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 SofiaP@oic.wa.gov

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 bk@kregerbeeghly.com

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 bk@kregerbeeghly.com

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; HearingsU@oic.wa.gov. 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 HearingsU@oic.wa.gov

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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: bk@kregerbeeghly.com

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: bk@kregerbeeghly.com

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 info@americanhealthhub.com

Samuel A. Llanes 1401 N University Dr Ste 500 Coral Sp~ings, FL 33071-8930 Samuel@americanhealthhub.com ·

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 HearingsU@oic.wa.gov.

. 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 info@americanhealthhub.com

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