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Augusta, Maine -

Superintendent Mila Kofman issued an emergency Cease and Desist order today. The action orders American Trade Association (ATA), Smart Data Solutions, Pinnacle Health Solutions, and operators of these entities to immediately stop sales in Maine, to issue refunds to consumers, and to pay medical claims.

“Promoters of phony insurance collect premiums from unsuspecting consumers, make false promises, and leave consumers with thousands of dollars in unpaid medical bills,” Superintendent Kofman stated. “If it seems too good to be true, it usually is. In most cases like this, there is no insurance, and people who have been paying premiums end up paying their medical expenses too.”

Between 2000 and 2002, the last cycle of large scale health insurance scams, more than 140 entities sold phony health insurance to over 15,000 businesses and more than 200,000 policyholders nationwide. These entities left consumers with approximately $252 million in unpaid medical bills.

It is not known how many Mainers are affected by the illegal activities of ATA. Superintendent Kofman is asking consumers to contact the Bureau of Insurance by phone at (207) 624-8475 or toll-free at 800-300-5000 and ask for Kelly Rogers. They can also contact the Bureau through e-mail at insurance.pfr@maine.gov and include ATA in the subject line; or by mail: ATA Consumer Assistance, Maine Bureau of Insurance, 34 State House Station, Augusta ME 04333-0034.

On April 9, 2010, Maine Superintendent of Insurance Mila Kofman issued an Emergency Cease and Desist Order against the American Trade Association (ATA) and related parties, finding that ATA has been selling and issuing insurance illegally in Maine.

Superintendent Kofman has ordered ATA to stop doing business in Maine immediately, and to continue paying benefits on coverage it has already sold. You have received this notice because you are on an ATA customer list.

• Your right to a refund – ATA has been ordered to give you a full refund, minus any claims they have paid.
• Your right to any benefits you have paid for – ATA has been ordered to continue honoring its obligation to pay claims.
• Your right to buy new coverage – Maine law gives all individuals and small businesses the right to buy any health insurance product sold by any licensed insurer, regardless of your health status. Information on your health insurance options may be found at:
  www.maine.gov/pfr/insurance/consumer/indhlth.htm (individuals) www.maine.gov/pfr/insurance/employer/smallemp.htm (employers)

  If you have questions, or would like to contact the Maine Bureau of Insurance – you may reach the Bureau in any of these ways:

  By phone at (207) 624-8475, or in Maine at (800) 300-5000. Please ask for Kelly Rogers.

  By e-mail at insurance.pfr@maine.gov. Please include ATA in the subject line.

  On the Internet at: www.maine.gov/pfr/insurance

  By mail at:

  ATA Consumer Assistance Maine Bureau of Insurance 34 State House Station Augusta ME 04333-0034

The Bureau of Insurance is part of the Department of Professional and Financial Regulation which encourages sound ethical business practices through high quality, impartial and efficient regulation of insurers, financial institutions, creditors, investment providers, and numerous professions and occupations for the purpose of protecting the citizens of Maine. Consumers can reach the Bureau through its web site at www.maine.gov/insurance; by calling 800-300-5000 in state; or by writing to Bureau of Insurance, 34 State House Station, Augusta ME 04333.

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Last Updated: July 26, 2011 7:57 AM