There's no question that the nation's health care system is in astate of change and unrest – and it looks like a good number ofhealth insurance brokers are sick and tired of it.

Nearly half of America's brokers (45%) say they're consideringexiting the health insurance business altogether, with the majority(51%) saying they are only slightly or not at all confident aboutthe future of their firm and their industry, according to a newAflac WorkForces survey.

Wide-ranging changes in health care — notably the Patient Protection and Affordable Care Act — and economicunrest are causing brokers' self-doubt, Aflac reported, just asemployers and employees say they need brokers most.

Almost one-third of brokers (29%) say they're concerned aboutremaining relevant to their clients, the report found.

Though brokers' concerns over their future have been widelyreported, albeit anecdotally, Aflac's survey of more than 300brokers offered a clearer picture of how many are thinking aboutleaving the business.

The numbers left some in the industry puzzled.

“It surprises me,” David Smith, vice president of health andwelfare benefits at North Carolina-based Ebenconcepts, said of theresults. “Most of the professionals I know are not planning onleaving the business. I'm sure there are people who do nothing butthe occasional health insurance policy who may now decide to getout of the business.”

The survey comes at a time when workers and employers say theywant more help from brokers and benefits experts as they try tomake sense of health care changes — especially as Obamacare goesinto effect.

Other big changes employers need help with? The movement fromHMO and PPO plans to consumer-driven options as well asimplementing wellness programs.

According to Aflac's report, the majority of employees (78%) atleast somewhat agree they would be more informed about their healthinsurance choices if they worked with an insurance consultantduring benefits enrollment; more than one-third (35%) of thosequestioned strongly or completely agree with that statement.

Industry insiders say the “crisis of confidence among brokers”is a trend that can be turned around if brokers realize theincreasing opportunities coming their way thanks to the PPACA.

That was a sentiment echoed recently by Janet Trautwein, CEO ofthe National Association of Health Underwriters, after the Obamaadministration announced the one-year delay to PPACA's employermandate.

She encouraged employer groups to “seek counsel from anexperienced, licensed health insurance agent.”