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CFO Issues Warning about Single-employer Trusts

4/12/2004

CONTACTO: Nina Banister
(850) 413-2842

TALLAHASSEE - Florida's Chief Financial Officer Tom Gallagher is alerting employers to use caution when considering setting up a health benefit plan through a Single Employer Trust (SET) document that requires sending financial contributions to an out-of-state bank account. Los consumidores de la Florida han sido víctimas de esos planes, incluso el Meridian Benefit Plan está en bancarrota federal en New Jersey.

Los planes fuera del estado y las cuentas bancarias dejan a los empleadores vulnerables al fraude y pueden dejar a los reguladores del estado con muy pocas opciones para ayudar con la recuperación. En el caso de Meridian Benefit, los distribuidores también reclamaban una cobertura de reaseguro o cobertura por lucro cesante cuando no la tenían.

"A single-employer trust may appear to offer substantial benefits and savings, but they are complex arrangements that can be rife with financial risk," said Gallagher, who oversees the Department of Financial Services. "With any insurance or financial transaction, it is imperative to verify before you buy. Remember, if it sounds too good to be true, it probably is."

Desde febrero de 2001 se ha ordenado a más de 200 entidades de seguros, distribuidores, agentes de seguros y otros individuos no autorizados cesar de vender seguros fraudulentos, no autorizados en la Florida. El Departamento reconoce que el concepto de fideicomiso para empleador único puede ser una opción legítima, pero los reguladores sospechan que los fideicomisos para empleador único pueden ser el más reciente vehículo utilizado en un intento por estafar a empleadores que luchan por encontrar cobertura asequible para sus empleados.

An employer approached to buy this type of plan will be told it is an Employee Retirement Income Security Act (ERISA) qualified plan regulated by the U.S. Department of Labor. To implement the trust, the employer is asked to sign a standardized document, then is billed monthly for a financial contribution deposited in an out-of-state custodial bank account. Las primas mensuales, o contribuciones, se pagan en una cuenta bancaria de custodia que se supone cubre reclamaciones médicas y compras de reaseguros o seguros con pérdida limitada para cubrir los costos que exceden el saldo de la cuenta.

Aunque puede haber una contabilidad de las contribuciones de cada empleador, existe un riesgo de que los fondos que se supone están separados en cuentas de custodia se confundan.

Employers and their employees should consider the following before establishing a single-employer trust plan:


· Is the purported insurance, reinsurance or stop-loss insurance company approved in Florida?

· Even if the insurer is authorized in Florida, is it actually providing the insurance coverage?

· Have legitimate policies actually been issued and are they still in force?

· Is the monthly contribution reflective of the advertised health benefits? Is the offer too good to be true?

· What due diligence has been performed and is this documented? Well-intentioned agents and individuals have been misled by some of these plans.

· What is the track record of the plan administrator? How long has it operated and does it pay claims, both the big and the small, in a timely basis?

· Is the plan administrator willing to provide its certified and audited financial statements?

· Has any state insurance department or the U.S. Department of Labor taken action against the plan administrator, its principals, or the individual that is soliciting you?

· As to other employer plans that the plan administrator is already administering, are required ERISA filings being made with the U.S. Department of Labor and the Internal Revenue Service? Contacte el Departamento de Trabajo de EE.UU en http://www.dol.gov/ebsa/forms_requests.html o llame al 1-866-444-3272.

· As to the establishment of an out of state custodial bank account, what due diligence has been performed and is it documented? ¿Cómo funcionan estas cuentas bancarias realmente, quién las controla y hay preguntas en cuanto a si las cuentas bancarias de los empleadores existentes han sido malversadas?

For more information or to find out if an insurance company or agent is authorized to transact in Florida, log on to www.fldfs.com or call the Department of Financial Services Consumer Helpline at 1-800-342-2762.