When Congress passed the Patient Protection and Affordable Care Act (PPACA) in March 2010, the law's language made it clear that insurance agents should continue to deliver health insurance products under the new system—thanks to heavy involvement at the law-drafting level by insurance associations. 

However, current regulations are making that difficult.

Under the law, as of Jan. 1, 2011, health insurers must spend at least 80 percent of the funds they receive in health plan premiums from the individual and small group markets—and 85 percent from the large group market—on a combination of medical care claims and activities to improve healthcare quality. If a carrier does not meet these ratios, rebates are due to the consumer, starting in August 2012. 

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