The Division of Insurance is again reminding consumers looking to purchase health insurance to use caution when searching the internet for coverage. While some companies lure consumers with promises of lower premiums, these entities are often not licensed to sell insurance in Massachusetts, which can leave consumers facing significant medical bills in the event care is needed.
Health insurance products purchased from an unlicensed insurance company do not comply with the Affordable Care Act and do not meet Massachusetts’ Minimum Creditable Coverage requirements. Consumers should also use caution when considering alternatives to traditional health insurance plans, such as discounted health insurance plans or health care sharing ministries. While legal, these plans are exempt from the Division’s oversight and do not offer the same consumer protections as a traditional insurance plan and may not guarantee payments for or discounts on medical services and expenses.
There are nine (9) licensed insurance carriers approved to sell insured health plans to Massachusetts-residents. A list can be found here.
However, over the past year, the Division has received inquiries or complaints about organizations called First Health, First Continental Life and Accident, Sovereign Nations Insurance, Quick Health Insurance, Salvasen Health, Multiplan/PHCS, and BlackHawk Claims, none of which are licensed health insurance companies in Massachusetts and in some cases are only access to networks of providers.
Before purchasing health insurance, consumers should:
Be careful when looking at other websites when you are trying to learn about comprehensive health coverage available through the Health Connector. The Massachusetts Health Connector can only be accessed by using http://www.MAhealthconnector.org/. Websites, including MassHealthPlans.com, Massachusetts-healthplans.com, and websites that reference “ObamaCare or ACA plans” may look like the state’s exchange but are not. These websites connect consumers with individuals, who may or may not be licensed insurance agents, in order to help sell other types of insurance or wellness plans, such as hospital indemnity insurance, limited benefit health plans, discount health plans, health care sharing ministries, or other non-comprehensive health plans.
You should read all the fine print when you are asked to sign anything. Even if you are signing up online, look for disclaimers on the website or policy documents such as “this is not insurance” or “does not meet Minimum Creditable Coverage.” It is a violation of the state’s insurance consumer protection laws for a licensed agent or company to knowingly mislead or misinform a consumer about the product they are looking to purchase so consumers should be sure to ask whether the product they are buying is an insured health plan that is compliant with the Affordable Care Act.
When you are considering your options, you should take notes when you speak with an agent and ask the agent for their first and last name, as well as their Massachusetts producer license number. Any individual who is unwilling to allow you to verify their credentials should not be trusted.
Avoid being pressured into providing personal or financial information. In order to send you quotes, a legitimate insurance company only needs to know your name, age, and contact information and whether you are looking for coverage for just yourself or if you have family members who would also be covered by the plan. They cannot ask questions about your medical history, such as whether you have pre-existing conditions or what prescriptions you might be taking.
Consumers with questions or concerns about the legitimacy of a health insurance plan or company are urged to visit the Division’s website at www.mass.gov/doi, or to contact the Division’s Consumer Services Unit at (617) 521-7794 or by email at CSSComplaints@mass.gov.
For information on purchasing a health insurance plan from the Health Connector, please call 1‑877-MA-ENROLL or visit www.MAhealthconnector.org.
About the Division of Insurance
The Division of Insurance is an agency within the Office of Consumer and Business Regulation. The primary mission of the Division is to monitor the solvency of its licensees in order to promote a healthy, responsive and willing marketplace for consumers who purchase insurance products. The Division is responsible for regulating Massachusetts’ $60 billion insurance industry and overseeing more than 1,600 licensed insurance companies and approximately 141,000 individual insurance producers. Protection of consumer interests is of prime importance to the Division and is safeguarded by providing accurate and unbiased information so consumers may make informed decisions and by intervening on behalf of consumers who believe they have been victimized by unfair business practices.