The Louisiana Department of Insurance warns consumers to be on alert
April 16, 2010
searching for health insurance coverage since the passage of the
Patient Protection and Affordable Care Act of 2009 (PPACA)
should be on the lookout for
scammers hoping to take advantage of the confusion surrounding the details of
the new law. State insurance regulators are receiving complaints about scam artists
going door-to-door selling fake insurance policies or claiming there is a limited
open-enrollment period to buy health insurance. Some of these scam artists have
even set up bogus toll-free numbers to sell policies. The Louisiana Department
of Insurance warns consumers who have been offered a policy that is a “limited-time
offer,” has limited benefits or is advertised as necessitated by health
insurance reform, to STOP before signing anything or making a payment, CALL the
Louisiana Department of Insurance and CONFIRM that the policy, agent, and company
While there are many changes coming in the health insurance marketplace, there
are no provisions in the PPACA that require consumers to make immediate modifications
to their health coverage. Many of the initial changes will go into effect six
months from when the law was signed by President Obama - or September of this
year. Until then, agencies in Louisiana and the federal government are working
on implementing the changes. This means designing and putting into place at the
state level many of the new consumer programs and regulations.
Be Misled! Here are some important “red flags” to watch
agent or salesperson says the premium offer is only good for a
There is no open enrollment period currently associated with the new health
care law, so if the salesperson is pressuring you to buy the policy because
or option is only good for a short time, be wary. Before you write a check
or sign a contract for one of these policies, call the Department of Insurance
make sure the insurance company and agent are licensed in your state and
carefully read the contract to make sure you understand the coverage and
agent or salesperson says the coverage is necessitated or required
health care reform law.
You may have heard that all Americans will be required to purchase health
insurance under the new law, but this requirement does not go into effect
until 2014 for
most people. If an agent or salesperson implies you have to purchase coverage
now, stop and call the Department of Insurance at 1-800-259-5300.
agent or salesperson does not explain the coverage included in
the policy or does not provide a full list of the coverage.
benefit health insurance plans are legitimate health insurance
plans offered by many insurance companies, but some agents or salespeople
be fully explaining the limits to these policies. These bare bones policies
typically have lower premiums, but they only cover specific expenses and
have many more limitations than a comprehensive medical plan.
plans also have
higher co-insurance percentages, co-payments and deductibles than comprehensive
plans. These types of policies also have low maximum benefit limits called “caps,” so
it may be possible for you to reach your cap quickly, leaving you responsible
for the balance of the bill. If you are considering a limited benefit health
insurance plan or a high deductible health insurance plan in conjunction
with a Health Savings Account (HSA), be sure to research the plan before
• The agent or salesperson claims the coverage will be "grandfathered" or
exempted from changes required by the health care reform law.
Only policies purchased
before President Obama signed the PPACA on March 23, 2010, will
be "grandfathered" or exempted
from changes required by the law. Any policy purchased now must comply
with all of the changes required by the bill to satisfy the individual
mandate in 2014. If an agent or salesperson claims otherwise, stop
and call the Department of Insurance at 1-800-259-5300.
For a list of the changes included in the PPACA and when they will
go into effect, visit the NAIC Health and Managed Care Committee
Web page (http://www.naic.org/committees_b.htm) and look for the
PPACA charts. Information can also be found on the White House Web
site (http://www.whitehouse.gov/healthreform) and the HHS Web site
(http://www.healthreform.gov/). Commissioner Donelon urges consumers
who feel uneasy about any insurance related transaction to call the
Department of Insurance Fraud Section at 225-342-4956 or 1-800-259-5300.
If callers do not want their names used, they can request that their
involvement be kept confidential.