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Private Health Coverage: Results of Covert Testing for Selected Offerings

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Report Type Reports and Testimonies
Report Date Aug. 24, 2020
Release Date Sept. 16, 2020
Report No. GAO-20-634R
Summary:

Our undercover agents conducted 31 tests on health insurance sales representatives to gauge their use of deceptive practices, such as making false statements about coverage. Agents said they had pre-existing conditions, such as diabetes, and sought coverage.

In 8 tests, sales representatives engaged in potentially deceptive practices, such as claiming the pre-existing condition was covered when plan documents said otherwise. We referred these cases to the Federal Trade Commission.

In 21 tests, representatives referred our agents to an appropriate plan. In 2 tests, representatives did not appear to be deceptive but were unclear or inconsistent.

medical bill, stethoscope

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