Agents who Lie About Income = $250,000 Fine

[cadylou]

Very simple - they want agents out of the individual market . . . only a matter of time.

 

[FLM2]

These rules are ridiculous and unless someone knowingly and deliberately violates HIPAA protected information would ever be enforced.

We have all been subject to the laws relating to HIPAA protection for many years-it has a $50,000 minimum fine, has anyone ever thought twice about this?

In order to protect ourselves, however, it would be best to have each client sign something that agrees that the information provided regarding the subsidy determination is accurate to the best knowledge of the applicant at the time the application was submitted and that the agent has no influence on this information-I would think that would be enough to avoid any issues. At the same time, however, I am probably going to discuss this new rule with an attorney and come up with a plan to CMA. I have done a great job for my clients in full compliance of the law and will not jeopardize that by making assumptions.

 

[RayNY]

In order to protect ourselves, however, it would be best to have each client sign something that agrees that the information provided regarding the subsidy determination is accurate to the best knowledge of the applicant at the time the application was submitted and that the agent has no influence on this information

You have to agree to something saying almost exactly that in order to get a subsidy.

If they're disregarding the applicant (not broker) agreeing to that, why would a different piece of paper saying the same thing, involving the same people, signed at the same time, be any more valid?

It's going to be a game of "he said-she said", and you know who the first person to be thrown under the bus is when the client gets a clawback taken from their tax return. They'll happily cost us a quarter million, our license, and reputation, to get an extra $1,000 on their tax return.

 

[FLM2]

You have to agree to something saying almost exactly that in order to get a subsidy.

If they're disregarding the applicant (not broker) agreeing to that, why would a different piece of paper saying the same thing, involving the same people, signed at the same time, be any more valid?

It's going to be a game of "he said-she said", and you know who the first person to be thrown under the bus is when the client gets a clawback taken from their tax return. They'll happily cost us a quarter million, our license, and reputation, to get an extra $1,000 on their tax return.

If a client makes that claim after agreeing that the information provided was correct then an agent would have cause for legal action against the client for full damages, why would anyone want to start something like that?

No one is going to get fined $250000 for an applicant saying that they didn't give you the information on the application, civil penalty awards would have to be based on the harm to the applicant.

If this were enforced to the maximum of the law (or anything close to it) an agent would have to be crazy to take this risk, period.

 

[bill3173]

If agents are really doing this to a large extent, and not just the client fudging, then heads will roll over this s-word.

 

[somarco]

Unless you have a recording of the conversation it is your word against theirs.

Of course buyers are never liars.

 

[taterpeeler]

Unless you have a recording of the conversation it is your word against theirs.

Of course buyers are never liars.

hahah... recording you say? really? who the hell has that technology? What agent records all his calls?.... ME ME ME ME ME ME ME ME ME ... record every damn one of them, including all calls to WBE venders... I record my wife talking to her parents in Sweden every week... just let one client attempt to hang me out to dry and watch me hang them by their private parts

 

[AllenChicago]

CMS makes enrollment so easy that a demented chimpanzee can do it, yet they are paranoid that someone will cheat the system?

There are very few Non-Obamacare companies naive enough to allow enrollment in an insurance (life, disability, LTC, etc.) plan with no wet signature, secure electronic signature method, or verification call requirement.

 

[RayNY]

hahah... recording you say? really? who the hell has that technology? What agent records all his calls?.... ME ME ME ME ME ME ME ME ME ... record every damn one of them, including all calls to WBE venders... I record my wife talking to her parents in Sweden every week... just let one client attempt to hang me out to dry and watch me hang them by their private parts

I do the same thing here, and archive all e-mails. IP phones are awesome.

OF course, all those clients who typed their initials in and agreed to the attestation? No way to prove they really did that.

FLM, while CMP's are typically tied to the monetary gain, the agent has no monetary gain (commission is the same, regardless of subsidy), and the client has no loss/harm (no punitive damages, just a "wash" when the APTC is reconciled. In fact, it might even be a net gain due to clawbacks, as we've discussed previously). These fines are going to be purely punitive, and as such, just becomes a matter of how much they feel like you should pay. I'd bet, they feel like you should pay a lot.

 

[FLM2]

I do the same thing here, and archive all e-mails. IP phones are awesome.
fines are going to be purely punitive, and as such, just becomes a matter of how much they feel like you should pay. I'd bet, they feel like you should pay a lot.

No offense but that is a ridiculous comment based on an assumption.

If you believe that something written (a statement from the client) then why would you think a recorded phone call would be any better? The client could simply say 'there was another conversation' or 'the recording has been edited' or any number of other things and then it is still 'he said she said'.

These kind of punitive fines would never hold up in court-that doesn't mean I won't take steps to protect myself but I'm not going to lose any sleep over it either.

The company that has the most to lose is Ehealth, their fines potentially could be in the tens of millions of dollars, it will be interesting to see their reaction to this as well as the other large national agencies.