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The Role of Agents and Brokers in the Market for Health Insurance

Pinar Karaca-Mandic, Roger Feldman, Peter Graven

NBER Working Paper No. 19342
Issued in August 2013
NBER Program(s):Health Care Program, Industrial Organization Program

Health insurance markets in the United States are characterized by imperfect information, complex products, and substantial search frictions. Insurance agents and brokers play a significant role in helping employers navigate these problems. However, little is known about the relation between the structure of the agent/broker market and access and affordability of insurance. This paper aims to fill this gap by investigating the influence of agents/brokers on health insurance decisions of small firms, which are particularly vulnerable to problems of financing health insurance. Using a unique membership database from the National Association of Health Underwriters together with a nationally representative survey of employers, we find that small firms in more competitive agent/broker markets are more likely to offer health insurance and at lower premiums. Moreover, premiums are less dispersed in more competitive agent/broker markets.

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Document Object Identifier (DOI): 10.3386/w19342

Published: Pinar Karaca-Mandic & Roger Feldman & Peter Graven, 2018. "The Role of Agents and Brokers in the Market for Health Insurance," Journal of Risk and Insurance, vol 85(1), pages 7-34.

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