As health insurance producers look back on one of their busiest quarters in recent memory, it's easy to forget that just a year ago many were predicting that the Patient Protection and Affordable Care Act would spell the end for brokers and agents. Now producers are back. In fact, they never left. Oliver Wyman and Benefits Selling's annual health care survey asked more than 400 brokers and agents for their take on the market, the business environment and their plans for the future. We found producers adapting quickly to the post-reform world, though many challenges remain.

The picture for producers looking forward is one of opportunity in the midst of disruption, where scale and innovation pay dividends.

Surviving the public exchanges

In May, the Centers for Medicare & Medicaid Services finally confirmed it would permit brokers and agents to play a major role on the public exchanges. If that wasn't enough to drive home to consumers the value of trusted advisors, the fumbled launch of HealthCare.gov in October seemed to finish the job.

But by November, when we conducted our survey, brokers were of two minds about the public exchanges. Sixty-eight percent of producers handling individual business described consumer demand for exchange enrollment services as “none” or “weak,” while 32 percent said it was somewhat strong or very strong. Based on the compensation received versus the effort to enroll, 19 percent believed it was worth their time to support individual enrollment on the public exchanges—a small but significant share.

Demand for my services to help enroll individuals on the public exchange has thus far been:

Problems with the public exchanges—not just the federal exchange but some of the state programs as well—compounded the challenges in the early days of open enrollment. Of brokers who attempted to enroll members, 85 percent said they succeeded 5 percent of the time or less, and only 3 percent succeeded at least half the time. On the other hand, 75 percent of respondents, both large and small, agreed that carriers viewed them as partners in the public exchange segment. Larger brokers were more likely than smaller to express a positive opinion of the economics of the public exchanges—consistent with the generally more positive attitude of larger brokers toward the business environment and the future.