Tag Archives: insurance exchange

Health Insurance Exchange Scam Alert: Beware of Fake Websites

The Identity Theft Resource Center (ITRC) has growing concerns regarding the potential for new scams concerning the implementation of the Health Insurance Exchange (HIE) websites as part of the Patient Protection and Affordable Care Act (also known as Obamacare). These exchanges are currently online with enrollment due to start on October 1st.

According to the Act, each state must implement insurance exchanges. These exchanges are to serve as online marketplaces (websites) for consumers to compare rates and make choices about which health insurance coverage is best for them. Each state has the ability to determine the best way to manage these exchanges in order to meet the needs of their uninsured residents.

The open enrollment period for these exchanges begins on October 1, 2013. There have already been some predictions that there will be “bugs and glitches,” to quote President Obama, during this process. IT professionals are already voicing concerns regarding the ability to handle the amount of traffic anticipated on the first day of the rollout. However, no one is talking about ensuring that consumers actually know and understand where to go in the first place.

There is huge potential for misinformation and misunderstanding with this new insurance exchange program. Consumers will now be mandated (or face a penalty come tax time) to purchase health insurance if they don’t have existing coverage. The official website, www.healthcare.gov will be used by the majority of the states. But 17 states have opted to manage their own unique exchange with a different URL. This has the potential to cause much confusion for consumers. While it may appear that this information would easily be located via an internet search, our experience was that the official website was not easy to locate. In fact, when we searched for “health insurance exchange official websites” (rather than “website”) the websites for the 17 states that have their own unique URLs appeared, but www.healthcare.gov did not appear on the first page.

From our experience with scams and fake websites, we believe it would be extremely easy for scammers to create multiple websites that will trick consumers into thinking that it is either the federal health exchange website or one of the alternative state websites. Without known and reliable sources, there exists a great opportunity for gaming of the Internet search engines to attract consumers to websites intent on harming them by eliciting the fraudulent collection of personal identifying information (PII). There is a need to present factual information about which websites represent the accredited websites for the new insurance exchanges.

While there is a comprehensive list of insurance exchange websites on www.healthcare.gov, we are concerned that consumers may not find their way there in the first place. Already our searches indicate that there are organizations using keywords such as “Obamacare” and “Health insurance exchange” in the paid advertising section that are not the official insurance exchange websites. While these websites may not be scams, our concern is that it will only be a matter of time before imposter websites intent on real consumer harm surface.

This concern has a historical basis. The Fair Credit Reporting Act (FCRA) requires each of the Credit Reporting Agencies (CRAs: Experian, Transunion, and Equifax) to provide consumers with one free credit report annually. Confusion still exists between www.annualcreditreport.com, which is the court-mandated website hosted by the credit reporting agencies that actually provides annual free credit reports to consumers, and other websites that offer free credit reports or free credit scores such as www.freecreditreport.com, hosted by one of the credit reporting agencies. Soon after the creation of the original mandated website, dozens of look-alike websites were created. Consumer protection organizations, including the Federal Trade Commission, continue to educate consumers about this to this day (Consumer Information: Free Credit Reports) even though the mandated free website was launched in December 2004.

With the operational launch of these new insurance exchanges just a few short months away, consumers will be scrambling to comply before the January 1st, 2014 deadline. We already stated that we expect consumers to use search engines to locate the particular website they are supposed to use, and that the searches are inconsistent. With that knowledge, will regulators put provisions in place to identify, deter, monitor and address imposter websites? Or do they presume that the existing regulatory or enforcement provisions will deter those who create malicious fake websites intended to capture the personally identifiable information of consumers? Information provided to a fake insurance exchange website could be used to commit identity theft and other frauds.

There will be two types of imposter websites that will require redress. Not all imposter websites are created equal. There are differing levels of harm depending upon the type of imposter website consumers discover. There are legitimate businesses cutting corners and engaging in misleading tactics to secure new business and there are outright scam websites, whose intention is to secure personally identifiable information for malicious use.

Phishing and smishing could eventually come into play.

In 2012 “Imposter Scams” ranked 6th (out of 30) in the list of most complained about fraud events according to the FTC Consumer Sentinel Report. The 82,896 complaints represented 4% of the total complaints received by the FTC.

This category is defined by the FTC as “complaints about scammers claiming to be family, friends, a romantic interest, companies, or government agencies to induce people to send money or divulge personal information.” Complaints included the following: Scammers posing as friends or relatives stranded in foreign countries without money, scammers claiming to be working for or affiliated with government agencies, and scammers claiming to be affiliated with a private entity (a charity or company).

By far, the largest subtype of scam was regarding government agency imposters, with over 43,000 of the total in that category. Previous years’ statistics indicate that year over year, government imposters were the most complained about subtype: 47,454 in 2011 and 49,321 in 2010.

This demonstrates that the scammers continue to find impersonating the government to be a lucrative enterprise. Since this is a new program, even those consumers who normally know not to click on strange links in emails or respond to unknown senders of text messages, may feel compelled to respond and potentially share their personally identifiable information via these means. Why should we believe that the health care exchanges will be immune to this kind of impersonation?

If past behavior is an indicator, we can be sure that there will be financial harm to at least some of these victims.

The Internet Crimes Complaint Center (IC3) 2011 report states that it received approximately 39 complaints per day regarding FBI impersonation email scams. IC3 presented a total loss for this type of impersonation scam (via phishing emails) as over $3 million dollars. This number is just for the complaints that the IC3 received and does not take into account all the unreported losses.

A fundamental part of the Identity Theft Resource Center’s mission is to serve as a relevant national resource on topics such as this. In an effort to provide consumers with the important information they need about potential insurance exchange scams, the Identity Theft Resource Center has developed a scam alert and posted additional information on its website to help educate consumers.

The Identity Theft Resource Center is hopeful that there will be strong and coordinated efforts to educate consumers as to the authentic websites for these exchanges. As they differ from state to state, universal messaging will be difficult to coordinate. Of course, there will be glitches, and as with any new process, we will only discover what these are when the actual user experience is reviewed. However, these efforts need to take place now.

Is It Better To Pay The PPACA Penalty Or Continue Offering Health Coverage?

When 2014 arrives, employers and their workers must be prepared for the changes brought by the Patient Protection and Affordable Care Act (PPACA). New regulations will require larger employers to offer medical coverage to employees or pay a penalty for not doing so. This is why it is important for employers to start analyzing their options and developing a strategy sooner rather than later.

Many employers have reported that the PPACA law will increase their expenses, which will result in the need to reduce workers' hours or lay off employees. Many employers are favoring the idea of eliminating their health insurance offerings, in part because the penalty appears to be much cheaper than the cost of the coverage they are currently providing. Although paying the penalty may seem like the right answer for some employers, there are several reasons why this may not always be the best choice.

Reporting Requirements
If employers eliminate their health coverage offerings, they will be subject to federal reporting rules to determine the amount of the company's penalty that applies. In addition to collecting more data from employees, employers may have to deal with the hassles of inquiries from the state insurance exchanges about whether coverage is available to employees.

Losing Tax Breaks
Employers offering health coverage qualify for several tax breaks. For example, employee premiums paid through Section 125 plans are not counted as taxable wages, which reduces the payroll taxes paid by the employer and employees. Employers who do not sponsor coverage will lose some of these tax breaks.

Difficulty Recruiting And Keeping Top Talent
If employers make too many cuts to their health programs or choose not to offer coverage, they could make their companies less attractive to the best potential employees. Workers who are considered top talent may start looking elsewhere for employers offering health benefits. In addition, the costs of hiring new workers, compensating for lost productivity and paying the costs associated with business disruptions could cost more than offering reasonable coverage.

Variable Financial Complications
If employers decide to drop coverage, they will likely see employees start demanding other forms of compensation, since they will be expected to use their own money to pay for coverage in the state insurance exchange. Furthermore, the penalties are not deductible as a business expense for the company, and the penalties may increase over time.

Counting Difficulties
It will be difficult for most employers to form a final count of their staff. Classifying part-time and full-time employees is not an easy process. In 2012, the Internal Revenue Service released a set of rules that are not completely clear about what constitutes part-time status. If employers miscalculate how many part-time workers they have, this mistake could be costly.

The Patient Protection and Affordable Care Act will bring big changes for both employers and employees. As employers develop their plans for 2014, the impact on both the business and the employees over the next several years should be considered.