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

代理人和经纪人在健康保险市场中的作用 - 他们有帮助吗

• 批准号: 7774730
• 负责人: PINAR KARACA-MANDIC
• 金额: $ 10万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7774730
• 关键词: Role; Agents; Brokers; Market; Health

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.

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，提供专业服务来帮助消费者应对保险产品的复杂性，在健康保险的获取、融资和交付方面发挥着重要作用。作为交换，他们从保险公司获得佣金。人们对代理/经纪人市场的结构与保险的准入、负担能力和慷慨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型企业健康保险决策中的作用，该行业特别依赖代理人/经纪人，同时容易受到健康保险融资潜在问题的影响。我们关注的焦点是，由代理人和经纪人充当中介机构的健康保险市场结构是否会导致严重依赖这些中介机构的小公司出现信息问题和效率低下。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买和提供保险、慷慨程度和保险类型以及小企业对高免赔额计划和健康储蓄账户的反应等一系列广泛结果相关。小公司历来报告过健康保险的可用性和负担能力方面的问题，并且它们严重依赖代理商和经纪人来购买健康保险和进行咨询。我们的研究结果将加深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，并将为政策提供有关改善代理人和经纪人市场竞争的必要性的信息。此外，我们的研究将为立法和医疗改革的设计提供信息。国家或州的改革举措可以通过多种方式实施，以增强代理人和经纪人对健康保险购买决策的参与，或完全绕过它们。雇主可能会因接触经纪人和代理人而受益匪浅，他们会就改革条款向雇主提供教育和建议。另一方面，如果代理人/经纪人和雇主之间的代理关系严重破裂，重新思考代理人和经纪人的角色或改革市场以使其更具竞争力，医疗改革举措将受益。无论哪种情况，在不认识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。