Fraud alert for health insurance consumers

California Attorney General Kamala Harris issued the following alert regarding the removal of 10 private health insurance websites that may have misled Californians by imitating Covered California, the state’s official online health insurance marketplace:

“These websites fraudulently imitated Covered California in order to lure consumers away from plans that provide the benefits of the Affordable Care Act,” Attorney General Kamala Harris said. “My office will continue to investigate and shut down these kinds of sites. I urge Californians to avoid health care scams by visiting coveredca.com.” In September, the California Attorney General’s Office began an investigation into websites that imitate the state’s Covered California website (www.coveredca.com). Multiple website operators were sent cease and desist letters informing them that their websites were in violation of state law and demanding the immediate removal of the website or transfer of the domain name to the state’s official exchange. These websites were operated by private health insurance brokers or companies that were not affiliated with Covered California. The websites have domain names similar to the state’s official health care exchange and contain unauthorized references to the official exchange’s trademarked logo and name. In several cases, websites used the phrases “Get Covered,” “Covered California” and “California Health Benefit Advisers.” The California Affordable Care Act forbids individuals or entities from claiming to provide services on behalf of Covered California without securing a valid agreement with the state exchange. (Gov. Code, § 100510.) State law also prohibits solicitations that falsely imply a governmental connection (Bus. & Prof. Code, § 17533.6), the use of a domain name that is confusingly similar to another entity (Bus. & Prof. Code, § 17525), making or disseminating untrue or misleading representations with the intent of selling goods or services (Bus. & Prof. Code, § 17500) and unfair competition through untrue or misleading advertising (Bus. & Prof. Code, § 17200). To date, all website operators who have been contacted by the Attorney General’s Office have complied, and the following websites have been either deactivated or redirected to the official exchange website:

www.californiabenefitexchange.com

www.californiahealthbenefitexchange.com

www.coveredcalifornia.com

www.shopinsuranceexchange.us

www.shopinsuranceservices.com

www.healthexchangeinsurance.com

www.shopforhealthcare.org

www.taxcreditinsurance.com

www.smallbusinesshealthoptionsprogram.com

www.stateexchanges.org

The California Health Benefit Exchange is charged with implementing the ACA and is the operator of California’s online health insurance marketplace known as Covered California. California consumers who purchase health insurance policies through this marketplace receive protections guaranteed by the ACA that may not exist in policies outside of the exchange. Health insurance plans sold outside the official exchange on the individual market before Jan. 1, 2014, do not qualify for federal subsidies and do not have the guarantees provided by the ACA’s consumer protection provisions. Major consumer protections include: no denials based on preexisting conditions; no rating differences based on factors other than age, geography, and family size; issuers may not impose any annual dollar limits for covered services; and all qualified plans must cover essential health benefits identified under the ACA. The California Attorney General’s Health, Education and Welfare Section, in conjunction with Covered California and the California Department of Insurance, will continue to monitor these and other potentially fraudulent sites. To avoid scams related to California’s health insurance marketplace, Harris has released the following tips for consumers:

  • California’s only official health insurance marketplace is www.coveredca.com, which is where individuals, families and small businesses can get information, compare plans and enroll.
  • Be wary if you receive a call from a representative claiming to be a government official asking for your personal information like Social Security number or Medicare card number. You should not provide personal or financial information over the phone and should instead contact Covered California directly.
  • If you are approached by someone offering assistance from Covered California, verify that they are a Certified Enrollment Counselor by asking to see their required ID badge or by contacting Covered California directly.
  • Never pay someone for assistance with health care enrollment. Free enrollment assistance is available by contacting Covered California directly.
  • If you believe that you have been the victim of a scam, please report it by contacting Covered California directly or by filing a consumer complaint with the California Attorney General’s office at: http://oag.ca.gov/contact/consumer-complaint-against-business-or-company

To contact Covered California directly, call (800) 300-1506 or email consumerprotection@covered.ca.gov. Assistance by phone is also available in the following languages:

Arabic: 800-826-6317

Armenian: 800-996-1009

Chinese: 800-300-1533

Farsi: 800-921-8879

Filipino: 800-983-8816

Hmong: 800-771-2156nie

Khmer: 800-906-8528

Korean: 800-738-9116

Lao: 800-357-7976

Russian: 800-778-7695

Spanish: 800-300-0213

Vietnamese: 800-652-9528

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    Joe Goldeen

    Joe Goldeen has been with The Record since 1990. He is an award-winning journalist and member of the California Endowment Health Journalism Fellowship. He is a native of Northern California with a bachelors degree in political economy from the ... Read Full
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