Cashing in on ACA Confusion
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 — 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 — 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/.
ARUN RATH, HOST:
And with those federal insurance exchanges still not fully functional, many uninsured are turning to local groups to figure out how and where to purchase insurance.
In North Florida, a lack of coordination among the different agencies charged with doing outreach for the health care law has created big gaps in the system, and that's opened a door for some dubious outfits to enter the scene.
Lynn Hatter of member station WFSU in Tallahassee looked into those groups.
LYNN HATTER, BYLINE: The 30 or so attendees at Tallahassee's St. Mary's Primitive Baptist Church believed they were about to hear a presentation on the Affordable Care Act.
H.B. HOLMES: So if anybody is interested tonight in getting enrolled, we can enroll you tonight.
HATTER: The presenters call themselves the Obamacare Enrollment Team but are not part of the federal government. Fiorella Insurance Agency vice president Nick Fiorella Jr. runs the teams, which operate in different states.
NICK FIORELLA JR.: Specifically in a lot of urban communities where we feel that there's a lot of misinformation and a lot of education that needs to be done to inform individuals of their health insurance options with regard to health care reform.
HATTER: Tonight's presenters were Florida Pastor H.B. Holmes and Katrina Copeland. They talked about Obamacare but were full of misinformation. They didn't actually mention HealthCare.gov, the federal marketplace website. And they steered people towards a smaller range of insurance plans than what the federal government's health insurance marketplace offers. And Katrina Copeland is not certified to help people enroll as she claims.
KATRINA COPELAND: I don't have to be licensed because I am a registered lobbyist with the Senate and House, so I don't have to have a navigator license. I have my credentials from the U.S. Senate and House of Representatives.
HATTER: But she does have to be licensed. Real navigators and certified application counselors have received federal approval to assist people in signing up for insurance through HealthCare.gov. The presenters also weren't forthcoming about who they represented. Copeland and Pastor Holmes work for the insurance broker Fiorella, a fact Holmes only admitted after he was asked directly.
You guys are not working directly with HealthCare.gov. You are working with insurance agents...
HATTER: ...and the state?
HATTER: And you are affiliated with Florida Blue.
HOLMES: That is correct. We're doing some work with them on the marketing side, yes.
HATTER: Company vice president Nick Fiorella says his agency represents several health insurers, including Florida Blue and Humana, marketing and selling individual health insurance plans to consumers and families.
JR.: The Obamacare Enrollment Team should not be associated with any specific insurance carrier. None of the materials (unintelligible) should have any specific carrier on them.
HATTER: But those materials include a logo for Florida Blue Insurance and one similar to an emblem most people associated with the president: a large O with a blue outline, white center and three red stripes. Nick Fiorella.
JR.: Whenever we're made aware of materials that are not approved, we do our best efforts to get those materials out of circulation.
HATTER: The Fiorella Insurance agents are also licensed and authorized to sell consumers' insurance. Florida Blue officials did not return a request for comment, and Humana officials declined to be interviewed on tape.
However, in a statement, company spokesman Mitch Lubitz confirmed Humana does do business with Fiorella, but that the company, quote, "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 Team and the Fiorella Insurance Agency as giving their industry a bad rap. Bart Gunter is the vice president of Rogers, Gunter, Vaughn Insurance company in Tallahassee.
BART GUNTER: Transparency has got to be in the forefront because when you're taking advantage of - there's a void of education. And so, you know, people are vulnerable to that void. And so when people don't know, it always - the darker side kind of comes in and tries to take advantage of that.
HATTER: A complaint against the Obamacare Enrollment Team was filed in Illinois regarding the group's website, but the group was cleared of wrongdoing. Consumers have also raised concerns in Michigan where people say they were led to believe the group is affiliated with the federal government's health insurance marketplace website. For NPR News, I'm Lynn Hatter in Tallahassee.
RATH: This story is part of a reporting partnership with NPR, WFSU and Kaiser Health News. Transcript provided by NPR, Copyright NPR.