Employers Network Association (aka, ENA) & Louis Deluca (aka, Louis R. Deluca, III) Accepted $1800/month but failed to make payments for medical services Valhalla Nationwide

I am a New York State resident, small business owner in Manhattan and live in Manhattan with my spouse and two children boys. Helen Altman-Felsher, MBA, a health insurance broker, referred me to a health plans, and I decided on the Cigna “Choice Fund PPO” Network plan (aka, VEBO PPO Plans and ENA Veba Trust).  In order to get this health insurance plan, I had to complete and sign enrollment form and worksheet for a company called “Employers Network Association” (ENA). ENA charged me a one-time processing fee of $125 and a monthly premium of $1634 in 2015 and $1833 in 2016. This health insurance plan was managed by Tall Tree Administrators, a third party administrator (TPA). On December 12, 2016 we received a letter stating that, as of 12/1/2016, our insurance carrier and TPA had changed to PHCS and Benefit Plan Administrators, Inc, respectively.  We were given NO prior warning about the change, were not asked for our consent, and were not given the option to terminate.  We were given no details about the ramifications of these changes and were not even given an identification card or ID number. Even though we have been paying ENA $1833/month for health insurance, none of our claims have been processed since 12/1/2016 (5 months ago).  No one from ENA will answer the phone or return emails.  Ms. Altman-Felsher has been of no help and washed her hands of this.  In fact, she only offered to get me another plan (and to keep receiving commission payments).  ENA has set us up with a third party administrator (TPA) called Benefit Plan Administrators (BPA), Inc., who are completely incompetent and who have been repeatedly lying to us about the problems for the past 5 months.  We didn’t even had an ID card for the first month and the ID #  and group # was changed three times in 2-3 months. The TPA (BPA, Inc.) is stating that they will not pay the claims until they receive the funding.  When I did some investigating, I found that: (1) ENA used an unlicensed company (BPA, Inc.) for the administration, (2) ENA is run by Louis Deluca (aka, Louis R. Deluca III), who has been implicated in several insurance fraud cases and accused of previously violating provisions in insurance laws across several states.  ENA is also in collaboration with  Rod Maynor (CEO of Black Wolf Consulting, Inc.), who is currently being sued for alleged breach of implied covenant of good faith and fair dealing. The plaintiffs allege that the defendant, Mr. Maynor, did not transmit plaintiff's payment to Veritas or to the VEBA trust, failed to provide participants with insurance cards and failed to provide timely information when requested. The case is being tried in Raleigh, WV (Raleigh Circuit Court Case number 17-c-1)

Relavant articles about ENA CEO, Louis Deluca (aka, Louis R. Deluca, III)

http://www.courthousenews.com/insurance-called-85-million-rico-scheme/

https://goo.gl/jhn95b

http://www.state.nj.us/dobi/division_insurance/pdfs/e10_34.pdf

https://goo.gl/IWCkLc

http://www.nytimes.com/1994/11/03/nyregion/5-arrested-in-thefts-from-union-workers-plans.html

http://familiesusa.org/sites/default/files/product_documents/Scam-Insurance-Plans.pdf

https://goo.gl/g0oIIF

http://www.floir.com/siteDocuments/AIMetalCD111720-10.pdf

https://goo.gl/n7v2tZ

https://casetext.com/case/broadbent-v-am-for-affordable-healthcare-inc

https://goo.gl/AqkeuZ

Relevant articles about Rod Maynor (CEO of Black Wolf Consulting, Inc.)

https://goo.gl/mkXFFW