MIAMI, April 7, 2026– On behalf of their whistleblower client, Phillips & Cohen LLP announces that AssuredPartners, Inc. and AP of South Florida, LLC, a national partnership of insurance brokers and its subsidiary that purchased certain assets of a Florida insurance brokerage, have agreed to pay $135 million to resolve civil allegations that they were responsible for the submission of fraudulent applications for government-subsidized Affordable Care Act policies.
AP of South Florida, LLC, has pled guilty for its role in the fraud following the November criminal conviction of an APSF executive for his role in the fraud; for which he was sentenced to 20 years in federal prison. AssuredPartners was not charged in the criminal matter.
In what the Department of Justice called a scheme “that flouted ACA program requirements at every turn,” the conduct “deliberately targeted and preyed upon some of the most vulnerable populations in this country . . . among others to steal millions of dollars from a critical social safety net.”
The resolved allegations against Assured Partners and AP of South Florida, LLC portray a fraud scheme in which low-income individuals were lured into applying for ACA health plans for which they weren’t eligible and coached to report a level of income they did not have or expect to have. The same fabricated income amount – which was the exact minimum income necessary to qualify for a full government subsidy – was used on thousands of applications. A sales commission was paid to the insurance brokerage for each policy. The settlement also resolved allegations that Assured Partners, the parent of AP of South Florida, LLC, benefitted financially from the scheme.
The sophisticated fraud allegedly thwarted the federal government’s attempts to verify income and other information in many ways, including by using fake “qualifying life events” that continuously extended the deadlines for providing verifying information – and therefore extended the subsidies – and allowed plans to be sold, and commissions earned, outside of the open enrollment period. It was also alleged that the brokerage routinely sabotaged its customer’s Medicaid applications – ensuring they were denied – to circumvent ACA eligibility requirements.
The allegations involve more than just the loss of government money; driven by commissions, insurance agents moved applicants, without their knowledge, from no cost Medicaid coverage to ACA plans with deductibles and co-payments they couldn’t afford.
“The sinister irony of this fraud,” said Jeffrey Dickstein, a Phillips & Cohen partner who filed the whistleblower lawsuit, “is that a ‘free’ health plan resulted in applicants receiving no healthcare at all – when they needed it the most.”
“As blatant and large as this fraud scheme was, it took the tremendous skill and effort of the Department of Justice to put a stop to it and hold the fraudsters accountable,” said Amy Easton, a partner at Phillips & Cohen who represented the whistleblower. “Wendy Zupac and David Wiseman of DOJ Civil Fraud’s Section, Jeremy Bloor and Randy Harwell of the United States Attorney’s Office for the Middle District of Florida and Jamie de Boer and Keith Clouser of DOJ’s Criminal Strike Force were extraordinary.”
“Whistleblowers are essential to alerting the government to ACA insurance fraud,” said Claire Sylvia, a Phillips & Cohen partner who also represented the whistleblower “Our client witnessed this alleged conduct and meticulously presented the government with evidence.”
The case was brought by Jeffrey Dickstein, Amy Easton and Claire Sylvia of Phillips & Cohen LLP. Andrew Searle of Searle Law P.A. served as local counsel.
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DOJ Press Release: https://www.justice.gov/opa/pr/national-partnership-insurance-brokers-and-its-former-subsidiary-agree-pay-over-160-million