News 4 Investigation prompts feds to look into alleged illegal s -

News 4 Investigation prompts feds to look into alleged illegal sales of Obamacare policies

Posted: Updated:
Credit: KMOV Credit: KMOV

Federal agencies tell News 4 they will be conducting an investigation of allegations made by several former employees of an insurance sales company in St. Louis County.

News 4 Investigates spoke with six former employees, three of them on camera, who all say they were directed to falsify applications for insurance coverage so that applicants would be eligible for federal subsidies under the Affordable Care Act, or ACA (also known as "Obamacare"). 

The employees, who are all licensed or certified to sell insurance policies by the State of Missouri, say they worked for ISC Direct, based in Maryland Heights, during the open enrollment period this past year. 

They say that during that period, ISC Direct was contracted by Direct Insurance Today, an insurance sales company in Dallas.  Working under direct guidance from two officers with Direct Insurance Today, the employees claim they made sale calls to potential customers in Texas, offering insurance policies that would be eligible for federal subsidies under ACA.  Under ACA guidelines, customers must make a certain amount of income to be eligible for subsidies.  If they don't make enough income, they are directed to seek care through Medicaid.

The employees who spoke with News 4 say the officers with Direct Insurance Today instructed them to falsify income levels on applications for prospective customers who did not make enough money to get the subsidies. 

"We were told to adjust peoples incomes so they would qualify for a tax subsidy when they didn't.  We were told do whatever we had to do to make the sale," one employee said.

When asked who told them to do that, the employee said, "Britt Parent and Ben Jones who's the regional manager."  Britt Parent and Ben Jones are officers with Direct Insurance Today in Dallas.

Other employees described how it might work.

"Let's say someone makes $8,000, we were told to boost it up to $12,000 so they could be eligible for the subsidy for the Affordable Care Act."

Another recalled the direction they would get while making calls.

"They would walk around and listen to us on the phones, correct us if we said something wrong, and if we said they didn't qualify, say, 'call them back, change the income make them qualify. "

News 4 Investigates reporter Chris Nagus went to Dallas to speak with officers with Direct Insurance Today, but found the storefront shop was not occupied.  Benton Jones, a manager for Direct Insurance Today, spoke with Nagus by phone later, and denied the employees' claims. 

He said the calls are recorded and the company has proof that no such practices occurred, but said it would be difficult to release the documents because of federal laws protecting patient privacy.

News 4 also called a top officer with ISC Direct, which runs the St. Louis County office where the employees worked.  He had no comment, and hung up. 

A spokesman with the federal agency that regulates implementation of the Affordable Care Act tells News 4 any such practices would be illegal, and tells us the agency will conduct an investigation and notify state agencies about the allegations as well.

Copyright 2016 KMOV (Meredith Corporation). All rights reserved

Powered by Frankly