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Focus on Health Care Fraud - MEWAs

Quick Links
  • How To Protect Your Employees When Purchasing Health Insurance - A fact sheet with tips employers can use when comparing benefits and costs of multiple insurance products.
  • What To Do If Your Health Coverage Can No Longer Pay Benefits - This fact sheet provides basic information regarding options consumers may have if health coverage can no longer pay benefits because of insolvency or fraud, causing the plan to file for bankruptcy or to go out of business.
  • Multiple Employer Welfare Arrangements Under ERISA (MEWA) - A booklet addressing many questions concerning the effect of ERISA on federal and state regulation of MEWAs.
  • Final Affordable Care Act Regulations Related to Multiple Employer Welfare Arrangements - A fact sheet describing final rules under the Affordable Care Act relating to the reporting requirements for multiple employer welfare arrangements and the additional enforcement authority to crack down on fraudulent health plans.
  • MEWA Enforcement - The Labor Department has devoted significant resources to investigating and litigating issues connected with abusive MEWAs who sell the promise of inexpensive health benefit insurance, but default on their obligations. Particular emphasis has been put on identifying ongoing abusive and fradulent MEWAs and working to shut down such operations.
  • Procedures for Administrative Hearings Regarding Plans Established or Maintained Pursuant to Collective Bargaining Agreements Under Section 3(40)(A) of ERISA - These regulations are intended to assist labor organizations, plan sponsors and state insurance departments in determining whether a plan is a "multiple employer welfare arrangement" within the meaning of section 3(40) of ERISA.
  • The Form M-1 Online Filing System is an electronic filing system for the Form M-1 annual report for multiple employer welfare arrangements. The system allows filers to complete the form and submit it at no cost. This system is an example of an E-Government initiative which uses improved technology to make it easier for citizens and businesses to interact with the government.
  • The ERISA Public Disclosure System is an internet-based application designed to facilitate the search and retrieval of Form M-1 filings. The Form M-1 is filed annually by MEWAs (Multiple Employer Welfare Arrangements) and ECEs (Entities Claiming Exception). Users can search by plan name, sponsor name, employer identification number (EIN), or the state of the MEWA headquarters or where coverage is offered by entering data in one or more fields. The search is most effective when data is entered into several fields. For more information and instructions on how to use the ERISA Public Disclosure System for the Form M-1 filings, at the bottom of the Form M-1 Search page, select EPDS User Manual. Copies of the Form M-1 filings are also available from EBSA’s Public Disclosure Room at 200 Constitution Avenue, NW, Room N-1513, Washington, DC 20210, or by calling 202.693.8673.
  • National Association of Insurance Commissioners - The NAIC Website will help you find out information about the regulation of health insurance providers in your state.

MEWA Civil Enforcement News Releases

  • Solis v. John J. Koresko, V, et al., involving consent judgment against Farmers & Merchants Trust Co. of Chambersburg [11/28/12]
  • U.S. Labor Department obtains court order barring New York defendants from future dealings with employee benefit plans [07/06/10]
  • U.S. Labor Department bars Raymond Palombo from running federally-regulated health plans [10/28/09] [Reopen Order] [Monetary Award Order]

Archived News Releases — Caution: Information may be out of date.

  • U.S. Labor Department obtains order requiring restoration of more than $500,000 to Georgia Plumbers Trade Association Health Plan [01/18/08]
  • U.S. Labor Department resolves unpaid health claims of participants covered by Mississippi State Medical Association plan [08/16/07]
  • U.S. Labor Department obtains independent fiduciary to oversee Texas health benefit plan [05/31/07] [Consent Order]
  • U.S. Labor Department recovers more than $2 million to pay New Jersey benefit plan health claims [04/02/07]
  • U.S. Labor Department obtains consent order shutting down 'sham' health care fund based in California [03/26/07] [Consent Order]
  • U.S. Labor Department sues Georgia health provider and affiliates over mismanagement of plan assets [03/22/07]
  • U.S. Labor Department Obtains Court Order Barring Idaho Company and Executives from Service to Employee Benefit Plans [06/21/06]
  • U.S. Labor Department Sues California Health Benefit Fund to Recover $1.2 Million for Unpaid Health Claims [12/13/05]
  • U.S. Labor Department Obtains Judgment Against Sham Florida Union for Payment of $11 Million in Health Benefits [12/08/05]
  • U.S. Labor Department Obtains Court Order Reimbursing $1 Million to California Health Benefit Fund [12/05/05]
  • U.S. Labor Department Sues Former Minneapolis Executives For Health Plan Mismanagement [11/22/05]
  • U.S. Labor Department Obtains Order Restoring Over $4 Million to TRG Health Plan [07/21/05]
  • U.S. Labor Department Sues Company Hired to Service Pension and Welfare Plans of Six Chicago Area Local Unions and Employer Associations [07/06/05]
  • Former Plan Official Sentenced For Embezzlement From Union Health Plan [02/16/05]
  • U.S. Labor Department Sues President of Nashville Leasing Firm Over Misuse of Health Plan Assets [01/25/05]
  • Court Rules Indiana Marketing Firm and Executives Must Restore Losses to Health Plan [01/05/05]
  • U.S. Labor Department Obtains Court Order Reimbursing California Health Benefit Fund [12/15/04]
  • U.S. Labor Department Sues Plan Officials of Beverage Association Over Mismanagement of Health Plan [11/23/04]
  • U.S. Labor Department Removes Health Benefit Fund Trustees [09/15/04]
  • U.S. Labor Department Order Permanently Bans Former Leasing Firm President From Overseeing Employee Benefit Plans [08/02/04]
  • U.S. Labor Department Obtains a Court Order Appointing Temporary Independent Fiduciary for Purported Union Benefit Fund [05/06/04]
  • Court Replaces Trustees of Defunct West Hills Union Health Plan - U.S. Labor Department Investigation Reveals $7 Million in Unpaid Health Claims [05/06/04]
  • U.S. Labor Department Sues Former President of Leasing Firm Over Mismanagement of Health Plan [04/19/04]
  • U.S. Labor Department Sues Fiduciaries of Tulsa Health Arrangement Over Excessive Fees and Misrepresentations [03/01/04]
  • Nevada Court Enters $7.3 Million Judgment Against Principals of Employers Mutual [10/14/03]
  • U.S. Labor Department Obtains Decision Replacing Officials of New York Union Plan - Affects Workers in Pennsylvania and New Jersey [10/08/03]
  • New York Corporation and Owner Ordered to Restore $1.7 Million to Health and Welfare Plan [10/07/03]
  • U.S. Labor Department Sues Principals Of Florida-Based Health Plan Service Provider [06/24/03]
  • U.S. Labor Department Obtains Final Settlement of Lawsuit Against U.S. Alliance Fiduciaries [05/21/03]
  • U.S. Labor Department Settles Part of Its Lawsuit With U.S. Alliance Health Care Officials [10/25/02]
  • U.S. Labor Department Obtains Court Order Freezing Assets of Florida Health Plan [10/11/02]
  • U.S. Labor Department Secures Temporary Restraining Order Against Georgia Health Plan Operators [06/18/02]
  • Independent Fiduciary Appointed To Operate New York Health and Welfare Plan In Consent Order Obtained By Labor Department [05/17/02]
  • Nevada Court Freezes Assets of Health Associations And Principals of Employers Mutual [02/08/02]
  • SAI MED Health Plan Officials Barred From Serving ERISA Plans [01/04/02]
  • U.S. Labor Department Sues Trustee and Others for Diverting More Than $2.2 Million of New York Health and Welfare Plan [12/18/01]
  • U.S. Labor Department Sues Nevada Associations and Principals for Misusing Over $6 Million in Health Assets [12/13/01]
  • U.S. Labor Department Sues Alabama Association And Plan Official For $4.15 Million In Fees, Commissions And Loans [10/04/01]
  • U.S. Labor Department Obtains Court Order Freezing Assets of Several New York Health Providers [07/12/01]
  • U.S. Labor Department Seeks to Recover Over $1 Million from Defunct Maryland Health Provider [02/06/01]

MEWA Criminal Enforcement News Releases

  • Former Executives at Sommet Group, LLC Charged with Conspiracy, Fraud and Tax Charges [03/02/12]
  • Former Upstate Resident Guilty of One Million Dollar Insurance Premium Theft [10/20/11]
  • Former HBPA President Pleads Guilty to Conspiracy to Commit Mail Fraud, Wire Fraud, Identity Fraud, and Health Care Fraud [08/31/11]
  • Colorado Health-Plan Founder Indicted for Mail Fraud, Embezzling Plan Funds and Money Laundering [04/05/11]
  • Hogge Sentenced in Health Care Fraud Scheme [03/28/11]
  • Employee Benefit Plan Manager Sentenced to more than Five Years in Federal Prison for Stealing $1 Million [03/24/11]

Archived News Releases — Caution: Information may be out of date.

  • HBPA President and Executive Director Indicted for Conspiracy to Commit Mail Fraud; Wire Fraud; Identity Fraud; Health Care Fraud and Witness Tampering; HBPA Farm and Field Director Charged with Conspiracy to Commit Identity Fraud [11/18/10]
  • Employee Benefit Plan Manager Admits Stealing More Than $1 Million [04/19/10]
  • Employee Benefit Plan Officials Are Sentenced [08/06/08]
  • Co-Owner of TRG Health Plan Sentenced for Embezzling Health Care Premiums [12/21/07]
  • Federal Indictment Charges Amarillo, Texas, Woman with Healthcare Fraud, Wire Fraud, Mail Fraud and Money Laundering [11/30/07]
  • Operator of Employers Mutual Going to Prison for 25 Years for Operating Bogus Health Insurance Provider [02/05/07] [Conviction Release] [Arrest Release]
  • Attorney Sentenced For Mail Fraud Involving Health Plan Assets [06/29/06]
  • Former Durham Business Owner Sentenced for Fraud, Tax Evasion [06/15/06] [Indictment Release] [Arrest Release]
  • Founders of SAI Plus Health Plan Sentenced for Defrauding School Districts and Other Businesses [06/09/06] [Conviction Release]
  • Florida Man Admits Embezzling from Susses County Union; Defendant is Stepfather of Former Party Chaiman Awaiting Trial [04/21/06]
  • Owner of Bankrupt Medical Benefits Company Sentenced to 84 Months in Prison [04/17/06] [Guilty Plea Release]
  • Indianapolis men Sentenced for $400,000 Embezzlement from Health Care Benefit Program [10/21/05] [Indictment Release]
  • Former President of Interstate Services Incorporated Sentenced to 41 Months for Health Care Fraud [06/29/05] [Guilty Plea Release]
  • Former Sussex Political Party Chairman and Others Charged with Embezzling From Union and Bankrupt Health Fund [02/23/05]
  • Former Plan Official Sentenced for Embezzlement from Union Health Plan [02/16/05]
  • Justice Department Sues to Shut Down Alleged Fraudulent Employment-Tax Scam; Plans Alleged To Disguise Taxable Wages As Non-Taxable Healthcare Reimbursements [04/15/04]