Streams

Adding To Insurance Confusion, Outside Groups Try To Cash In

Saturday, November 02, 2013

Thirty or so attendees at St. Mary Primitive Baptist Church in Tallahassee, Fla., gathered on a recent evening to hear a presentation by the Obamacare Enrollment Team on their options to get insurance under the Affordable Care Act.

"If anybody is interested in getting enrolled, we can get you enrolled tonight," they were told.

Signs outside the church looked official: A familiar, large "O" with a blue outline, white center and three red stripes.

But the presenters, Pastor H.B. Holmes and Katrina Copeland, are not part of the federal government, nor are they credentialed by the federal government to be "navigators."

"I'm a registered lobbyist with the Senate and House, so I don't have to have a navigator license," Copeland said. "I have my credentials from the U.S. Senate and House of Representatives."

Actually, she does have to be licensed. Real navigators and certified application counselors have received federal approval to impartially assist people in signing up for insurance through HealthCare.gov, the federal website where people are supposed to be able to browse all the plans available, figure out what subsidies they might qualify for (or if they qualify for Medicaid), and apply for coverage with a private insurer.

The Obamacare Enrollment Team didn't mention HealthCare.gov during their presentation at St. Mary. Instead, they offered a narrower choice of plans than consumers can find on the federal site.

In fact, Copeland and Holmes work for health insurance agencies and agents, specifically the Fiorella Insurance Agency in Stuart, Fla.

The agency's vice president, Nick Fiorella, runs Obamacare Enrollment Teams in various states โ€” particularly "in urban communities where we feel there is a lot of misinformation and education that needs to be done in order to inform individuals of their health insurance options in regard to health care reform," he says.

After questioning, Holmes reluctantly acknowledged that he and Copeland weren't working directly with HealthCare.gov, and were instead "marketing" for specific insurers, including Florida Blue and Humana.

What the Fiorella insurance agents are licensed and authorized to do is to sell insurance to consumers.

Florida Blue officials did not return a request for comment, and Humana officials declined to be interviewed. However, in a statement, company spokesman Mitch Lubitz confirmed Humana does business with Fiorella's agency, but that Humana "does not endorse nor participate in Fiorella's health reform or Affordable Care Act seminars."

Other insurance agents trying to navigate the new health insurance market see the Obamacare Enrollment Teams as giving their industry a bad rap.

"Transparency has to be at the forefront because ... there's a void of education," says Bart Gunter, executive vice president of Rogers, Gunter, Vaughn Insurance company in Tallahassee. "People are vulnerable. When people don't know, the darker side kinda comes in and takes advantage of that."

When asked about the similarity of the Teams' promotional materials to the Obama campaign logo, Fiorella said:

"Whenever we're made aware of materials that are not approved, we make our best efforts to get those materials out of circulation." As of now, the familiar symbol is gone from the Enrollment Team website.

Several attendees at the St. Mary church event, who did not want to be identified or directly quoted, said they were worried about the lack of transparency, but were grateful the Obamacare Enrollment Team had come into their community โ€” and openly questioned why the federal government's own navigators and counselors weren't present.

The U.S. Department of Health and Human Services didn't comment for this story, but in a statement, a spokeswoman says allegations of fraud are taken seriously.

A complaint against the Obamacare Enrollment Team has been filed in Illinois regarding the group's website, but it was cleared of any wrongdoing. Consumers also have raised concerns in Michigan, too, where people say they were led to believe the group is affiliated with the federal government. Another complaint was filed in Florida, and now state regulators there are looking into the group's activities as well.

This story is part of a collaboration with NPR, WFSU and Kaiser Health News.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Source: NPR

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