💡 When Insurance Stops Serving People: A Wake-Up Call on Broker Access, Public Records, and Your Rights

Health insurance is supposed to be about protecting people. It’s a public good, built on laws and regulations that are meant to create fairness, transparency, and access. But today, a dangerous pattern is emerging—one that’s quietly consolidating power, limiting competition, and hurting both consumers and independent agents.

Here’s what you need to know.

🗂️ Insurance Filings Are Public Record—for a Reason

All insurance products sold to the public are filed with and approved by your state’s Department of Insurance. These filings include everything from plan benefits to pricing to how those plans are distributed.

Because health insurance is a regulated industry, these filings are meant to be transparent and public—ensuring that any licensed agent can access the system and help consumers navigate their options fairly.

But in practice, it’s not working that way.

🔒 Gatekeeping and Broker Lockouts

Instead of allowing all qualified, licensed brokers to represent their products, many insurance carriers now restrict distribution to a select few marketing firms called General Agencies (GAs) or Field Marketing Organizations (FMOs).

If an independent agent isn’t part of the “club,” they’re locked out—even if they’re legally certified and in good standing.

This isn’t just bad for brokers. It’s bad for everyone:

• Consumers lose access to unbiased advice.

• Prices go up due to lack of market competition.

• Agents are forced into quasi-employment structures under third parties who act like employers—but without offering employment rights or benefits.

These practices resemble monopolistic behavior. In fact, watchdog agencies like the GAO, FTC, AMA, and NAIC have all published warnings about how concentrated insurance markets hurt competition and inflate premiums.

📉 Fewer Choices, Higher Costs, Less Freedom

According to a GAO report, in many states the top three insurers control 80% or more of the individual market. These dominant players then restrict which brokers can represent their plans, creating artificial scarcity and hiding plan options from consumers.

Research from Health Affairs and the AMA shows this leads to:

• Higher premiums

• Limited provider networks

• Less innovation

• Weaker consumer protections

It’s a system where you pay more for fewer options—while independent professionals are forced to work under third parties they didn’t choose.

🗽 Is It a Violation of First Amendment Rights?

Here’s where it gets even more serious.

The First Amendment protects more than just free speech. It protects freedom of association, freedom of thought, and the right to professional expression.

When a health insurance company files a plan for public sale, it is declaring—by law—that the plan is for public distribution through licensed agents.

But when that same company privately restricts broker access to only those under a third-party agency, they are creating an unconstitutional interference in:

• A professional’s right to express knowledge freely

• A consumer’s right to receive balanced information

• A state-licensed agent’s right to associate directly with carriers

In short, forcing agents to work only through authorized third parties limits their freedom, their income, and their speech—while denying consumers fair access to the full insurance marketplace.

This should raise red flags for everyone who values economic freedom and personal choice.

✅ Take Action: Sign the Tsunami Health Pledge

At Tsunami Health, we believe in:

• Transparency in plan availability

• Open access for licensed, independent agents

• Freedom of association and professional advocacy

• Consumer-first values that reduce costs and increase trust

If you believe health insurance should serve the people, not monopolies—join us.

✍️ Sign the Tsunami Health Pledge

Stand with us in defending:

• Open access to public filings

• Agent independence

• Affordable coverage through competitive markets

Together, we can build a better system.

• 📚 Citations in APA Format – Monopolistic Practices in Insurance Distribution

  1. National Association of Insurance Commissioners (NAIC). (2020). State Licensing Handbook (8th ed.).
     https://content.naic.org/tools/state-licensing-handbook

     Documents how restrictive appointment practices and “captive” broker networks limit competition.

  2. U.S. Government Accountability Office (GAO). (2011). Private Health Insurance: Research on Competition in the Insurance Industry (GAO-11-793).
     https://www.gao.gov/products/gao-11-793

     GAO found that in most states, the top three insurers controlled at least 80% of the market—limiting consumer choice and agent competition.

  3. American Medical Association. (2019). Competition in Health Insurance: A Comprehensive Study of U.S. Markets (19th ed.).
     https://www.ama-assn.org

     Reveals that insurance markets are highly concentrated, with dominant carriers often controlling broker distribution channels.

  4. Federal Trade Commission (FTC). (2004). Improving Health Care: A Dose of Competition.
     https://www.ftc.gov/sites/default/files/documents/reports/

     FTC warned that selective broker access and vertical integration practices reduce competition and drive up consumer costs.

  5. Health Affairs. (2017). Consolidation in the US Health Insurance Industry: Impacts on Prices and Access.
     Dafny, L. S., Gruber, J., & Ody, C.
     https://doi.org/10.1377/hlthaff.2017.0554

     Empirical research on how restricted access to carrier contracts and fewer brokers leads to higher premiums and limited options.

  6. National Association of Health Underwriters (NAHU). (2021). Broker Access & Fair Compensation Principles.
     https://nahu.org/advocacy/issues/broker-access

     Argues that limiting broker appointments forces many independent agents into quasi-employee roles under GA/FMO arrangements.

  7. Consumer Federation of America. (2013). The Decline of Competition in Health Insurance Markets and Its Impact on Consumers.
     https://consumerfed.org

     Critiques how selective contracting harms consumer protection and pricing transparency.

  🧾 Key Allegations Supported by These Sources

  • Hurting Consumers: Reduced competition leads to higher premiums, fewer plan options, and weakened advocacy.

  • Inflating Prices: Monopolistic control over distribution allows insurers to set terms without downward pressure from market competition.

  • Forcing Independent Agents into Employer-Like Arrangements: Agents must operate under General Agents/FMOs with limited control, despite no employment benefits—blurring legal employment definitions without protection.