In the state of Texas, the Department of Insurance recently sent out a bulletin warning health insurance agents and third-party administrators (TPAs) about the dangers of “assisting a company engaging in the unauthorized business of insurance.” While the bulletin was specific to Texas agents, it’s a message that brokers across the country should take to heart.

If you think back to the days when you were studying for your insurance license, you may remember learning a couple terms that are related but have different meanings. In this post, we’ll discuss Adverse Selection and Moral Hazard and explain why both of these terms are relevant in today’s health insurance environment.

As premiums continue to increase and plan designs are tweaked to keep costs under control, today’s health insurance policies are quickly turning into catastrophic coverage. They’re great if you have a big, unexpected medical expense but aren’t all that useful for some of the day-to-day needs like doctor visits and prescription drugs. Sure, members do get the benefit of the carrier’s negotiated rate if they stay within the insurance company’s shrinking provider network, but consumers are beginning to realize that there are other options outside the health plan that might help them save money while receiving better care. And as health insurance plans cover less and less, we’ll see more and more of these non-insurance solutions.