2025 requires health insurers to have adequate medical capability, digital capability supported by sufficient information systems, and an adequate Medical Advisory Board, and to obtain OJK approval before operating a health insurance business line, including for sharia insurers and sharia units; it also mandates a coverage summary for prospective policyholders, allows premium or contribution repricing no more than once per year, and requires utilisation reviews to be conducted by doctors and health insurance experts. While firms must provide products without risk-sharing features, products that include risk sharing are subject to a 5% co-payment capped at IDR 300,000 per outpatient claim and IDR 3,000,000 per inpatient claim and or an agreed annual deductible, with application possible to individual and group products; the regulation also prioritises coordination among scheme operators and cooperation with healthcare facilities, third party administrators and BPJS Kesehatan and other scheme operators. POJK 33/2025 has applied since 1 January 2026. POJK 36/2025 takes effect three months after promulgation on 22 December 2025 and withdraws Circular Letter SEOJK 7/2025.

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