As described in the recent New York Times article, “Con Men Prey on Confusion Over Health Care Act,” the number of questions about Obamacare is rivaled only by the number of scams targeting this confusion. The scams vary from convincing people to buy extra unnecessary insurance and charging exorbitant fees to “help” them navigate the new system, to stealing Medicare and Social Security information on the pretext of “updating” their Medicare records. Though these types of fraud target individuals, there are also scams focused on employers.

Employers need to accomplish two primary goals:

  • Decide what they need or wish to provide to employees, keeping in mind the new Affordable Care Act regulations.
  • Educate their employees on their healthcare plan options. 

Further complicating these tasks are the complexities of the regulations and the significant rise in the number of employed individuals reaching Medicare age. This creates an opportunity for fraud on a much larger scale.

To avoid falling prey to employee benefits program scams, executives and business owners need to distinguish between 2 different types of brokers:

 Health Insurance Brokers(Medicare) Education Brokers
What They Offer
  • Offer to "assist" employees in enrolling in the new federal insurance exchanges
  • Often offer rebates to businesses if they enroll employees in their programs
  • Offer Medicare education services: explain to employees how the employer plan interacts with Medicare coverage
  • Businesses refer employees on Medicare or reaching Medicare age to this optional service
What You Get
  • Potential legal trouble, as rebates are widely considered unethical in the insurance field and in many states rebating is explicitly illegal
  • Help with understanding the new system
  • Employees get a choice
  • Employers get goodwill for offering another resource resource
Bottom LineBe wary of brokers offering you rebates or offering to do your job for you.Be open to brokers offering to educate your employees on their options.
 Source: TrustedPeer.comExpert Dan Hodges

As with any new governmental program, there will be difficulties in its implementation.  Both individuals and businesses should be aware of the potential for fraud or unethical practices. If you have any questions regarding the new rules and regulations, seek assistance from known and reputable advisors. Most businesses are aiming to help demystify the healthcare enrollment process, but it’s always worth it to make sure you know who you are doing business with, especially in the brave new world of health care.

If you need consulting on Employee Healthcare Benefits, contact TrustedPeer Expert Dan Hodges.