Report: Former TV writer exploiting ACA to sell bare-bones insurance plans

A former TV comedy writer is operating a telemarketing group for low-value medical insurance, selling plans on a marketplace that exploits a complicated loophole in the Affordable Care Act (ACA) that allows companies to “hire” members for fake jobs, effectively making them eligible for coverage that does not meet the standards of the law. 

The company, Quick Health, is run by Arthur Walsh, whose alleged deceptive practices have resulted in raids on his business from the FBI. However, the company is still operating, despite an ongoing federal investigation into its practices. 

The story is told in an exposé from Bloomberg, that details how Joe Strohmenger, a self-employed contractor from Rocky Point, New York, and his wife were signed up for medical coverage that later failed to pay claims. 

According to the couple, a salesperson from Quick Health promised coverage for essential services, including treatment for Strohmenger’s ongoing battle with a brain tumor. 

However, after paying $8,734 for a year of coverage, Joe and his wife Sarah discovered the plan was a “junk” policy with minimal benefits, leaving them with over $20,000 in bills that should have been covered. The couple soon learned their plan, which is regulated by the Employee Retirement Income Security Act (ERISA), is only allowed to be offered to employees of a company. 

Joe and Sara contend that—unbeknownst to them—their coverage was tied to a "job" in Georgia, where Joe is listed as an “employee” of a company he's never heard of. 

Bloomberg said this is an all-too-common tactic used to circumvent health insurance laws and avoid ACA requirements. While seemingly tantamount to fraud, loopholes make it possible—and enrollees seeking insurance online are falling victim. According to the report,more than 10,000 people a year are unwittingly signed up for insurance under the pretense of being employees of an organization.

Walsh blames outreach and brokers for any deception, and he denied that his company engaged in any fraud or illegal activity.  

For a lot more context, read the full feature from Bloomberg at the link below.