Dive Brief:
- Aetna says it has severed ties with an insurance agent who sold no-premium health plans to hundreds of homeless people, as the N.C. Department of Insurance performs a review of the agent's actions.
- The agent claimed he had found a legal method to use the ACA to provide health plans for people in North and South Carolina, assisting those left behind by the states' decisions to refuse Medicaid expansion.
- North Carolina is planning an "informal administrative conference" on the sales on Sept. 3, following questions over the legality of the sales and criticism from Charlotte-area advocates for the homeless.
Dive Insight:
Insurance agent Will Kennedy told the Charlotte Observer in June that he advised homeless people to estimate their 2015 income at $11,700 in order to obtain the highest possible ACA subsidy. As a result, he reportedly sold hundreds of high-deductible plans for which the federal government paid the full premium.
"What I have done, and what I make no apology for, is to work diligently to inform low-income individuals about their rights under the ACA and to help those who qualify obtain the health insurance for which they are eligible," Kennedy told the Observer.
However, critics note the plans leave these recipients with a $5,000 deductible they are unlikely to be able to pay, and impact their eligibility for other free or low-cost medical services. Adding to the concern is that some of the enrollees claim they never signed up or reported an income of $11,700 a year.