care act
Accused seller of ‘sham’ insurance paid for consumer refunds
A Tampa-based health insurance distributor accused by the Federal Trade Commission of misleading consumers into buying “sham” health insurance plans has filed for Chapter 11 bankruptcy protection.
Benefytt Technologies, which has offices in Fort Lauderdale and Sunrise, last year settled a Federal Trade Commission complaint that it participated in “deceptive, unfair and abusive acts” in connection with the sale and marketing of its memberships and related health products, including short- term medical plans, limited benefit plans and medical discount plans.
According to the FTC, the company targeted customers searching for insurance that complied with the Affordable Care Act. In agreeing to the settlement, Benefict agreed to pay $100 million to refund consumers but neither admitted nor denied the allegations.
That $100 million payment, combined with $27.5 million the company paid to settle a class-action lawsuit over related allegations and $11 million paid to settle claims by the Securities and Exchange Commission, contributed to a cash-flow problem that nearly forced the company to cease operations, Benefytt disclosed in its bankruptcy filing on Tuesday.
In addition to paying the $100 million, Benefit’s settlement with the FTC includes its agreement not to lie about its products, tell customers its plans to comply with the ACA, or charge “illegal junk fees.” The company’s former CEO and former vice president of sales were permanently banned from selling or marketing any health care product.
The SEC’s complaint accused Benefit of concealing consumer complaints about its health insurance products between 2017 and 2020 and falsely telling investors that it held its distributors to high compliance standards.
Benefytt operates a number of subsidiaries, including the direct-to-consumer platform TogetherHealth Insurance, which are all parties to the bankruptcy case. Benefytt currently employs 855 workers and operates in 44 states, its bankruptcy filing states.
Benefict’s restructuring plan, filed Tuesday in
Medicaid redetermination drive insurance broker marketing
Health insurance brokers and independent agents are leaning up marketing as states pare the Medicaid rolls for the first time in two-and-a-half years.
These salespeople will play a critical role helping former Medicaid beneficiaries enroll in alternate coverage, such as subsidized plans from the health insurance exchanges. About 3 million of the 15 million people projected to lose Medicaid benefits because they no longer qualify are expected to be eligible for subsidized exchange coverage, according to the Health and Human Services Department.
That’s 3 million customers health insurance companies could gain, or at least retain in the case of carriers that administer Medicaid plans. Yet studies show that fewer than 5% of those who disenroll from Medicaid successfully convert to exchange coverage.
Independent agents are advertising on Facebook and in physician offices and are hosting events at churches and other community spaces to promote their services during this time, said Ronnell Nolan, president and CEO of Health Agents for America, a trade group for independent health insurance agents.
“It’s going to take a village, as they say, to help all these folks come off,” Nolan said. “What I’ve been telling our agents is: Encourage people to go into their Medicaid portal and update their information. So when they do get that pink letter in the mail, they know, ‘I need to call someone to get help.’”
Government agencies and health insurance companies themselves are also stepping in to provide transitional assistance to those losing Medicaid benefits after the expiration of a COVID-19 relief program that offered states extra federal Medicaid funding in exchange for them allowing enrollees to maintain coverage even when their incomes rose above eligibility levels.
Agents and brokers are receiving calls from consumers confused about the future of their health coverage and are spending hours reviewing
Millions of ACA health insurance plans may face hikes unless Congress acts
WASHINGTON — Do you or a loved one get your health insurance through the Affordable Care Act?
The latest numbers show health-coverage-through-affordable-care-act.html”31 million people are currently enrolled in either marketplace plans or through Medicaid expansion nationwide – that’s a record.
However, there are looming questions about whether a major rate hike is on the horizon for many of those health insurance plans.
THE ISSUE
There is inflation and there is Ukraine. There is an ongoing abortion debate.
Let’s face it — the country is facing a lot.
Well, you can add health insurance premium hikes to the ongoing list of issues facing the United States.
Remember the Affordable Care Act and how it created new health insurance options for those who don’t have insurance?
When President Joe Biden signed the American Rescue Plan into law during the height of the pandemic, it created what’s known as “advanced premium tax credits” that made health insurance plans obtained through the government marketplace cheaper.
The average family saved $200 in premiums, according to the latest data.
4 out of 5 consumers were eligible for plans that cost $10/month.
Enrollment has been up 21% this year — with lower prices playing a big role.
However, the funding that made plans so cheap will expire at the end of this year with families set to receive notice just a few weeks before Election Day.
Some plans may go up by hundreds of dollars each month.
More than a dozen Democratic governors wrote to Members of Congress last week asking them to take action to prevent what they call “dramatic premium increases” soon.
There are concerns in states like California, Colorado, Michigan and Nevada that this could lead to Americans declining health insurance.
So far, though, it’s unclear whether Congress will address