More than 1,000 South Carolinians reported their health insurance plans were switched without consent in 2024, according to the state Department of Insurance. These cases made up 22% of all fraud complaints filed that year. Victims were enrolled through Healthcare.gov, the online marketplace established by the Affordable Care Act. Director Michael Wise said rogue brokers used basic personal information to illegally alter policies and collect commissions, often without ever speaking to the victim.
The scam, known as UPS (unauthorized plan switch), is growing nationally. In just the first half of 2024, the Centers for Medicare and Medicaid Services (CMS) received nearly 74,000 UPS complaints. In response, CMS changed its policy to require a three-way call between the broker, consumer, and a federal call center before any changes could be made.
South Carolina has not filed criminal charges yet, though investigations are ongoing. Department prosecutor Joshua Underwood identified Florida as a hotspot for such fraud. He warned consumers to read any insurance-related mail carefully, as brokers often gather personal data through deceptive surveys. Victims typically learn of the fraud only when denied expected coverage at a doctor’s office.
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