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Presented By: Department of Economics

Going for Broker? Intermediation in Health Insurance Markets

Anran Li, University of Minnesota

Anran Li Anran Li
Anran Li
This paper studies how insurance brokers affect product choices, premiums, and welfare in the employer-sponsored insurance market. We compile a novel database of contracting relationships among employers, brokers, and insurers in New York State. Exploiting variations in commission schedules, we document two market distortions: First, brokers exhibit traditional agency frictions, steering employers towards more financially lucrative products. Second, commission levels affect ex-ante insurer-broker networks and, in turn, insurers' competitive pressure, leading to anti-competitive distortions. We develop and estimate a structural model of employer insurance demand, insurer pricing, and formation of broker-insurer contracting networks. We use the model to study a commission-cap counterfactual. A one-percentage-point cap reduces broker-induced steering and raises employer surplus by 3\%, but the resulting reduction in insurer competition lowers surplus by over 6\%, yielding a net decline of about 3\%. We also explore the impacts of fiduciary duties and network regulations for insurance brokers.

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