office of insurance commissioner hearings unit please … · 2019-12-31 · office of insurance...
TRANSCRIPT
MIKE KREIDLER STATE INSURANCE COMM ISSIONER
STATE OF WASHINGTON
OFFICE OF
INSURANCE COMMISSIONER
HEARINGS UNIT
PLEASE E-MAIL FILE-STAMPED COPY TO CONFIRM RECEIPT.
TO: Office of Administrative Hearings
MATTER: In the Matter of National Health Hub, LLC & Samuel LLanes Order Revoking Licenses, OIC Docket No. 19-0159
Phone: (360) 725-7000 www.insurance.wa.gov
COUNSEL REPRESENTING COMMISSIONER: Commissioner appearing through :
Sofia Pasarow, Insurance Enforcement Specialist, primary counsel Daniel Jacobs, Insurance Enforcement Specialist, secondary counsel Office of the Insurance Commissioner (OIC) , Legal Affairs Division P.O. Box 40255 Olympia, Washington 98504-0255 360-725-7181 [email protected]
AGGRIEVED PARTIES:
National Health Hub, LLC and Samuel A. Llanes 2950 W. Cypress Creed Road, Suite 301 Ft. Lauderdale, FL 33309
COUNSEL REPRESENTING AGGRIEVED PARTIES:
Brian Kreger Kreger Beeghly, PLLC 1001 Fourth Ave Suite 4400 Seattle, WA 98154 [email protected]
OIC HEARINGS UNIT ACTION TO DATE: Notices of Receipt of Demand for Hearing sent to Aggrieved Paiiy on April 11 , 2019 . The OIC's Order Revoking License, effective April 12, 2019, is stayed pending the entry of a Final Order.
Mailing Address: P. 0. Box 40255 • Olympia, WA 98504-0255 Street Address: 5000 Capito l Blvd.• Tumwater, WA 98501
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National Health Hub, LCC & Samuel Llanes No. 19-0159 Page 2
AGENCY REQUEST: As soon as possible, please assign an ALJ to hold an evidentiary hearing and any necessary preliminary conference(s), enter an Initial Order, and then return the original file and hearing record to the OIC Hearings Unit.
Should this matter be settled prior to hearing before the ALJ, or the Aggrieved Party fails to appear at scheduled hearing, the ALJ will issue a Final Order.
OTHER INFORMATION: 1) The OIC requires insurance agents and brokers who are the subjects of disciplinary matters to appear in person at evidentiary hearings, because assessing their demeanor is important. 2) If the ALJ permits any non-agent, non-broker entity (or its attorney) to appear by telephone, both parties (or their attorneys) should appear by telephone, so one party/attorney is not alone with the ALJ. 3) Absent unique circumstances and agreement of all parties, hearings should be held in Olympia. 4) This is one of 6 demands filed/to be transferred to the OAH.
Documents included in transmission:
1. Notice of Receipt of Demand for Hearing dated April 11, 2019 2. Demand for hearing, filed April 11, 2019, with attachments, 3, Order Revoking License, No. 19-0147, dated March 28, 2019
Agency Contact: Rebekah Carter, Hearings Unit Paralegal Office of Insurance Commissioner P.O. Box 40255 Olympia, WA 97504-0255 (3 06) 725-7002 Hearings U@oic. wa. gov
Billing Contact: Same.
Date: April 15, 2019
~-----Rebekah Carter for the OIC Hearings Unit
STATE OF WASHINGTON MIKE KREIDLER
STATE INSURANCE COMM ISSIONER
To:
From:
Copy to:
Date:
Hearing:
OFFICE OF
INSURANCE COMMISSIONER ,
HEARINGS UNIT
NOTICE OF RECEIPT OF DEMAND FOR HEARING
Brian Kreger Kreger Beeghly, PLLC 1001 Fourth Ave Suite 4400 Seattle, WA 98154 [email protected]
Rebekah Cmier, Paralegal, OIC Hearings Unit
Sofia Pasarow and Daniel Jacobs, OIC Legal Affairs Division
April 11 , 2019
National Health Hub, LLC & Samuel Llanes, Order Revoking Licenses, OIC Docket No. 19-0159
Phone: (360) 725-7000 www. insurance.wa.gov
This is to advise you that on April 11 , 2019, the Hearings Unit received and filed the Demand for Hearing submitted on behalf of National Health Hub, LLC, and Samuel Llanes.
Pursuant to RCW 34.05.425(l)(c) and WAC 284-02-070(2)(d)(i), your Demand for Hearing will be transmitted to the Office of Administrative Hearings (OAH) where an administrative law judge (ALJ) will be assigned to conduct prehearing activities and preside over the evidentiary hearing. The ALJ will schedule a prehearing conference to discuss this matter with all parties. Following the hearing, the ALJ will enter an Initial Order in accord with RCW 34.05.461(1)(c), including findings of fact and conclusions of law, which will then be sent to our unit along with the hearing record for review by our Presiding Officer and entry of a Final Order pursuant to RCW 34.05.464.
Please direct any questions to Rebekah Cmier, Hearings Unit Paralegal, (360) 725-7002; [email protected]. For more information on our hearings process, visit http://www.insurance. wa. gov /laws-rules/ administrative-hearings/.
Mailing Address: P. 0. Box 40255 • Olympia, WA 98504-0255 Street Address: 5000 Capitol Blvd. • Tumwater, WA 9850"1
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OFFICE of I he
State of Washington Office of the Insurance Commissioner Hearings Unit PO Box 40255
I Demand for Hearing -
INSURANCE COMMISSIONER
Olympia WA 98504-0255 5000 Capitol Boulevard Tumwater, WA 98501 (360) 725-7002 FAX (360) 664-2782 [email protected]
( r~~R 1, 2m9 =~8~ -s:E'~?-.:;~ :
Please type or print in ink. Attach a copy of the Order or correspondence in dispute and all documents supporting your demancl. ~· This Demand for Hearing can be mailed, faxed, hand-delivered or emailed to the Hearings Unit at the address above. For OIC Demands, please provide contact information for all other interested parties and their representatives.
d Requesting Party (required information)
Name/Business Name OIC Case/Order No. National Health Hub, LLC and Samuel A. Llanes 19-0159 Street Address City, State, Zip 2950 W. Cypress Creek Road , Suite 301 Ft. Lauderdale , FL 33309 Telephone Number Fax Number
Contact Person Telephone Number Emai l Address
II Authorized Representative/Attorney for Requesting Party
Last Name First M.I.
KreQer Brian Business Name Kreger Beeghly, PLLC Street Address I City, State, Zip 1001 Fourth Avenue, Suite 4400 Seattle , WA 98154 Telephone Number Fax Number 206-389-1610
I Email Address bk@kregerbeegh ly. com
d Subject Matter of Demand for Hearing 0 Revocation or Denial of License D Revocation or Denial Certificate of Authority or Registration D Cease and Desist Order
D Imposition of Fine/Consent Order □Other ___________________________ _
Kl Additional Parties/Representatives (for more parties and/or representatives, please attach additional pages)
Last Name First M.I.
Business Name
Street Address I City, State, Zip
Telephone Number Fax Number I Ema il Address
d Issues and Arguments a. Issues - Briefly describe each issue or area of dispute that you wish us to consider. Attach addition~! pages if necessary.
See Demand For Hearing , Attached .
REV (6/18)
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b. Arguments - Explain why each issu, area of dispute listed above should be decided our favor. Attach additional pages if necessary. To the extent known, cite applicable rules , statutes, or cases in support of your arguments. Enclose copies of documents concerning your arguments including documents the Department previously requested from you that you have not yet provided.
See, Demand For Hearing , Attached
b Signature
Either the Requesting Party or the Attorney/Representative can sign this Demand for Hearing. However, if the Representative is submitting the Demand, contact information for the Requesting Party must be provided under Section 1 above and the Attorney/Representative's contact information must be provided in Section 2.
Reques~
Signature
Brian F. Kreger Name (please print or type)
Authorized Representative:
Signature
Name (please print or type)
REV (6/18)
Date
Attorney Title
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Title
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THE STATE OF WASHINGTON OFFICE OF THE INSURANCE COMMISSIONER
In the Matter of
National Health Hub, LLC,
and
Samuel A. Llanes,
Licensees/Respondents,
ore ORDER NO. 19-0159
LICENSEES ' /RESPONDENTS ' DEMAND FOR HEARING
11 COME NOW Licensees/Respondents, by and tlu·ough their undersigned
12 counsel, and hereby file their Demand For Hearing contesting the Washington State
13 Office of the Insurance Commissioner ("OIC") Order No. 19-0159, titled "Order
14 Revoking Licenses" (hereafter, Order"), pursuant to which the OIC intends to revoke the
15 producer license of Licensee/Respondent National Health Hub, LLC (WAOIC NO.
16 929239) and the producer license of Licensee/Respondent Samuel A. Llanes (W AOIC
17 NO. 852038) .
18 Licensees/Respondents are aggrieved and harmed by the acts and tlu·eatened acts
19 of the Washington Insurance Commissioner and the ore in regard to the OIC ' s Order in
20 several respects, including, but not limited to the following:
21 1. The Insurance Commissioner and the ore appear to base the OIC's Order on
22 two alleged complaints, but the Insurance Conm1issioner and the OIC do not allege any
23 specific acts or failures to act by the Licensees/Respondents that relate in any respect to
24 the alleged complaint. The OIC ' s Order fails for lack of specificity as to any alleged
LICENSEES ' /RESPONDENTS ' DEMAND FOR HEARING - 1
---= K 1u ::c_;u~ BEEG H LY. i> Ll .C =-100 I Fourth Ave, Suite 4400
Seattle, WA 98154 (206)389-1610
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wrongdoing on the part of the Licensees/Respondents in regard to the complaints that
forms the basis of the OIC's Order.
2. The OIC's Order appears to identify several other parties whose actions or
failure to act may relate to the alleged complaints on which the OIC's Order is based, but
the OIC does not allege any relationship between such other parties and their acts or
failures to act and the Licensees/Respondents to indicate that the Licensees/Respondents
have conducted themselves in a manner contrary to law or in any way connected to the
alleged complaint on which the OIC's Order is based or are legally responsible for the
alleged acts of other persons or entities named in the OIC's Order but who are not parties
to, nor, apparently, subject to the OIC's Order. The Insurance Commissioner and the
OIC have failed to accurately allege any acts of the Licensees/Respondents that support
the OIC's Order in any respect. As a result, the Licensees/Respondents are harmed in
their reputation and their legitimate business operations.
3. The Insurance Commissioner and the OIC seek to revoke the license of one
of the Licensees/Respondents that terminated months before the OIC's order was issued
to Licensees/Respondents. By vi1iue of that license having been terminated before the
Insurance Commissioner and the OIC issued the OIC 's Order, that license ceased to exist
on that date and did not exist at the time the OIC issued it Order. Consequently, the
Insurance Commissioner and the OIC have no jurisdiction over that
Respondent/Licensee and have no authority to revoke a license that does not exist. The
OIC's Order is completely without merit as to this Licensee/Respondent and lacks any
legal basis whatsoever.
4. The Insurance Commissioner and the OIC refer to several sections of the
Insurance Code (Title 48 Revised Code of Washington ("RCW")), but do not specify
LICENSEES '/RESPONDENTS' DEMAND FOR HEARING - 2
--= K l{l:Cl. l~ B l ECHLY. P LL.C =-1001 Fourth Ave, Suite4400
Seattle, WA 98154 (206)3 89-1610
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any acts or failure to act on the part of the Licensees/Respondents that may constitute
and violation of the any of the provisions of Title 48 RCW cited in the OIC's Order. The
OIC's Order fails to specify any alleged acts of the Licensees/Respondents that are
contrary to the Insurance Code, thereby causing damage and harm to the
Licensees/Respondents in their business, their reputation, and their personal lives.
5. The Insurance Commissioner and the OIC make an unsubstantiated and vague
reference to the offer of discount programs in the OIC's Order, but do not allege any
specific actions on the paii of the Licensees/Respondents, that could be considered the
offering of any discount programs. Based on these unsupported and tmspecified
allegations regarding discount programs, the Insurance Commissioner and the OIC go
on to make a number of references to Chapter 48.15 RCW (relating to Unauthorized
Insurers or "Surplus Lines") and to Chapter 48 .15 5 RCW (relating to Health Care
Discount Plans). The Insurance Commissioner and the OIC do not allege any acts
engaged in by the Licensees/Respondents that are in violation of these provisions of Title
48RCW.
Licensees/Respondents are insurance producers who represent health insurance
companies. None of the business activities conducted by the Licensees/Respondents in
the State of Washington involves surplus lines carriers under Chapter 48.15 RCW, since
that chapter regulates only commercial property and casualty insmance and does not
apply at all to the business of the Licensees/Respondents. The OIC's Order fails to state
a case against the Licensees/Respondents in this regard and, thereby fails totally .
By the same token, the Insurance Commissioner's and the OIC' s references to
Chapter 48.155 RCW are not well-placed. The OIC makes unsupp01ied allegations that
a "discount medical health insurance plan", was sold by Licensees/Respondents ai1d fails
LICENSEES ' /RESPONDENTS ' DEMAND FOR HEARING - 3
-= Km::cl:.ll BEECH LY. PLLC =-100 I Fourth Ave, Suite 4400
Seattle, WA 98 154 (206)3 89-1610
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to allege any facts either describing what the alleged discount medical health insurance
plan consisted of and failed to establish that the Licensees/Respondents sold such a
discount medical health insurance plan, and if so, how such a plan was subject to
regulation under the provisions of Chapter 48.155. The OIC 's Order is defective and
cannot stand the test of proof.
6. The Insurance Commissioner and the OIC do not set forth in any detail or
specificity whatsoever which, if any, alleged acts of the Licensees/Respondents violate
Title 48 RCW. Nevertheless, the Insurance Commissioner and the OIC threaten to
revoke the producer licenses issued by the OIC to the Licensees/Respondents, and
attempt to revoke a license that does not exist. These acts and threatened acts of the
Insurance Conm1issioner and the OIC, as set forth in the OIC's Order, constitute a
violation of the due process rights afforded the Licensees/Respondents under the
Constitution of the United States and the Constitution of the State of Washington.
7. The Insurance Conm1issioner' s and the OIC ' s threat ofrevoking the licenses
of the Licensees/Respondents also violates the property rights of the
Licensees/Respondents as those rights are protected tmder the Constitution of the United
States and the Constitution of the State of Washington.
8. Because the Insurance Conm1issioner and the OIC have failed to allege any
specific violations of Washington law engaged in by the Licensees/Respondents in the
conduct of their business as life and health insurance producers, the OIC' s Order
Revoking the Licenses of the Licensees/Respondents is not supported in fact or law and,
therefore, is excessively punitive, arbitrary, and capricious.
9. The Licensees/Respondents are materially harmed by the acts and threatened
acts of the Insurance Commissioner and the OIC with respect to the business and
LICENSEES ' /RESPONDENTS ' DEMAND FOR HEARING - 4
--= K IU:Cl::l l Bl::El; I-I LY. PLI .C =-1001 Fourth Ave, Suite 4400
Seattle, WA 98154 (206)3 89- I 610
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reputation of the Licensees/Respondents as well as in their professional and personal
lives, and are entitled to relief as a matter of law.
WHEREFORE, by this Demand for Hearing, the Licensees/Respondents request
the following relief and remedies:
1. That the OIC's Order No. 19-0159 Revoking the Licenses of the
Licensees/Respondents be stayed pursuant to RCW 48.04.020, and also in accordance
with the directive of the Insurance Commissioner as set forth in page 9 of the OIC's
Order, pending a final resolution of this Matter.
2. That, pursuant to RCW 48.04.010(5), this Matter and the
Licensees ' /Respondents ' Demand for Hearing herein shall be presided over by an
independent administrative law judge assigned under Chapter 34.12 RCW.
3. That the OIC 's Order No. 19-0159 be stricken in its entirety and rescinded ab
initio and that an appropriate Order be so granted and entered on the record.
4. That the Licensees/Respondents be awarded their actual attorney fees and
costs incurred in defending against the OIC' s Order.
5. That the Licensees/Respondents shall be entitled to and shall recover such
other and further relief as may be reasonable and necessary under the circumstances.
LICENSEES ' /RESPONDENTS ' DEMAND FOR HEARING - s
-=: K J~ECl:: l l BLEC ; I-I LY. J> LLC =-1001 Fourth Ave, Suite4400
Seattle, WA 98154 (206)389-16 10
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DATEDthis ~ dayof ~ , 2019
KREGER BEEGHLY, PLLC
~1ce= Brian F. Kreger, WSBA Number 10670
Attorney for Licensees/Respondents
LICENSEES' /RESPONDENTS' DEMAND FOR HEARJNG - 6
-=: K 1u :: c__; L-. 1{ B1::: 1.:.c H LY. i>Ll.C =l00 l Fourth Ave, Suite 4400
Seattle, WA 98154 (206)389-1610
(
- KREGER BEEGHLY, PLLC -
April 8, 2019
Daniel Jacobs
ATTORNEYS
1001 Fourth Ave., Suite 4400 Seattle, WA 98154
Brian F. Kreger Mobile: 206-931-5594
Main Office: 206-389-1610 E-Mail: [email protected]
Insurance Enforcement Specialist
Office of the Insurance Commissioner
P.O. Box 98504
Olympia, WA 98504
RE: National Health Hub, LLC
Samuel A. Llanes
Office of the Insurance Commissioner Order No. 19-0159 Order Revoking Licenses
Mr. Jacobs:
This is to advise you and the Washington State Office of the Insurance Commissioner ("OIC") that our
office has been retained to represent and assist Mr. Samuel A. Llanes and National Health Hui:;), LLC in
the above-referenced matter. Accordingly, you and the OIC are hereby instructed that you may not
contact our client directly with respect to this matter and that any further communication regarding our
client and this matter shall be directed to me.
Your cooperation and courtesy are greatly appreciated.
Regards,
Bri~
C. File; S. Llanes
www.kregerbeeghly.com
April 8, 2019
Josh Pace
Legal Assistant
- KREGER BEEGHLY, PLLC =-ATTORNEYS
1001 Fourth Ave., Suite 4400
Seattle, WA 98154
Brian F. Kreger Mobile: 206-931-5594
Main Office: ;w6-389-1610 E-Mail: [email protected]
Office of the Insurance Commissioner
P.O. Box 98504
Olympia, WA 98504
RE: National Health Hub, LLC
Samuel A. Llanes
Office of the Insurance Commissioner Order No. 19-0159 Order Revoking Licenses
Mr. Pace:
This is to advise you and the Washington State Office of the Insurance Commissioner ("OIC") that our
office has been retained to represent and assist Mr. Samuel A. Llanes and National Health Hub, LLC in
the above-referenced matter. Accordingly, you and the OIC are hereby instructed that you may not
contact our client directly with respect to this matter and that any further communication regarding our
client and this matter shall be directed to me.
Your cooperation and courtesy are greatly appreciated.
Regards,
l~ --Brian F. l<reger
www.kregerbeeghly.com
,STATE OF WASHINGTON OFFICE OF THE iNSURANCE COMMISSIONER
In The Matter of
NATIONAL HEALTH HUB, LLC,
and
SAMUEL A. LLANES,
Licensees.
To: National Health Hub, LLC Shirley M. Garcia 2950 W Cypress Creek Rd Suite 301 Fort Lauderdale, FL 33309 [email protected]
Samuel A. Llanes 1401 N University Dr Ste 500 Coral Sp~ings, FL 33071-8930 [email protected] ·
Samuel A. Llanes 11330 NW 68th CT Parkland, FL 33076-3857
ORDER NO. 19-0159
WAOIC NO. 939239 FEIN 47-3603079
W AOIC NO. 852038 NPN ' 16911191
ORDER REVOKING LICENSES
IT IS ORDERED AND YOU ARE HEREBY NOTIFIED that ~our.Wal§hin~on State
insurance producer licenses are REVOKED, effective April 12, 2019, pursuant to
RCW 48.17.530.
BASIS:
1. National Health Hub, LLC ("the Agency") was a Washington nonresident
insurance producer licensed from December 21, 2016 to December 21, 2018,when the Agency's
producer license expired. The Agency was authorized to sell life and disability insurance in
Washington,Dfrring the· period the Agency was licensed, it did not hold any affiliations and. only
held one appointment to Chesapeake Life Insurance Company,
2. Samuel A Llanes ("Llanes") is a Washington nonresident insurance produce~ ORDER REVOKING LICENSES 1 State of Washington . ORDER NO. 19-0159 Office of the Insurance Commissioner
PO Box 40255 LA- 1448834 & 1536283 - 1 , Olympia, WA 98504-0255
licensed in Washington since January 28, 2014. Llanes was the Designated Responsible Licensed
Person ("DRLP") for the Agency. Llanes was not affiliated with the Agency, as requir~d by the
Washington Insurance Code.
Consumer A
3. Jose Rodriguez ("Rodriguez") (WAOIC 936225) is a Washington nonresident
insurance producer licensed since November 7, 2016. The Agency terminated Rodriguez's
employment during the course of this investigation.
4. The Insurance Comqiissioner's Investigations Unit ("Investigations") received a
complaint from a Washington consumer, ("Consumer A") alleging that she purchased a short-term
medical ("STM") health policy from "Shawn Allan" ("Allan"), who acted on behalf of the Agency.
She reported Allan misrepresented that the policy he sold to her would cover her son's pre-existing
eye condition.
5. Pedro Rivera ("Rivera") (aka Shawn Allan) does not hold a Washington insurance_
producer license. The Agency reported to Investigations that "Shawn Allan" no longer works for •
the Agency.
6. The Agency provided policy documents that identified the producer as Rodriguez. (
Consumer A and Rodri,guez reported to Investigations that Consumer A never spoke to Rodriguez.
Rodriguez stated he was not at work on the day the insurance policy was sold to Consumer A.
7. Shirley Garcia ("Garcia") of the Agency, 'provided a letter to Investigations signed
by Rodriguez, $tating that he solicited the policy and did not provide false information regarding
the pre-existing exception. The letter also stated that during the verif.ication call, the "verifier
indvertenl}'. mention [sic] Samuel Llanes as the agent of record, it should have been Jose
Rodriguez. Shawn was the fronter at the time the call was transferred."
8. Rodriguez believes he was terminated by the Agency; as a result of informing
Investigations that he did not produce Consumer A's policy.
9. Rodriguez acknowledged signing the letter written and emailed to him for signature
by Garcia in error. He later determined through his records that he never spoke ·with Consumer A.
Lastly, Rodriguez reported Allan was a false name of Pedro Rivera, who sat close to Rodriguez as
a co-worker at the Agency. He stated the Agency has a practice of using unlicensed people to sell
insurance.
ORDER REVOKING LICENSES ORDER NO. -19-0159
LA - 1448834 & 1536283 - 1
2 State of Washington Office of the Insurance Commissioner PO Box 40.255 Olympia, WA 98504-0255
10. Investigations reviewed the STM he.alth policy and products sold to Consumer A'
by Health Plan Intermediaries Holdings I~c. d/b/a He1,1-lth Insurance Innovations ("HII"), th.rough
the Agency. Investigations identified that the policy was sold to Consumer A through a ' membership with the National Congr1;Jss of Employees (''NCE"). The NCE membership was an
additional cost to Consumer A. The NCE- membership included GapAfford Plus, a discount
medical health insurance plan which was not authorized for sale in Washington. Consumer Awas
also provided a membership with ScripPal, a discount medical health insurance plan which was
not authorized for sale in Washington.
11. Consumer A paid a total of $5,363.26 to HII for the STM health policy ($476.26
per month for 11 months with an additional $125 one-time NCE membership charge), and a total
of $1,677 for the Ameritas dental policy t~ough a USA+ membership. A total of $670;80 was
paid to HII in commission. The Agency received a total commission of $1°,203.84 ($109.44 per
month) for the Unified health poli.cy. The NCE membership materials state multiple times that the
products sold to Consumer A were not autl:ioriied for sale in Washington.
12. A claim involving Consumer A's son's eye was denied by the insurer. Consumer
A reported her insurance policy expired and she obtained insurance from another insurance
company. She estimated she has about.$14,000 in medical bills that the insurer had denied, then
indicated it would pay. However, the insurer has since conducted an audit and told her the
condition was pre~existing and she would be responsible for paying the medical bills.
ConsumerB
13. Serena Rae Goldin ("Goldin") (WAOIC 926664) was a Washington nonresident
insurance producer license~ from August 16, 2016 to January 5, 2918, when her Washington
insurance producer license expired ... -··
14. Investigations received a· second coin.plaint from -a Washington consumer
("Consumer B") arising from the purchase of a STM policy. C~nsumer B purchased the coverage
in May 2017, and allowed it to lapse after the policy's three-month term expired. Included with
the STM policy provided to Consumer B was membership with ScripPal.
15. Consumer B's short term medical plan insurance application, dated May 1-6, 2017,
identified Goldin as the "company appointed producer." Goldin's license number is not on the
application. Goldin responded to written questions.from Investigations, asserting that she had no ORDER REVOKING LICENSES 3 State of Washington ORDER NO. 19-0159 Office of the Insurance Commissioner
PO Box40255 LA - 1448834 & 1536283 - 1 Olympia, WA 98504-0255
records regarding Consumer B, and no longer worked for the Agency. Goldin was no·t appointed
to the insurer until May 24, 2017, a week after the policy was produced.
16. In answering Investigations' written questions, the insurer identified HII as its
"program manager," while also providing a Managing General Underwriters Agreement that
.purported to appoint HII as "its ·agent to ... solicit and sell short-term medical insurance on behalf
of [the underwriter]." The insurer confirmed that it paid HII commissions at a rate of "31 % of
gross premium," and that HII was permitted, per the agreement, to appoint "sub-producers" and to
pay commission to those "sub-producers." The insurer, relying on information provided by HII,
relayed that Llanes received commission from.Consumer B's purchase. Neither Llanes nor the
Agency were ever affiliated with HII or appointed by the insurer, as required by the Washington
Insurance Code.
17. RCW 48.01 .030 provides that the business of insurance is one affected by the public
interest, requiring that all persons be actuated by good faith, abstain from deception, a11d practice
honesty and equity in all insurance matters. Upon the insurer, the insured, their providers, and their
representatives rests the duty of preserving inviolate the integrity of insurance.
18. WAC 2 84-17-4 73 provides that individual licensees that repte§ent a business entity
or act on its behalf must be affiliate.cl with the licensed business entity. A business entity must have
at least one affiliated individual licensee in order to transact jnsurance business.
19. RCW; 48.17.090(3)(b) provides before approving an insurance producer
application, the Insurance Commissioner shall find that the business entity has designated a
licensed insurance producer responsible for the business entity's compliance with the insurance
laws and rules of Jhis state.
20. RCW 48.155.010(5)(a) provides that a "Discount plan organization" means a
person that, in exchange for. fees, dues, charges,. or other consideration, provides or purports to
provide access to discounts to its members on charges b}'. providers for µealth care services.
21. RCW 48.155,015(1) provides that chapter RCW 48.155 applies to all discount
plans and all discount plan organizations doing business in or from this state or that affect subjects
located wholly or in part to be performed within this state, and all persons having to do with this
business.
22. RCW 48.155.020(1) provides that before conducting discount plan business to
'-- -- -- - - - - which-this ·chapter applies,a-person-must-obtain-a-license from .the Insurance Commissioner to_ ORDER REVOKING LICENSES 4 State of Washington. ORDER NO. 19-0159 Office of the Insurance Commissioner
PO Box 40255 LA - 1448834 & 1536283 - 1 Olympia, WA 98504-0255
r
operate as a discount plan organization. *
2l RCW 48.155.130(2) provides that a person that willfully operates as, or aids and
abets another operating as a discount plan organization in violation of RCW 48.155.020(1) ) ...
· commits insurance fraud and is subject to RCW 48.15.020 and 48.15.023, as ifthe unlicensed . ' .
discount plan organization were an unauthorized ·insurer, and the fees, dues, charges, or other
consideration collected from the metribers by the unlicensed discount plan organization or
marketer were insurance_ premiums.
24. RCW 48.15.020(2)(a) provides that a person may not, in this state, represent an
unauthorized insurer except as provided in this chapter. This. subsection does not apply to any
adjuster or attorney-at-law representing an unauthorized insurer from tlme to time in this state in
his or her professional capacity.
25. RCW 48.15.020(3) provides that each violation of subsection (2) of this section
constitutes a separate off ens~ punishable by a fine of not more than twenty-five thousand dollars,
and the Insurance Commissioner, at the Insurance Commissioner's discretion, may order
replacement of polisies improperly place<:l with an unauthorized insurer with policies issued by an
authorized insurer. Violations may result in suspension ortevocation of a ,license.
26. RCW 48.17.067(1) states that any producer or agent soli~it_ing, negotiating, or
procuring an application for insurance or health care services in this state must make a good faith
effort to determine whether the entity that is issuing the coverage is authorized tQ transact insurance )
or health coverage- in this state.
27. RCW 48.17.160(1) provides that ai+ insurance producer shall hot act as an agent of
an insurer unless the insurance producer becomes an appointed agent of that insurer.
28. . RCW 48.17.270(3) provides that if the compensation received by ah insurance
producer who is dealing directly with the insured includes a•fee, for each policy, the insurance
producer must disclose in writing to the insured:
(a) The full amount of the fee paid by the insured;
(b) The full amount of any commission paid to the insurance producer by the ' .
insurer, if one is received;
( c) An explanation of any offset or reimbursement of fees or commissions as
· described in subsection (2)( c) of this section;
ORDER REVOKING LICENSES, ORDER NO, 19-0159
LA - 1448834 & 1536283 - 1
5 State of Washington Office of the Insurance Commissioner PO Box 40255 Olympia, WA 98504-0255
( d) When the insurance producer ma1 receive additional commission, J1otice
that states the insurance producer:
(i) May receive additional commission in the form of future incentive.
compensation from the insurer, including contingent commissions
and other awards and bonuses based on factors that typically
. include the total sales volume, growth, profitability, and retention
of business placed by the insurance producer with the insurer, and .
incentive compensation is only paid if the performance criteria
established in the agency-insurer agreement is met by the
insurance producer of the business entity with which the insurance
producer is affiliateµ; and
(ii) Will furnish to the insured or prospective insur.ed specific
information relating to additional commission upon reques1; and
_ ( e) The full name of the insurer that may pay any commission to the insurance
producer.
29. RCW 18.17.270(4) provides tha~ written disclosure ofcompensation as required by . .
subsection (3) of this section shall be provided by the insurance pro.ducer to the insured prior to
the sale of the policy.
30. RCW 48.17.270(5) provides that written disclosure as required by subsection (3)
of this section must be signed by the insurance producer and the insured, and the writing must be
retained by the insurance producer for five (5) years. For the purposes of this section, written
disclosure means the insured's written cons~nt obtained prior to the insured's purchase of . '
insurance. In the case of a purchase over the telephone or by electronic means for which written
consent canno_t be reasonably obtained, consent documented by the insurance producer shall be
acceptable .. ' 31. RCW 48.17.530(1)(b) allows the Insurance Commissioner to place on probation,
suspend, revoke, or refuse to issue or renew an adjuster's license, an insurance producer's license,
a title insurance agent'.s license, or any surplus line broker's license for violating any insurance
laws, or violating any rule, subpoena, or order of the Insurance Commissioner or of another state's ORDER REVOKING LICENSES 6 State of Washington ORDER NO. 19-0159 Office of the Insurance Commissioner
PO Box 40255 LA - 1448834 & 1536283 - 1 Olympia, WA 98504-0255
insurance commissioner.
32. RCW 48.17.530(1)(h) allows the Insurance Commissioner to place on probation,
suspend, revoke, or refuse to issue or renew an adj¥ster's license, an insurance producer's license,
a title insurance agent's license, or any surplus line broker's license for using fraudulent, coercive,
or dishonest practices, or demonstrating incompetence, untrustworthiness, or financial
irrespo'nsibility in this state or elsewhere. ·1
33. RCW 48.17.530(1)(1) allows the Insurance Commissioner to_place 6n probation,
suspend, revoke, or refuse to issue or renew an adjuster's license, an insurance producer's license,
a title ins1,1rance agent's Jicense, or any surplus line broker's license for knowingly accepting. -
insurance business from a person who is required to be licensed under this title and is not' so
licensed, other than orders for issuance of title insurance on property located in this state placed
by a nonresident title insurance agent authorized to act as a title insurance agent in the title
insurance agent's home state. . 34. RCW 48.17.530(2) allows the Insurance Commissioner to suspend, revoke or
refuse to issue or renew the license-of a business entity if he finds that an individual licensee's
violation .was known or should have been known by one or more of the.partners, officers, or
managers acting on behalf of the partnership or corporation, and the violation was neither reported
to the Insurance Commissioner nor corrective action taken.
35. RCW 48.17.530(3) states the Insurance Commissioner shall retain authority to
enforce the provisions of and impose an):' penalty or remedy authorized .by this chapter and this
title against any person who is under investigation for or charged with a violation of this chapter
or this title, even if the person's license or registration has been surrendered or has lapsed by
operation of law.
36. By representing that ~n insurance policy was produced by a licensed producer
when, in fact, an unlicensed person solicited, negotiated, or sold such policy, acting _as an agent of
an insurer without being appointed, failing to affiliate producers acting on its behalf, knowingly
accepting insurance business from a person who is required to be licensed and is not so licensed,
aiding arid abetting another in the operation of an unlicensed discount plan organization,
representing an unauthorized insurer, failing to make a good faith effort to determine whether the
entity issuing coverage is authorized to transact insurance or health cover~ge in this state, f~iling
to disclose compensation in writing to the insured prior to the sale of the policy, failing to retain ORDER REVOKING LICENSES 7 State of Washington ORDER NO. 19-0159 Office of the Insurance Commissioner
PO Box40255 LA - 1448834 & 1536283 - I Olympia, WA 98504-0255
written disclosure signed by the insurance producer for five (5) years, and demonstrating
fraudulent, coercive, or dishonest practices, or demonstrating incompetence, untrustworthiness, or
financial irresponsibility, the Agency and Llanes violated WAC 284-17-473, RCW 48.155.020(1)~
RCW 48.155.130(2), RCW 48.15.020(2)(a), RCW 48.17.067(1), RCW 48.17.160(1), RCW
48.17.270(3), RCW 48.17.270(4), RCW 48.17.270(5), RCW 48.17.530(1)(b), RCW
48.17.530(1)(h), RCW 48.17.530(1)(1), justifying the revocation of their licenses under RCW
48.15.020(3), RCW 48.17.530(1), and RCW 48.17.~30(2).
2 O·ftA day of /VI,.,. """I. ENTERED at Tumwater, Washington, this __ o__ __,_ _ ___,;;v_v,_ ,~_n ____ ., 2019.
MIKE KREIDLER Insurance Commissioner
By and through his designee
c:~ ~7ASAROW Insurance Enforcement Specialist Legal Affairs Division
2 6,..\,1.. All (_ ENTERED at Tumwater, Washington, this -=-__.Q_ ____ d_a .... Y-_•o..,..f_/_v l._tJ<.._r_C_v __ ~--~-' 2019. . .
orrt-~ MIKE KREIDLER Insurance Commissioner
By and through his~
;;;7f£: DANIEL JACOBS InstJrance Enforcement Specialist Legal Affairs Divis~on
ORDER REVOKING LICENSES ORDER NO. 19-0159
LA- 1448834 & 1536283 - 1
8 State of Washington Office of the Insurance Commissioner PO Box 40255 Olympia, WA 98504-0255
NOTICE OF YOUR RIGHT TO A HEARING
If you are aggrieved by this Order Revoking Licenses, you may_ demand a hearing in
accordance with RCW 48.04.010, WAC 284-02-070, and WAC 10-08-110. Generally a hearing
demand must be in writing and received within ninety (90) days after the date of this Or~er
Revoking Licenses, which is the day it was mailed to you, or you will waive your right to a
hearing.
If the Insurance Commissioner receives your demand for a hearing before the effective
date listed on the order revoking your licenses, the -revocation will be automatically stayed
(postponed) and your licenses will remain in effect pending the hearing.
You may fill out a demand for hearing form online at the following location: https://www.insurance.wa.gov/how-file-demand.:hearing
Alternatively, if you choose to file by mail, your dem~~d for hearing must briefly state
how you are harmed by this decision and why you disagree with it, along with contact
information (phone number, m~iling address, e-mail address, etc,) for yourself and any
representative that appears on your behalf. The ~emand may be sent to the following address:
Hearings Unit Office of the Insurance Commissioner· ·PO Box 40255 Olympia, WA 98504-0255
You will be notified of the time and place of your hearin,&, If you have questions about ' '
filing a demand for hearing or the hearing process, please telephone the Hearings Unit at (360)
725~7002, or send an email to [email protected].
. ORDER REVOKING LICENSES ORDERNO. 19-0159
✓ LA - 1448834 & 1536283 - 1.
9 State of Washington Office of the Insurance Commissioner PO Box40255 Olympia, WA 98504-0255
CERTIFICATE OF MAILING
the undersigned 9ertifies under the penalty of perjury under the laws of the state of
Washington that I am now and at all tinies herein mentioned, a citizen of the United States, a
resident of the state of Washington, over the age of eighteen years, not a party to or interested in
the above-entitled action, and competent to be a witness herein.
On the date given below I caused to be served the foregoing Order.Revoking License on ·,
the following indivjdual by email and by depositing in the U.S. mail via state Consolidated Mail . .
Servic~ with proper postage affixed:
National Health Hub, LLC Shirley M. Garcia 2950 W Cypress Creek Rd Suite 301 Fort Lauderdale, FL 33309 [email protected]
Samuel A. Llanes 1401 N University Dr Ste 500 Coral Springs, FL 33071-8930 S amuel@americanhealthh ub .com
Sainuel A. Llanes 11330 NW 68th CT Parkland, FL 33076-3857
Dated this ;28-f:b. day of . r{Je1-~
PM..C J0SHP A..,....iHir½IEi..;;._=. -=.--,,-------'-~
· Legal Assistant Legal Affairs Division
ORDER REVOKING LICENSES ORDERNO. 19-0159
LA - 1448834 & 1536283 - 1
10
, 2019, in Tumwater; Washington.
State of Washington Office of the Insurance Commissioner PO Box40255 Olympia, WA 98504-0255