I have a business in Portland, Oregon where I provide health insurance to about
50 employees. For the past several years I have used an agent to shop
the Health Insurance market. I'm wondering if I would do better rate
wise if I were to go direct to the carriers and bypass the agents all
together. My thinking is that if I go direct, the Insurance Companies
might just pocket the money that they would have paid to the agent as a
commission and not pass any of the savings on to me.

If your agent work for a firm then there could be charges from the
firm. When you contact a company directly they usually send you to an
agent. It can be important to have an agent to answer your question
and take care of claims. The costco link
is giving me an error page.

Don't know for sure, but since I work as a claims adjuster at a Health
Insurance company that you've heard of, I thought I might throw out a
few things to think about.

*) Agents acount for a significant share of health insurance sales,
especially with smaller companies. Carriers might well pocket the
difference, but they're even more interested in not angering their
agents by significantly undercutting them.

*) Carriers actively court and offer good deals to their only their
largest customers. Yours is not nearly that large. They'll be civil
and write you a policy, but don't expect the type of deal a 3000
employee company gets.

*) For a while there was a trend to cut costs by switching from FFS
plans to HMOs. Now the trend is to cut benefits. The new "Consumer
Directed" health plans are a way of cutting benefits while attempting
to make consumers feel good about the process.

*) Even for more traditional policies, making consumers research and
choose cheaper care may be the next thing. There's a move to divide
hospitals into "tiers", that is "cheap" and "expensive".

* For employers willing to take risk in exchange for cheaper rates,
"self-insured" policies are out there. I'm not sure how many people it
takes to qualify, but I once worked for a company of a couple of
hundred that had one. Some self insured policies have a "stop-loss",
where there is a set maximum to the risk assumed by the employer and
any risk beyond that is the carriers.