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作为消费者的代理人，在获取、融资和交付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，他们从保险公司那里获得佣金。对于代理人/经纪人市场的结构与保险的准入、可负担性和慷慨程度之间的关系，人们知之甚少。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商和经纪人在小企业健康保险决策中的作用，这是一个特别依赖代理商/经纪人的行业，同时也容易受到健康保险融资方面潜在问题的影响。我们的重点是健康保险市场的结构，代理人和经纪人充当中介，是否会导致严重依赖这些中介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和经纪人的市场结构是否与购物和提供保险相关的一系列广泛结果，以及提供的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有关。小公司历来报告健康保险的可得性和可负担性存在问题，它们严重依赖代理人和经纪人购买健康保险和咨询。我们的研究结果将提高我们对小企业在获取和提供健康保险方面面临的障碍的理解，并将为政策提供信息，说明有必要改善代理商和经纪人的市场竞争。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各种方式实施，以加强代理人和经纪人在医疗保险购买决策中的参与，或者完全绕过他们。雇主有机会接触到经纪人和代理人，他们会就改革条款向他们提供教育和建议，这似乎是合理的。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打破，则重新思考代理人和经纪人的作用或改革该市场，使其发挥更有竞争力的作用，将有利于保健改革倡议。无论是哪种情况，如果不认识到代理人和经纪人的关键作用，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.