The Role of Agents and Brokers in the Market for Health Insurance - Do They Help

描述（由申请人提供）：保险代理人和经纪人通过充当消费者的代理人，在获得，融资和提供健康保险方面发挥着重要作用，提供专业服务，帮助消费者驾驭保险产品的复杂性。作为交换，他们从保险公司获得佣金。代理人/经纪人市场的结构与保险的获得、可负担性和慷慨程度之间的关系知之甚少。经济理论表明，代理人/经纪人-客户关系可能存在缺陷。 我们的研究旨在调查代理人和经纪人在小企业的健康保险决策中的作用，这是一个特别依赖代理人/经纪人的部门，同时容易受到有关健康保险融资的潜在问题的影响。我们的重点是健康保险市场的结构，代理人和经纪人作为中介，是否会导致信息问题和效率低下的小公司谁大大依赖这些中介。我们将调查健康保险代理人和经纪人的市场结构是否与购物和提供保险的广泛结果有关，以及提供的保险的慷慨程度和类型，以及小企业对高免赔额计划和健康储蓄账户的反应。小公司历来报告的问题与医疗保险的可用性和负担能力，他们严重依赖代理人和经纪人购买医疗保险和咨询。我们的研究结果将提高我们对小企业在获得和提供健康保险方面面临的障碍的理解，并将为改善代理人和经纪人市场竞争的必要性提供政策信息。此外，我们的研究将为立法和医疗保健改革的设计提供信息。国家或州的改革举措可以以各种方式实施，以加强代理人和经纪人参与健康保险购买决策，或绕过他们。似乎雇主可以从经纪人和代理人那里得到很大的好处，这些经纪人和代理人可以就改革条款对他们进行教育和提供咨询。另一方面，如果代理人/经纪人与雇主之间的代理关系被严重破坏，重新思考代理人和经纪人的作用或改革该市场，使其更具竞争力，将有利于保健改革举措。无论是哪种情况，在不承认代理人和经纪人的关键作用的情况下推进医疗保险改革议程都将是一个错误。

DESCRIPTION (provided by the applicant): Insurance agents and brokers play a significant role in access, finance, and delivery of health insurance by acting as the consumer's agent, providing specialized services to help consumers navigate the complexities of insurance products. In exchange, they receive commissions from the insurer. Little is known about the relationship between the structure of the agent/broker market and access, affordability and generosity of insurance. Economic theory suggests that the agent/broker-client relationship may be flawed. Our research aims to investigate the role of agents and brokers in the health insurance decisions of small businesses, a sector that is particularly dependent on agents/brokers, and at the same time vulnerable to potential problems regarding health insurance financing. Our focus is whether the structure of the health insurance market, with agents and brokers acting as intermediaries, could lead to information problems and inefficiencies for small firms who significantly rely on these intermediaries. We will investigate whether the structure of the market for health insurance agents and brokers is associated with a broad set of outcomes related to shopping and offering of coverage, as well as generosity and types of coverage offered, and the small business response to high deductible plans and health savings accounts. Small firms have historically reported problems with the availability and affordability of health insurance and they heavily rely on agents and brokers for purchasing health insurance and for consulting. Our findings will improve our understanding of the barriers small businesses face in accessing and offering health insurance and will inform policy on the need for improving competition in the market for agents and brokers. Moreover, our research will inform design of legislation and health care reform. National or state reform initiatives can be implemented in various ways to enhance the involvement of agents and brokers in health insurance purchasing decisions, or to bypass them all together. It is plausible that employers would significantly benefit from access to brokers and agents who would educate and advise them on the reform provisions. On the other hand, if the agency relation between agents/brokers and employers is seriously broken, health care reform initiatives would benefit from rethinking the role of agents and brokers or reforming that market so that it functions more competitively. In either case, proceeding with a health insurance reform agenda without recognizing the key role of agents and brokers would be a mistake.