Some consumers in New Mexico have been purposely misdirected to private insurance brokers when they thought they were visiting the official Health Insurance Exchange website, healthcare.gov, or calling a qualified broker or enrollment counselor.  This is a serious issue because the official exchange is the only place to get financial assistance for premiums and out-of-pocket costs.  In addition, brokers continue to offer plans that do not meet the standards for a qualified health plan, leaving consumers with weak insurance that doesn’t shield them from tax penalties.

An enrollment counselor at the Southwest Women’s Law Center reports that she has seen an influx of consumers that have been victims of this scam.  The center’s Staff Attorney, Paige Duhamel, talked to a number of consumers who said that the brokers “talked at a rapid pace to pressure the consumer, refused to answer questions and caused a great deal of confusion and stress about the enrollment process.”  

It is important that consumers know what to do to avoid these types of issues.  Below are signs of fraudulent activity to keep an eye on when seeking enrollment assistance:

1) You are being charged an enrollment or sign-up fee

2) Your plan’s deductible is more than $6,350

3) The assister has you pay for the first few months’ premiums in advance

4) The assister does not speak to you about financial assistance or Medicaid eligibility

5) The assister asks you if you have a pre-existing condition

6) If you do enroll, the assister does not send you any documentation about your enrollment

7) The assister a) is unwilling to give you their name and direct contact number, b) has an out-of-state contact number, c) has a non-1800 number, or d) has a direct contact number that is anything other than the number for healthcare.gov (1-800-318-2596).  Always take down the name and phone number of the person with whom you are speaking

8) The assister only talks to you about one health insurance carrier’s plan