Date: September 24, 2013
For more information contact: J.P. Wieske, Public Information Officer, (608) 266-2493 or jp.wieske@wisconsin.gov

Scammers Take Advantage of Health Reform Confusion
State Insurance Regulators Warn Consumers to Be On Alert

Madison, WI—Since the Affordable Care Act (ACA) was signed into law in March 2010, unscrupulous scammers have been creating ways to take advantage of consumers' uncertainty surrounding the law. Posing as insurance agents or representatives of the federal government, these scam artists try to sell fraudulent policies or obtain sensitive information like Social Security and bank account numbers. The National Association of Insurance Commissioners (NAIC) and the State of Wisconsin Office of the Commissioner of Insurance (OCI) are warning consumers about common red flags and providing tips on how to avoid being the victim of a scam.

Health Insurance Marketplaces
One of the largest components of the ACA is the creation of new health insurance exchanges. An exchange is a Web site that will allow consumers to shop for health insurance plans. These online portals ask consumers to enter personal information and select a benefit level to receive a list of approved plans.

Open enrollment in the exchange begins October 1. However, bogus Web sites that purport to be part of the exchanges have been appearing online for more than a year. Do not enter any personal or financial information into a Web site that says you can purchase a policy before the open enrollment period on October 1, 2013.

The federal government is running the exchange in Wisconsin and the link can be found on www.healthcare.gov.

New "Obamacare" Insurance or Medicare Cards
Another common ploy involves unsolicited calls from scammers who claim to have your new "Obamacare" insurance card—they just need to get some information before they can send it to you. The caller then asks for credit card numbers, bank account information or your Social Security number. A variation of this trick specifically targets seniors on Medicare; the caller claims that in order for them to get their new Medicare card and continue receiving their benefits, they must verify their bank account and routing numbers. In other cases callers ask for their Medicare numbers, which are identical to Social Security numbers.

You are not required to obtain a new insurance or Medicare card under the ACA. Also, anyone who is a legitimate representative of the federal government will already have your personal and financial information and should not ask you to provide it.

Don't Be Misled
Here are some other important "red flags" to watch out for:

  • The salesperson says the premium offer is only good for a limited time.
    Enrollment in the exchanges will be open from October 1 to March 31, and rates for plans in the exchanges will have been approved for the entire enrollment period. Be skeptical of someone who is trying to pressure you into buying a policy because the rate is only good for a short time. Remember: if the offer sounds too good to be true, it probably is.
  • The salesperson says you could go to jail for not having health insurance.
    Starting in 2014, all Americans will be required to have health insurance. You will not face jail time if you do not purchase health insurance. However, those who remain uninsured and do not qualify for any exemptions will face a penalty of $95 (for each adult) or 1% of family income, whichever is greater. (www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision)
  • You receive an unsolicited phone call or e-mail from someone trying to sell insurance that you do not know. You may receive a phone call from an insurance agent or a navigator; however, always verify the identity of the person contacting you. Check with OCI and the exchange for the person's license number and ask for identification.

Protect Yourself
The best way to protect yourself from insurance fraud is to research the agent and company you're considering. Always STOP before writing a check, signing a contract or giving out personal information. CALL the Office of the Commissioner of Insurance and CONFIRM that the agent and company are licensed to write insurance in Wisconsin.

More Information
For more information on health care reform, visit www.healthcare.gov. You can find additional information on the ACA on the HHS Web site.


Created by the Legislature in 1871, Wisconsin's Office of the Commissioner of Insurance (OCI) was vested with broad powers to ensure that the insurance industry responsibly and adequately met the insurance needs of Wisconsin citizens. Today, OCI's mission is to lead the way in informing and protecting the public and responding to its insurance needs.