ACA - NoCall Leads Compliance

[Yagents]

It suppose to be 2 tax filings, which can be 3 yrs before terminated, and lots of commissions for a family of 4 during those 3 yrs

 

[Tkruger]

Right, Biden taking away someone's health plan? Not happening

Yagents, much respect.

Kinda missed the commission of fraud part.

 

[Yagents]

Yagents, much respect.

Kinda missed the commission of fraud part.

Don't understand your question or statement

 

[Tkruger]

Question is, if there is no contact with a person, selecting loss of Medicaid to gen an sep with no supporting documents...This not Fraud?

 

[scagnt83]

because its not relationship based, they are using ads saying they can have and agent find them the best plan $0 without ever speaking with an agent

thats the hook

then the prospect filles out a form where they check wavers allowing the agent to run apps for them

And the issue is..... what exactly?

I understand the business model.

They are getting a silver plan, right?

Are they getting screwed by not being sold a gold plan?

And why will requiring SSN kill that whole biz model?

 

[scagnt83]

Basically, they are using massive amounts of tax payor dollars, to fully pay for the ACA plan of up to $800/mo, where the client gets a free plan, without even providing a social security number, sometimes a fake address, no email address or phone number, and the client never knows that the policy just continues renewing at $0, doesn't file taxes, or reconcile the tax credits..........but the agent keeps getting paid the $20/mo commission. ACA is still the wild west, with lots of fraud being done by bad apple agents. Not saying it's Medicare Millionaire, as I don't know his model.

As someone who once signed up for ACA, that situation would keep someone covered for about 3 months based on my experience. Just the income verification alone will get the policy cut off unless there is a natural disaster exemption.

If what you describe is the case, then things must have changed since it first started.

 

[scagnt83]

I thought if you don’t file a return in 18-24 months they yank the subsidy ?

It was a lot quicker than that when I signed up for ACA back when it started. They gave me a 6 month extension because of a natural disaster. Without that, it was 3 months.

 

[scagnt83]

Question is, if there is no contact with a person, selecting loss of Medicaid to gen an sep with no supporting documents...This not Fraud?

Now that does sound like fraud

 

[Yagents]

As someone who once signed up for ACA, that situation would keep someone covered for about 3 months based on my experience. Just the income verification alone will get the policy cut off unless there is a natural disaster exemption.

If what you describe is the case, then things must have changed since it first started.

Separate income verification from tax reconciliation.

In today's market, less then 10% if my clients are required to send in proof of income, the Biden admin hates to make it difficult for low income to get coverage. Usually, proof of income is requested when client had high income in past years, and is now reporting much lower income for next year. Yes, you have 3 months to send in docs, or you lose your tax credit.

But, if no income docs are requested, and they do an automatic renewal in years 2 and 3, there are no income docs requested, and the client does not file taxes or reconcile their APTC tax credits, and the plan just continues to be active.........for 2-3 years

 

[Yagents]

Question is, if there is no contact with a person, selecting loss of Medicaid to gen an sep with no supporting documents...This not Fraud?

Of course that's fraud. And it's happening a lot since the Biden admin is no longer requiring proof of loss of coverage for the past 2 years. Many agents I'm sure are taking advantage of this loop hole.