Agents who Lie About Income = $250,000 Fine

[russelltw]

The IRS will go after those who claim too much subsidy. There is a cap to the clawback, for those under 400% of FPL, but the IRS will still collect. (The IRS is limited in collection techniques for the Individual Mandate Penalty, which many people assume applies to the clawback also, but it does not.)

Great point Ann. I hope this is true. I hate it that other agents (many of them are brand new) are ruining it for us once again. I tried to do everything by the book last year and this year. I have an agent (who is on this forum) have an issue with a local agent. The local agent created the entire app by himself. Asked the client for address, ssn, dob, etc. Then proceeded to submit half her income (20k instead of 40k), created the application entirely by himself. Client never enrolled, but the created app made issues when they tried to apply this year. Wonder how many people he did this with?

 

[somarco]

Many agents took advantage of the system when MA plans were first introduced. The result was a bunch of new rules and restrictions on marketing, certification, etc. and reduced commissions.

Obamacare will go through the same maturation process except much quicker than MA.

Of course the GSE type organizations that are allowed to do anything with impunity will continue to be a fly in the ointment.

 

[VolAgent]

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.

If you truly believe this, then why you are writing any marketplace business? In your world, a simple accusation is enough to hang an agent with a $250,000 fine. It doesn't even matter if you as an agent changed the person's income or not. They simply have to claim you did.

As a matter of fact, why are you in business period? If any recording or written document is suspect, then there is no basis on which business can be conducted with any level of trust.

It will be a complete "He-said, she-said" and there is absolutely no financial gain to the agent either way. You may get an administrative judge to rule against an agent, but a real judge is going to take a dim view of this unless they can show a pattern.

 

[FLM2]

If you truly believe this, then why you are writing any marketplace business? In your world, a simple accusation is enough to hang an agent with a $250,000 fine. It doesn't even matter if you as an agent changed the person's income or not. They simply have to claim you did.

As a matter of fact, why are you in business period? If any recording or written document is suspect, then there is no basis on which business can be conducted with any level of trust.

It will be a complete "He-said, she-said" and there is absolutely no financial gain to the agent either way. You may get an administrative judge to rule against an agent, but a real judge is going to take a dim view of this unless they can show a pattern.

I'm not sure why you chose to quote my post and question why I am in the business when I am taking basically the exact same position as you.

 

[VolAgent]

I'm not sure why you chose to quote my post and question why I am in the business when I am taking basically the exact same position as you.

Really? It seems your position is you are truly afraid of this.

I suspect it is mostly an empty threat and will only be used against those who have shown a pattern of bad behavior.

 

[yorkriver1]

At least one E&O carrier is notifying agents that tax advice about anything, including subsidies is not covered on their insurance agent E&O. They have provided a disclaimer paragraph to include in all correspondence.

Kind of a legalese of the humorous disclaimer Ann H includes in her tagline on the Forum. We point to tax rules, but don't give iron clad professional advice about them. Someone else can speak to the effectiveness of disclaimers, like the HIPAA paragraphs in emails and on faxes.

 

[Yagents]

At least one E&O carrier is notifying agents that tax advice about anything, including subsidies is not covered on their insurance agent E&O. They have provided a disclaimer paragraph to include in all correspondence.

can you copy/paste/type that disclaimer here on the forum?

 

[yorkriver1]

"We provide general information and resources for taxation questions applicable to health care reform. We do not provide tax advice since we are not a certified public accountant. If you have any questions, need clarification or tax advice, please contact your tax advisor."