4 Telemarketers indicted for selling BS health insurance

The United States Attorney recently unsealed an indictment against four telemarketers who were busted for using the telephone to sell essentially fake or worthless health "insurance" policies.

The situation is a look behind the curtain of how many telemarketers operate day in and day out.

According to the Justice Department's press release, Alan Redmond, Arthur Walsh, Jesus Barrera, and Albert Groff used phone calls to sell limited benefit plans that provided little or no coverage by falsely representing that the plans provided comprehensive health insurance coverage, also known as “major medical insurance,” or provided coverage equivalent to major medical insurance, when they did not. As telemarketers typically do, they gave themselves a fake job description “the national enrollment center for health insurance” while claiming to “work with over 30 of the top A-rated insurance companies”.

The government alleges that the defendants did not search the marketplace, did not work with the touted A-rated carriers, and did not even sell major medical insurance. Instead, the defendants peddled a limited set of discount plans that had lower and more restricted benefits than major medical insurance. In some instances, the limited benefit plans sold by the defendants were not even insurance.

Often when these press releases come out, people don't really hear the stories of who was hurt and how, so before we get to the boring part, I want to pull three stories from the indictment that illustrate that contrary to our friend Mr. Troutman's musings:

Are these defendants the real victims? You tell me. Example 1. On or about July 27, 2021, in a phone call with Victim-Purchaser B.B. in connection with the sale of a Limited Benefit Plan, a closer with defendant BENE MARKET misled B.B. into believing the Limited Benefit Plan was not a supplemental or discount plan and falsely told B.B. that the government gave the plan "its stamp of approval that yes, this is health insurance" and that the plan was an "affordable cataract policy, that way you know for sure this is actual health insurance and my doctor cannot deny me."

B.B. later had a stroke and called the Bene Market Group from the hospital complaining that the plan the Bene Market Group sold her did not cover any of her hospital or medication expenses and requested to cancel the plan. A representative of defendant BENE

MARKET twice attempted to sell B.B. another Limited Benefit Plan before agreeing to cancel.

In a second example, on or about January 15, 2022, in a phone call with Victim-Purchaser E.M., a fronter with defendant BENE MARKET misled E.M. in connection with the purchase of a Limited Benefit Plan, including by falsely telling E.M. that the Limited Benefit Plan would cover her pre-existing conditions of stage two brain cancer and herpes simplex encephalitis ("HSE") so that she would 'Just be able to walk into a hospital walk in wherever you need to go and be covered without having to pay little to anything out of pocket." The fronter then transferred E.M. to a closer with defendant BENE MARKET who also misled E.M. into believing her pre-existing brain cancer and brain disease would be covered by the Limited Benefit Plan.

In a third example, on or about January 24, 2022, in a phone call with Victim-Purchaser A.C., defendant ALBERT GROFF misled A.C. in connection with the purchase of a Limited Benefit Plan, including by falsely telling A.C. that the Limited Benefit Plan was a "full-fledged, comprehensive, Major Medical" plan and that if A.C. was "admitted in [to the hospital] the most you're paying is $350, she has a heart-attack, stroke, whatever the case may be, $350" and that no more than $350 will ever come out of A.C.'s pocket, even if A.C. was placed on a ventilator for ten years. Defendant GROFF then relayed the false claim that he personally had used the same Limited Benefit Plan to cover a $120,000 Cornea transplant, which had only cost him $350. Defendant GROFF also falsely instructed A.C. that she "can ignore" the verification recording relating to pre-existing conditions and to just let the verification "go in one ear and out the other."

These are just three examples of many dozens cited in the indictment. Instead of just telling you what the indictment says, here it is, see this telemarketing example for yourself and know who Mr. Troutman is running interference for.

The indictment chronicles how several businesses (Bene Market LLC and Seguro Medico LLC) began operating in the Reading Pennsylvania area in the 2018-2022 time frame, operating a call center selling discount health and dental plans over the telephone to tens of thousands of individuals throughout the united states. Collectively known as The Bene Market Group, they carried out its telemarketing business under various trade names including YourBenefits4U, QuickHealth, Express Benefits, Q Health, Quick Marketing, and Benefits Now. The entities in the Bene Market Group shared common management, operations, and/or control, and funds were transferred back and forth between entities.

The defendants used bait and switch sales schemes to sell essentially useless/worthless medical plans as if they were real health insurance by making false claims to consumers including that they were ACA compliant, they were selling plans from A-rated carriers, the plans covered typical medical costs, that the sales agents themselves used the plans, the plans could be canceled and refunded, and a long list of other lies and half truths.

They sold tens of thousands of these "policies" and raked in millions of dollars but I want to focus on the telemarketing aspect of this case. According to the indictment, the defendants paid lead generation entities and websites for leads on consumers who were looking to purchase healthcare insurance products from licensed insurance agents. These paid lead generators typically advertised and offered consumers a free quote on health insurance if the consumers filled out an online form or provided certain information.

What the lead generators were almost certainly doing was faking consents on the websites to generate the leads. Those "leads" generated telemarketing phone calls routed to the Bene Market Group's call center in or near Reading, Pennsylvania, where employees of the Bene Market Group known as "fronters" spoke with the consumers and offered to help them get a health insurance quote. The fronters obtained some basic information from the consumers, touted the products and process, and then transferred the consumers to salespersons at the Bene Market Group known as "closers" or "agents."

The defendants prepared, revised, approved, and distributed scripts and sales pitches for the Bene Market Group fronters and closers to use in selling the plan to the consumers who had been referred by the paid lead generators. These defendants, regularly trained the Bene Market Group fronters and closers on the scripts and the sales pitches used by the Bene Market Group.

The scripts and sales pitches were false and misleading. They were designed to create the false impression that the Limited Benefit Plans sold by the Bene Market Group covered considerably more medical and dental services, and paid larger portions of the consumers' medical bills and prescriptions, than they actually did.

The scripts and sales pitches often required fronters and closers to falsely state that Bene Market Group served as "the national enrollment center" which worked with 'over thirty A-rated carriers" in the consumer's state and that the Bene Market Group shopped the entire insurance marketplace for the consumer. These statements created the false impression that the Bene Market Group was functioning as an impartial broker for the top-rated health

insurance businesses in the consumer's state and would help the consumer research and choose an insurance policy that best met their needs. In fact, the purpose of the calls was for Bene Market Group to sell the Victim-Purchasers a specific Limited Benefit Plan which Bene Market Group had a specific contract to sell.

As the defendants were well aware, many of the Bene Market Group sales agents

made additional false statements and misrepresentations, beyond those contained in the standard scripts and sales pitch, for the purpose of selling the Limited Benefit Plans. These false statements included fraudulently representing that the plans and bundles sold by the Bene Market Group were comprehensive Major Medical Insurance, mimicked Major Medical Insurance, or provided coverage equivalent to Major Medical Insurance at a lower cost.

At the conclusion of the sales calls, the Bene Market Group closers typically played a verification recording or transferred the consumers to the verification department, which reviewed various terms and conditions relating to the plans and products sold. The closers often prepped the consumers so that they would agree that they understood the terms and conditions during the verifications. For example, the closers falsely told consumers that the

verifications were outdated, that the verifications were generic to all products sold, that the verifications could be ignored, or that the verifications could be passed over by just pressing 1. In other instances, the Bene Market Group simply skipped or shortcut the verification process altogether when selling Limited Benefit Plans to consumers.

There is nothing unusual in the allegations of the indictment, these are the sorts of phone scams that go on every day. These defendants might be worse in that they played with people's lives, but the only thing unusual about the entire situation is that these folks got indicted at all. Most phone scammers I mean telemarketers are well protected by defense attorneys and their patron saints and never face justice.

Do you have a question or a telemarketing, debt collection, or bankruptcy case that would make a great blog article? We might even review your pro-se complaint or motion in a blog post. Email peter@nwdebtresolution.com and/or nathen@nwdebtresolution.com and we may answer it for everyone!

Are telemarketers harassing you in Washington, Oregon, or Montana? My Washington State TCPA plaintiff law practice can help, just give us a call at 206-800-6000 or email peter@nwdebtresolution.com.

The thoughts, opinions and musings of this blog are those of Peter Schneider, a consumer advocate and Washington State plaintiff's TCPA attorney at Northwest Debt Resolution, LLC. They are just that, his thoughts, opinions and musings and should be treated as such. They are not legal advice. If you are looking to file a lawsuit for TCPA violations and unwanted calls please contact me for a consultation.

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