State Officials Warn Consumers about Scams Related to Federal Health Reform (ACA)

Insurance Superintendent Eric Cioppa and Governor Paul R. LePage are warning the public about scams related to the federal health reform law (ACA). Various schemes have been reported throughout the country to take advantage of consumers' uncertainty surrounding the law. Often posing as insurance agents or representatives of the government, these scammers attempt to sell fraudulent policies or obtain sensitive information like Social Security and bank account numbers.

Governor LePage encouraged people to contact the Bureau of Insurance if they receive calls or messages from individuals claiming to represent government agencies and offering to sell health insurance policies. "Consumers and business owners should be cautious when receiving an unsolicited sales pitch related to the ACA," Governor LePage said. "Government representatives aren't contacting consumers to sell insurance policies. We want Mainers to be vigilant about protecting their private information so they can avoid being scammed."

Insurance Superintendent Cioppa reinforced that message and noted that insurance agents should not be asking for personal or financial information when explaining policy options. "Maine's Bureau of Insurance is always available to assist consumers with questions or concerns about health insurance, and never contacts people to sell insurance products. Additionally, insurance agents should never request personal information, such as a Social Security Number or details related to financial accounts, when explaining health insurance policies."

Maine's Bureau of Insurance and the National Association of Insurance Commissioners (NAIC) are highlighting common red flags and providing tips on how to avoid being the victim of a scam.

-- Fraudulent Health Insurance Marketplaces: One of the largest components of the ACA is the creation of federal health insurance marketplaces, or exchanges. These online portals ask consumers to enter information about themselves, and select the level of coverage they desire, to receive a list of plans they can purchase. Open enrollment in the new marketplaces begins October 1. However, bogus websites that purport to be part of the exchanges have been appearing online. Do not enter any personal or financial information into a website that says you can purchase a policy before the open enrollment period. More information is available at www.healthcare.gov.

-- New "Obamacare" Insurance or Medicare Cards: Another common ploy involves unsolicited calls from scammers who claim to have your new "Obamacare" insurance card. The scammer then asks for information in order to send the card to you, such as credit card numbers, bank account information or your Social Security Number. A variation targets seniors on Medicare, with the caller claiming that in order for the senior 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. You are not required to obtain a new insurance or Medicare card under the ACA. Also, legitimate representatives of the federal government will already have the information they need and should not ask for personal or financial details.

-- Salesperson says Premium Offer is Good for a Limited Time: Enrollment in the exchanges will be open from October 1 to March 31, and the rates for plans will be good for the entire enrollment period. Be skeptical of someone who is trying to pressure you into buying a policy because the rate is only good for a short time.

-- Salesperson says You Could Go to Jail for Not Having Health Insurance: Starting next year, all Americans will be required to have health insurance. You will not face jail time if you do not purchase health insurance. Those who remain uninsured and do not qualify for an exemption will face a penalty of $95 (for each adult) or 1% of family income, whichever is greater. In 2015, the penalty will increase to $325 per adult or 2% of family income, and in 2016 and beyond, the penalty will be $695 per adult or 2.5% of family income.

-- Unsolicited Call or E-mail from Government Official Selling Insurance: Federal and state government representatives are not contacting individual consumers to sell insurance. Do not give any sensitive information to anyone who claims to be with the federal government or the Maine Bureau of Insurance.

Cioppa urged consumers to contact the Bureau of Insurance to check the validity of an insurance product, agent or company, particularly if an unsolicited sales pitch is received. The Bureau of Insurance can be reached by calling 1-800-300-5000. Individual and small group health insurance plans to be offered in Maine on the federal exchange can be reviewed on the Bureau's website (www.maine.gov/insurance). The website also contains a PowerPoint presentation regarding the ACA and Maine's insurance market.