Frederica Freyberg:
In consumer news related to healthcare, people who signed up for marketplace affordable healthcare act plans should be aware of unscrupulous insurance brokers who could do a bait and switch. Some of these web brokers are switching people’s existing plans without their knowledge and pocketing excess premiums according to the Kaiser Family Foundation. In Wisconsin, more than 250,000 people are on ACA plans through the federal marketplace. Caroline Gomez-Tom is an ACA enrollment network and accessibility manager for Covering Wisconsin. She joins us now and thanks very much for being here.

Caroline Gomez-Tom:
Thanks for having me, Frederica.

Frederica Freyberg:
Do you know how many people in Wisconsin might be victims of these web insurance brokers?

Caroline Gomez-Tom:
We’re still kind of understanding and trying to figure out the volume of folks that are impacted by this. We were brought aware of this based on some of our navigators who have seen individuals come to us because they were dually enrolled in Medicaid or the marketplace or we’re hearing it also from other states where they’re getting a lot more malicious predators, essentially, who are trying to target specific communities, but we’re definitely seeing more come up week after week.

Frederica Freyberg:
What are some examples you’ve seen in terms of unsuitable policies because of coverage or cost?

Caroline Gomez-Tom:
What it typically looks like is someone is actually still eligible or enrolled in Medicaid, which is the state’s program for lower income folks, and either they are up for renewal soon or they do need to renew and someone either reaches out to them proactively, somehow getting their contact information and there’s a way if someone just put health insurance in a Google search and went to a bad website. They could have accidentally got on this list of numbers that people will call. Otherwise, it’s actually someone that maybe they reached out, too, but they’re out of state and they’re now getting signed up for a marketplace plan, usually a zero-dollar a month plan, but because they actually should still be on Medicaid, are now dually enrolled in both of these programs. And it’s not until either they’re actually trying to seek healthcare or tax time when now the IRS is saying they have to reconcile tax credits that they never knew they had, they’re trying to figure out what went wrong.

Frederica Freyberg:
So I understand that many of these brokers doing this are out of state.

Caroline Gomez-Tom:
We haven’t seen any bad actors that are from Wisconsin, so I want to lead with that. And we actually do a really good job of working with our agent and broker community here in Wisconsin. We train with them, we partner with them, and we actually have quite a lengthy screener before we even include them in how we advertise for enrollment assistance.

Frederica Freyberg:
So what can people do to protect themselves from this?

Caroline Gomez-Tom:
So, of course, knowing the website that you’re putting in regarding seeking enrollment for health insurance, making sure that it has a “dot gov” ending. If you’re enrolling in Medicaid, it’s access.wi.gov. If you’re enrolling in the health insurance marketplace, it’s healthcare.gov. And then if you’re seeking assistance and you’re talking to someone on the phone or someone reaches out to you, don’t hesitate to ask questions, because if there’s any red flags, you should just stop the conversation and say, I will call someone if I need additional help and just end it there. But asking questions like what’s your license number? Who are you — who do you work for? What is your affiliation with the Office of the Commissioner of Insurance or Covering Wisconsin or the health insurance marketplace? Any person who is legitimately trying to help you can easily answer any of those questions and usually automatically goes through a consent process. We always just encourage folks even to call us directly from the get-go, because even if it’s just a question to make sure they’re at the right spot, like we’d rather them do that than be unsure and then find out the hard way.

Frederica Freyberg:
Yeah. Thank you for that important information for what people should look for. Caroline Gomez-Tom, thanks so much.

Caroline Gomez-Tom:
Thank you so much.