Flexible employment group is the key to achieving the goal of universal medical insurance. The low proportion of this group participating in employees’ basic medical insurance has resulted in adverse selection, inadequate protection, and separation of places of insurance and places of medical treatment (permanent residence). Local governments have explored and formed five modes for flexible employees to participate in employees’ basic medical insurance based on institutional elements such as the establishment of individual accounts, the threshold of insurance participation, payment and benefits. It is suggested to properly unify local regulations, not to establish individual accounts, to manage flexible employment personnel by classification, to appropriately lower the threshold of insurance participation, and to protect the rights and interests of flexible employment groups in platform enterprises.