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NAIC: Beware of Obamacare Fraud

admin by admin
9월 12, 2013
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Econintersect: The National Association of Insurance Commissioners (NAIC) has issued a warning that con artists posing as insurance agents or government officials associated with implemenatation of  The Patient Protection and Affordable Care Act (PPACA, aka Obamacare).

NAIC-logo

Some of the scams described by the NAIC:

Open enrollment in the new marketplaces begins October 1. However, bogus websites that purport to be part of the exchanges have been appearing online for more than a year. Do not enter any personal or financial information into a website that says you can purchase a policy before the open enrollment period.

……

Another common ploy involves unsolicited calls from scammers who claim to have your new “Obamacare” insurance card – they just need to get some information before they can send it to you. The caller then asks for credit card numbers, bank account information or your Social Security number. A variation of this trick specifically targets seniors on Medicare; the caller claims that in order for them to get their new Medicare card and continue receiving their benefits, they must verify their bank account and routing numbers. Some callers ask for their Medicare numbers, which are identical to Social Security numbers.

…….

The salesperson says the premium offer is only good for a limited time.

…….

The salesperson says you could go to jail for not having health insurance.

……..

You receive an unsolicited phone call or email from someone trying to sell insurance.

Official exchanges for each state can be found at healthcare.gov.

An obvious situation that could be exploited by fraudsters is the insurance exchange navigator system. The problem was described by Life Health Pro:

… if someone claims to be a health insurance exchange navigator, he or she won’t necessarily be licensed because the navigator is not acting in all instances as an insurance agent, but as more of a guidepost for consumers in the exchanges.

PPACA requires state health insurance exchange to hire navigators — who are not paid by health insurers — to help consumers understand how to use the exchange system. Navigators will be hired in the 34 states in which the federal government is running the marketplaces or where the state is engaged in a partnership with the federal government. The administration has said that navigators do not have to be licensed agents or brokers and may not be paid by insurance companies.

Obviously posing as a navigator would be a great entree for a scam artist.

Kansas Insurance Commissioner Sandy Prager and Montana Insurance Commissioner Monica J. Lundeen present a discussion of frequently asked questions about the PPACA in the following video prepared by the NAIC.

John Lounsbury

Sources:

  • Scammers Take Advantage of Health Reform Confusion (NAIC press release, no date on release)
  • NAIC Addresses Questions about Health Care Reform (YouTube, 02 June 2011)
  • NAIC fraud alert highlights consumers’ PPACA ignorance (Elizabeth Festa, Life Health Pro, 11 September 2013)
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