HealthCare.gov Blasts Reports of Unauthorized Plan Switching

News April 16, 2024 at 02:00 PM
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Managers of the federal health insurance enrollment website, HealthCare.gov, are asking consumers to call them if agents or brokers have put them in new plans without telling them.

Officials at the Centers for Medicare and Medicaid Services, the arm of the U.S. Department of Health and Human Services that runs HealthCare.gov, were reacting to a report by KFF that rogue agents and brokers are disrupting some consumers' coverage and finances by changing their coverage.

HealthCare.gov helps private health insurers enroll consumers in individual major medical coverage in 32 states. About half of its business comes in through agents and brokers.

CMS calls HealthCare.gov "the Marketplace."

If rogue producers have replaced consumers' coverage without warning, CMS can help them restore their old coverage, cancel the new coverage and correct their tax forms, officials said.

Consumers should call the HealthCare.gov call center at (800) 318-2596 to report the possibility of unauthorized plan switching, officials said.

"CMS suspends and terminates agents' and brokers' Marketplace privileges when they violate CMS rules or commit fraud," officials added. "Our regulations require agents and brokers to obtain and document consumer consent before enrolling a consumer in Marketplace coverage or updating a consumer's Marketplace coverage."

CMS intends to fight the problem by working with state insurance regulators and state law enforcement agencies and by updating its procedures and information technology systems.

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