When people like me have to make the often confusing decision on what kind of health insurance we need, we often turn to an insurance broker -- or an independent agent -- to make that decision for us and find the best deal at the best price.
I've had good experience with my broker. But recent events in Hamilton, New Jersey -- where I live -- have shown me that you have to keep a close eye on your agent or broker.
'Who's the boss?'
The upshot is: Your insurance agent or broker doesn't really work for you. He or she is nearly always paid -- and very well I might add -- by the insurance company that writes your policy. According to one survey, top insurance brokers earn an average $273,000 a year.
So when former insurance broker Marliese Ljuba was willing to forgo both a contract and paycheck to work for our school board, someone should have sensed something was rotten in the state of New Jersey. And someone eventually did. But not the school board, which, by Ljuba's own testimony, was being wined, dined and feted by her on someone else's tab.
Romancing the school board
That bill, in effect, was being paid by Horizon Blue Cross Blue Shield, which managed to keep this annual lucrative contract, despite the fact that it wasn't the lowest bidder. But Ljuba wasn't just romancing the school board; a portion of her fee from Horizon Blue Cross paid off local township officials like our mayor. According to Ljuba's own testimony, she paid "his honor" a $12,400 bribe to influence two school board members whom she couldn't convince to contract with the health insurer.
When a citizens watchdog group -- which had already seen similar statewide bribery and corruption cases involving insurance brokers -- blew the whistle, the FBI papered our township with subpoenas. And the whole deal unraveled in a high profile trial. Our mayor, who was found guilty, became the fall guy and consequently could spend up to 20 years in jail for very little gain.
Let's make a deal
Mark Twain once said that school boards were dumber than idiots and, judging by the outcome, he was right. Brokers are, by definition, dealmakers. And both Ljuba and Horizon Blue Cross brokered their own deals to sidestep this scandal.
Ljuba did hers with the prosecutor. She escaped criminal charges for bribery after she turned state's evidence and testified against the mayor.
And, for a $1.5 million payoff, Horizon Blue Cross got the school board to release it from civil liability and, in addition, imposed what effectively amounts to a gag order preventing the board or school officials from even talking about it.
Horizon Blue Cross earned about $20 million more than if the contracts were awarded honestly, according to one estimate. Ljuba earned $600,000 a year in commissions from the insurer during the years in which she worked for, or against, her alleged school board client. And, in return, our school board got back only $1.5 million.
Some school board members still say that they want to sue Ljuba and the district's current health insurance provider. But given their track record I find it hard to believe.
Perhaps the lesson for our school children, who are $20 million poorer, is that crime does pay.