Volume 3 Number 46
November 13, 2006

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WATCH OUT FOR UNLICENSED INSURERS

As a business or an individual looking for health insurance, do your homework to protect yourself against potential scams.

Small businesses may be vulnerable to health-insurance scams because of increased health-care costs, difficulty finding coverage, and lack of knowledge about the subject.

According to the National Association of Insurance Commissioners, states are finding it difficult to regulate association health plans that reach across state lines. Some  scams have duped consumers and businesses into paying for insurance that doesn't exist.

Fake insurance brokers might mimic the names of legitimate companies, and licensed insurance agents have been tricked into selling fake plans. Scams ultimately affect everyone from unpaid hospitals and health-care providers to consumers who are left with unaffordable health-care bills.

The U.S. Department of Labor and the National Association of Insurance Commissioners recommend that you:

  • Make sure that the person selling insurance is licensed by the state by asking the Florida Department of Financial Services, 1-800-342-2762 or go online to www.MyFloridaCFO.com and click on "Check out your insurance agent."
  • Confirm the insurance company is authorized to transact business in Florida by contacting the Florida Department of Financial Services, 1-800-342-2762 or go online to www.MyFloridaCFO.com and click on "Look up your insurance company." 
  • Do not confuse discount health plans or cards with health insurance.
  • Take a look at coverage and costs offered by several insurers. Comparing plans will tell you what constitutes standard coverage or cost. If you see a plan that claims to offer the same coverage as other plans but at a dramatically lower cost, ask about it. What appears to be too good to be true usually is.
  • Read the details so you know the extent of the actual coverage and the limits of the policy.
  • Request references of employers enrolled with the provider and contact them to ask about benefit payment history and claim turn-around time.
  • Beware of applications with just a few questions, coverage amounts with few limits, too generous benefits or unusually low rates. Nonrefundable deposits or fees to be paid when you apply are not normal practice for the industry.

You may download or order a copy of our free "Health Insurance Guide," a helpful resource under Consumer Guides at www.MyFloridaCFO.com.

If you think you have been taken in by phony insurance, contact the Florida Department of Financial Services at 1-800-342-2762 and the U.S. Department of Labor's Employee Benefits Security Administration at 1-866-444-3272 or www.askebsa.dol.gov.