Fairlyclueless

My true favorite was Assurance IQ:
2019 - Assurance IQ sold to PNC for $2.35B - www.reuters.com/article/tech...
2024 - Assurance shut down - www.geekwire.com/2024/prudent...
2025 - FTC fines them $145m for "misleading" consumers. www.ftc.gov/news-events/...

One of the greatest exits I've ever seen.

Now the next part of this is who is doing all this. Generally it's not your mom and pop health care agent, it's PE funded or large corporate backed bullshit, the same cause as the downfall of any half way decent industry. Bain capital was the backer of Enhance Health in the Turner case above.

A point I do want to hammer home is the fraud gets a cute name of unauthorized enrollment, because health care agents don't like the fact that what they're doing is identity fraud. They are cancelling people's insurance, resting deductibles and out of pocket maximums for people with cancer.

There is a lot of blurriness because expanded subsidies did open up the risk pool to additional parties who didn't need to pay a premium. However, I think the jump of people without claims is damning. Why get 'free' healthcare that you pay for with your future tax refund and then never use it.

Not to mention existing fraud that may have been baked into the baseline. We also see a smaller jump in Silver going 24% to 36%~. Some of this may have gotten caught, but it's a burdensome process to call CMS, fight with them, the insurers, the IRS.

Next 2022 starts to jump a little on bronze and silver for FL, but 2023 it explodes. In two years at 2021 we go from Bronze 32% to 47% and then 50% in 2024. Not all of that may be fraud, but there is a large number in the difference of 50% vs baseline of 32% that is probably the rising fraud.

So we get our baselines, where 2019 to 2021 Bronze is 32-34%~

Silvers at 22-24%~, and gold + platinum with the lowest rates at below 15% for both because people will need to pay a premium of some sort even with subsidy. There the payment processors deter fraud better than other methods.

I found it, warning clicking this starts downloading a 110mb excel file. cms.gov/files/docume...
So if you filter to just national and Florida, because Florida is the worst always in everything ever we can really start to see the trends. Then filter to individual as that's where the agent fraud is

Also if they half ass this, which their track record seems to indicate. The cartels will probably have the greatest opportunity to seize power over the state and make a true narco state.

The admin has spent this whole time saying we don't want refugees from Venezuela, and seems to be exacerbating the amount of refugees that will be coming from there. The country has problems, but what happens when we bomb their energy, water, and economic infrastructure. Whoever didn't leave will.

It is now the fomo and greed index

Looks like both went dark just now

If you're still in jail for fraud it just means you're too poor or cheap to bribe this admin.

Illegal Mopeds and Fake Names: Migrants Scrape By in Underground Economy (Published 2023)

Actually I think this is the story I was more thinking of. " for the privilege of using an Uber Eats profile under the name “Jessica,” he pays a weekly cut of $150 to a Venezuelan woman." www.nytimes.com/2023/09/15/n...

They fled Venezuela — and transformed D.C.’s food delivery scene A wave of new Venezuelan immigrants have turned to food delivery on mopeds as a way to make a living in the D.C. region.

Reminds me of the story on this arb that came when Venezuelans had legal status to get an account, so they'd rent out multiple accounts to different migrants who didn't have status and just collect middleman fees. www.washingtonpost.com/dc-md-va/202...

I tried to expand on this a bit here, hopefully I can try to knock some more out over the week. bsky.app/profile/fair...

Note to self, I need to find the big CMS spreadsheet of bronze, silver, etc... plans by state and breakdown the insane growth numbers in Florida to demonstrate the silly rates of Florida.

Why is the system even like this? My guess is health insurance companies use agents as a shielded marketing budget. They can pay a fee to an agent, and absolve themselves of liability and marketing problems by just shoving it onto a third party you don’t need to be responsible for.

Another undercounting method is a single person could have 10 to 20 agents passing their information around changing their enrollment monthly. So the person may complain against the one agent they have visibility into and the other 8 of 10 never get a complaint.

“From January 2024 through August 2024, CMS received 183,553 complaints that consumers were enrolled in FFM coverage without their consent (also known as an “unauthorized enrollment”). CMS is currently resolving these cases within approximately 52 days of receipt.”

The system also inherently undercounts the problem through no fault of their own. They were understaffed and the system seems to lack the information needed to bring transparency.

That doesn’t even address a lot of people being lied to about free $6,400 subsidy cards from the government by AI generated ads on Facebook.

So 2025 open enrollment, there were 24 million people, www.cms.gov/newsroom/pre... . Take with salt, but the new regime is claiming here www.cms.gov/newsroom/pre... 2.8 million double enrollments. So roughly 10% just here is potential oopsies or fraud, who is to say.

They work in call centers, maybe calling people, or faking the documents and just typing in lead list information directly into the applications and pumping them out as fast as they can.

Weird how a lot of the “allegations of making a misrepresentation in the sale of an insurance product.” allegations are for people in south Florida. IT’S BECAUSE SOUTH FLORIDA IS A FRAUD CESSPOOL.

Ever get bored? Feel free to look up some of the complaints in your state, usually it goes like state name, department of insurance / financial services, administrative complaints. Here’s Wisconsin for September, 2025. oci.wi.gov/Pages/PressR...

Not to mention all the other bullshit they sell on top to people that they package with the $0 premium ACA policy as the anchor to upsell hospital plans, life insurance, and any other piece of garbage they can think of to dump on a consumer.

Bam, 2x a return in 1-2 months, rinse, repeat, and you have a bunch of 20 something south florida instagrammers talking about passive income as a healthcare agent.

The agent’s buy lead lists at a rate of maybe $5-$10 a name, if they’re committing fraud, they don’t bother to talk to the consumer and get written consent and instead just fake it.

The health insurers don’t seem that good at accounting, so it’s pretty easy to see a world where a person gets paid a bonus on month 1 or 2, and then another agent came in and swooped the customer’s info away.