2 charged in alleged $162M ACA enrollment fraud scheme

The president of an insurance brokerage firm and the CEO of a marketing company have been charged for their alleged roles in a scheme to submit fraudulent enrollments for fully subsidized ACA plans in order to obtain millions of dollars in commission payments for insurance companies. 

Advertisement

Cory Lloyd, 46, of Stuart, Fla., and Steven Strong of Mansfield, Texas, are accused of targeting vulnerable, low-income individuals, and — through street marketers working on their behalf — sometimes offering bribes to persuade those individuals to enroll in subsidized ACA plans, according to a Feb. 19 Justice Department news release.  

The scheme caused the federal government to pay at least $161.9 million in subsidies, the Justice Department said. 

Marketers working for Mr. Strong’s company allegedly coached the vulnerable individuals on how to respond to application questions to maximize the subsidy amount and provided addresses and Social Security numbers that did not match the applicants’, according to the release. Some experienced disruptions in medical care as a result of enrolling in plans they did not qualify for.

Mr. Lloyd and Mr. Strong allegedly used misleading sales scripts and other deceptive sales techniques to convince the vulnerable individuals to state that they would attempt to earn the minimum income necessary to qualify for a subsidized plan, even when the individuals were initially projected to have no income.

The pair also allegedly conspired to bypass the federal government’s attempts to verify income and information.

Both men are charged with conspiracy to commit wire fraud, three counts of wire fraud, conspiracy to defraud the United States, and two counts of money laundering.

Advertisement

Next Up in Payer

Advertisement

Comments are closed.