The Insurance Fraud Accountability Act strengthens enforcement against fraudulent health insurance enrollments by imposing significant penalties on agents and brokers who provide false or incorrect information when signing people up for health plans through the ACA marketplace. Agents and brokers who act negligently face civil penalties of $10,000 to $50,000 per affected individual, while those who knowingly provide false information face penalties up to $200,000 per person and potential criminal charges including up to 10 years in prison. The bill requires the Department of Health and Human Services to establish verification procedures for agent- and broker-assisted enrollments by January 1, 2029, including obtaining written consent from enrollees before enrollment, delaying commission payments until inconsistencies are resolved, and ensuring consumers receive timely notifications of any changes to their coverage. The legislation also creates oversight mechanisms such as periodic audits of agents and brokers based on consumer complaints or suspicious enrollment patterns, requires reporting of agent terminations, and establishes standards requiring agents and brokers to act in the best interests of enrollees. These changes primarily affect insurance agents, brokers, and third-party marketing organizations, while protecting consumers from fraudulent scheme-related unauthorized enrollments.
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