Accuses Department of Cooperating with Anthem to Block Premium Savi…

Accuses Department of Cooperating with Anthem to Block Premium Savings

CINCINNATI– LAWFUEL – The Law Newswire –Total Benefits Planning Agency, Inc., has sued the Ohio Department of Insurance (DOI) to halt its improper efforts to block Total Benefits’ strategy for cutting employer health care costs.

Surveys show that those costs are the biggest problem facing small business today. Total Benefits has pioneered a strategy for controlling them, which involves raising insurance deductibles and replacing benefits with a Section 105 plan. “The strategy works for any employer, and works with any insurance coverage,” says Tom Quigley president of Total Benefits Planning Agency, Inc. Employers typically save 20-40% from the cost of traditional insurance coverage, with no lost benefits.

However, Anthem Blue Cross/Blue Shield — which loses premium dollars when clients adopt the strategy — has objected. Anthem has terminated Total Benefits’ contract to write new business, terminated agents doing business with Total Benefits, and threatened in writing to terminate agents even contemplating adopting the strategy. Anthem’s parent company, WellPoint, Inc. (NYSE:WLP) has terminated agents using similar strategies across the country. Total Benefits has already filed an antitrust action against that “Goliath” and its favored agents that is pending before the U.S. District Court.

Now Anthem has enlisted another “Goliath” in their efforts to stop Total Benefits. The Ohio Department of Insurance has subpoenaed Total Benefits to compel a statement under oath and subpoenaed several of Total Benefits’ clients (all of whom, in what appears more than coincidence, left Anthem after adopting Total Benefits’ strategy). Department agents have even visited those clients, unannounced, at their businesses. Total Benefits has repeatedly asked for copies of any complaints filed against Total Benefits, along with any additional information surrounding the investigation that could help Total Benefits respond. Yet the Department has refused all such requests and resisted efforts to resolve the dispute. “This sure smells like the fox investigating the henhouse,” Quigley says.

Total Benefits suit against the Department, filed in the U.S. District Court for the Southern District of Ohio, seeks to enjoin the Department from: 1) compelling Total Benefits to offer sworn testimony or contacting current or potential clients without first advising Total Benefits of the nature of the charges against Total Benefits; 2) making false and misleading statements about Total Benefits and its strategy; and 3) such further and additional relief as Total Benefits may be entitled to under law.

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