Under the new law, administrative and other costs must be limited to 15 percent, and the "medical loss ratio" (MLR) must be 85 percent of premiums.

The problem for agents is that currently, sale of small group and individual policies earn commissions as high as 20 percent.

Representatives of agent groups–specifically the National Association of Health Underwriters, the Independent Agents and Brokers of America, and the National Association of Insurance and Financial Advisors–have been working with the state commissioners in order to ensure that their role in the health care industry is assured going forward.

Mr. McCarty said that some people have said the insurance exchange program will lessen the role of agents.

"I disagree with that," he said. "Agents serve as a valuable tool" in providing health care, and we are working to protect the integrity of the relationship."

Mr. McCarty noted, however, that the state commissioners will seek to do that "while maintaining the transparency and integrity of the new law."

He added that agents provide comprehensive advice when selling and servicing health insurance policies. He said that comparing "buying an airline ticket with purchasing something as complicated as health insurance is not a fair comparison."

According to Jane Cline, West Virginia insurance commissioner and president of the NAIC, the MLR regulations must be in place before Dec. 31.

The commissioners brought up several issues in their meeting with reporters and noted that they are working hard with state Medicaid directors, state Departments of Health, and other regulators to reach consensus on regulations governing components of the health care bill.

Under the law, the state commissioners make recommendations on how to implement certain provisions of the Affordable Healthcare law, which must then be approved or modified by the Department of Health and Human Services.