In consumer news related to healthcare, people who signed up for Marketplace Affordable
Health Care Act plans should be aware of unscrupulous insurance brokers who could do
a bait and switch.
Some of these web brokers are switching people's existing plans without their knowledge and
pocketing excess premiums, according to the Kaiser Family Foundation.
In Wisconsin, more than 250,000 people are on ACA plans through the federal marketplace.
Caroline Gomez-Tom is an ACA enrollment network and accessibility manager for covering Wisconsin.
She joins us now, and thanks very much for being here.
Thanks for having me, Frederica.
Do you know how many people in Wisconsin might be victims of these web insurance brokers?
We're still kind of understanding and trying to figure out the volume of folks that are
impacted by this.
We were brought aware of this based on some of our navigators who have seen individuals
come to us because they were duly enrolled in Medicaid or the marketplace, or we're
hearing it also from other states where they're getting a lot more malicious predators, essentially,
who are trying to target specific communities.
But we're definitely seeing more come up week after week.
What are some examples you've seen in terms of unsuitable policies because of coverage
or cost?
Well, so right now, we are in the process or the end of the process of going back to some
of our Medicaid renewal rules that were in place before the pandemic.
And anytime there's a new change in policy, we always tend to see an increase in scams
and bad actors that are just taking advantage of a confusing time.
And since the sun winding started about a year ago, we were aware that this could happen.
But definitely through open enrollment, we saw an uptick of people.
And what it typically looks like is someone is actually still eligible or enrolled in
Medicaid, which is the state's program for lower income folks.
And either they are up for renewal soon, or they do need to renew.
And someone either reaches out to them proactively, somehow getting their contact information.
And there's a way if someone just put health insurance in a Google search and went to a
bad website, they could have accidentally got on this list of numbers that people will call.
Otherwise, it's actually someone that maybe they reached out to, but they're out of state.
And they're now getting signed up for a marketplace plan, usually a $0 a month plan.
But because they actually should still be on Medicaid are now duly enrolled in both of
these programs.
And it's not until either they're actually trying to seek health care or tax time when
now the IRS is saying they have to reconcile tax credits that they never knew they had.
They're trying to figure out what what wrong.
So I understand that many of these brokers doing this are out of state.
But who are they targeting?
Have you found?
Yeah.
So what we're hearing and so we haven't seen any bad actors that are from Wisconsin.
So I want to lead with that.
And we actually do a really good job of working with our agent and broker community here in
Wisconsin.
We train with them, we partner with them, and we actually have quite a lengthy screener
before we even include them in how we advertise for enrollment assistance.
What we're seeing are folks from Texas, New York, Florida, the list goes on doing some
of these malicious acts to get people enrolled in plans that they're really not suitable
for.
And they're doing so by targeting low-income folks, a lot of times immigrant communities
where maybe language is an issue in terms of translating information, especially complex
information like health insurance, senior community as well as our unhoused folks.
So what can people do to protect themselves from this?
Yeah.
So we always have taught a lot of preventative measures and how to avoid scams in general.
So of course, knowing the website that you're putting in regarding seeking enrollment for
health insurance, making sure that it has a .gov ending.
So if you're enrolling in Medicaid, it's access.wi.gov.
If you're enrolling in the health insurance marketplace, it's healthcare.gov.
And then if you're seeking assistance and you're talking to someone on the phone or
someone reaches out to you, don't hesitate to ask questions.
Because if there's any red flags, you should just stop the conversation and say, I will
call someone if I need additional help and just end it there.
And asking questions like, what's your license number?
Who do you work for?
What is your affiliation with the Office of the Commissioner of Insurance or covering
Wisconsin or the health insurance marketplace?
Any person who is legitimately trying to help you can easily answer any of those questions
and usually automatically goes through a consent process.
If someone is hemming and high or they hang up on you, which happens sometimes, or they
just are like, no, it's okay, we don't need to talk about that.
Let's just get you the insurance.
Those are all red flags.
And so we always tell folks, it's not worth it.
Just say, thank you for your time and get off the phone.
And then if for some reason someone is trying to charge you because there are some other
scams that we've seen where people are trying to charge an additional cost just to enroll
you in coverage, those are other red flags.
I would say.
Well, thank you for that important information for what people should look for.
Caroline Gomez, Tom, thanks so much.
Thank you so much.
Oh, gosh, there's a scam a minute, isn't there?
Yeah, that's something we've always had to be aware of.
And yeah, it's unfortunate that, and I didn't mention that people can reach out to us.
So I don't know if that's something that could be added covering Wisconsin.
Yes.
And so that's by calling two on one, they can get to us.
And then also by going to Whiskover.com, which is kind of our state partnership site.
Okay.
That's funny because whenever I think of health care sign up, I always, like I would warn
my children, make sure it's a .gov address, you know, because so many people go to healthcare.com.
And then that's something completely different.
Yeah.
And the thing is, like, insurance is complicated as it is, and then you have these bad actors
on top of it.
We always just encourage folks even to call us directly from the get go, because even
if it's just a question to make sure they're at the right spot, like we'd rather them do
that than, you know, be unsure and then find out the hard way.
Yeah, exactly.
All right.
Well, yeah, we will look into making people aware of where they should go and who they
should contact.
But again, thank you very much.
Thank you so much.
Okay.
All right.
Bye.
Take care now.
Bye-bye.