Renegade health plan agrees to make good on claims and leave Texas
Editor's note: Maryland Insurance Commissioner Steven B. Larsen has ordered unlicensed insurers SAI Med Health Plan and SAI Plus to stop selling illegal health insurance policies in Maryland. Larsen also revoked the companies' state registrations as third party administrators on April 3, 2001. Claimants who wish to file a grievance against either company should contact Carolyn Sullivan at the U.S. Department of Labor, 1730 K. Street, NW, Washington, D.C., 20006. For further information and telephone numbers, see How to make claims under a self-insured health plan.
The Texas Department of Insurance (DOI) has reached an agreement with SAI Plus LLC, an unlicensed health insurance business that collected premiums from more than 60 Texas employers but, according to the DOI, did not pay many customers' claims.
The consent order, signed March 29, 2001, after a six-month investigation of SAI Plus, requires the company to reimburse employers for unpaid claims or face a $1 million fine. SAI Plus also agreed to stop doing business in Texas, and to withdraw its application to become a third-party administrator for self-insured employer health plans.
|The DOI received more than 140 complaints about SAI Plus from consumers, employers, and medical providers.|
The DOI has received more than 140 complaints about SAI Plus from consumers, employers, and medical providers since Jan. 1, 2000. The complaints included non-payment of claims, incorrect copayment deductions, improper claim denials, and bounced checks to medical providers. The company did not have a license to do insurance business in Texas.
SAI Plus denies that it violated any Texas insurance laws.
Based in Maryland, SAI Plus has been in hot water with the Maryland DOI for engaging in insurance transactions without a license, and then for violating the DOI's order to cease and desist. SAI Plus, its sister company, SAI Med Health Plan, and its owners, Dr. Marhuthi S. Manney and Dr. Lakshmi Manney, also are under investigation by the U.S. Department of Labor (DOL) for violations of the Employee Retirement Income Security Act (ERISA). The DOL seeks more than $1 million from SAI Med, saying the company owes $1.6 million in claims to employers in Maryland, Virginia, and West Virginia.