State Auditor's office takes action against 'misleading' healthcare plans

The State Auditor's office is clamping down on what it called "a troubling and deceptive business practice" regarding "misleading" health insurance plans from companies that offer poor coverage and bad customer service.

In a press release, State Auditor James Brown said his office has received numerous complaints against a company, Strategic Limited Partners, that is not licensed to issue insurance policies in the state. The office has issued a cease-and-desist letter to the company. In a release, the Auditor's Office said the company has ceased issuing policies in the state.

"The complaints came from Montanans who thought they had purchased quality health insurance through SLP, but when they submitted claims for medical expenses, found that SLP would not cover them," Brown said in a release.

More than 130 complaints had been filed against SLP with the Better Business Bureau in the last three years.

The most recent complaint came from a Montana resident who received a $90,000 hospital bill the company refused to cover. Another involved a Montana church looking to offer a new pastor health insurance.

The plan the church offered the pastor "was presented to them as an (Affordable Care Act) compliant policy" but, in fact, was not. Only after the pastor incurred medical bills did the church find out that the policy only offered discounts on a limited number of services.

"Needless to say, this experience has been a source of stress for the consumer's family, the congregation, and the authorized representative who purchased the policy offered by the church," Brown said in a press release. "They discovered through their own diligent research that other legal action has been taken against SLP. In turn, they rightly filed a complaint with my office."

There may be other companies engaging in similar practices, the release said. In an effort to avoid consumer-protection regulations, some companies offer plans that refer to consumers as limited partners or employees.

"None of the consumers who have contacted Commissioner Brown have been aware that they were designated by SLP as employees or partners of the sponsoring company, RFA Group, Inc., a dissolved Texas corporation," the release stated.

If Montanans have questions regarding their insurance provider, they can contact the Insurance Consumer Service Bureau at the Office of Securities and Insurance. They can be reached at 800-332-6148 or 406-444-2040.

"If a deal looks too good to be true, it probably is," Brown said in a release. "If a health insurance policy offers unusually low premiums and low deductibles yet promises full or unlimited coverage, be skeptical. If a health insurance plan's fine print designates participants as 'employees' or 'partners,' find out more."

Brown has targeted wrongdoing by insurance companies during his time in office, recently winning a court battle over the right to investigate Blue Cross Blue Shield, and announcing it had gotten back over $37 million in wrongful billing schemes preying on Native American communities.

Courtesy of Daily Montanan