New Jersey – A Lakewood, New Jersey, insurance producer was charged today with conspiring to defraud several Blue Cross Blue Shield health care insurance affiliates of more than $10 million, U.S. Attorney Craig Carpenito announced today.
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Jonas Knopf, 63, of Lakewood, was charged by complaint with one count of conspiring to defraud three health care Blue Cross Blue Shield (BCBS) affiliates in Pennsylvania and the Washington, D.C., area. He is scheduled to appear today before U.S. Magistrate Judge Steven C. Mannion in Newark federal court.
According to documents filed in this case and statements made in court:
From 2009 to 2017, Knopf was the chief executive officer of Madison Financial Services (MFS) and a licensed insurance producer – a person who is licensed to sell insurance products.
MFS was the parent company of 11 sham companies created by Knopf and others solely for the purpose of marketing health insurance coverage to people who were not, in fact, his employees.
These companies purported to be located and doing business in Pennsylvania and/or Virginia, and created the appearance of employment status for hundreds of individuals, largely Lakewood residents who were seeking health care coverage through BCBS benefit plans.
The conspiracy began in Pennsylvania, and lasted until 2013, when an internal BCBS investigation uncovered irregularities in the information submitted by Knopf and others through his sham companies. Ultimately, the Pennsylvania Department of Insurance initiated an investigation and Knopf surrendered his Pennsylvania insurance producer’s license and ceased operation in the state. The conspiracy, however, continued in Virginia.
Knopf’s clients or purported employees paid him inflated insurance premiums as well as providing him with monies for payroll; Knopf, in turn, issued fake payroll checks, giving the false impression that they were actually employees being paid for services rendered. The conspiracy continued until January 2017. The conspiracy caused the health care insurers to pay out more than $10 million in fraudulent claims.
The count of conspiracy to commit health care fraud carries a maximum penalty of 10 years in prison and a $250,000 fine.
His attorney, Michael Gilbert, countered the government’s accusation of Knopf as a scam artist.
“He is an outstanding individual and a businessman with an unblemished record and we are confident that he will ultimately be vindicated,” Gilbert said.
The charge and allegations contained in the complaint, are merely accusations, and the defendant is presumed innocent unless and until proven guilty.
“The conspiracy caused the health care insurers to pay out more than $10 million in fraudulent claims.”
Let me out this in perspective,
1) its ten million over 8 years not one year
2) In all likelihood these guys would have had insurance anyhow esp since the pre existing clause. Its just premuims would be a drop a higher.
Far from 10 million. But fake news loves to blow things up
It’s probably not the claims that were fraudulent – it was the fact that the accused created companies for which the insured “worked” because it allowed them to get lower group rates. It was geneivas da’as perpetrated on Blue Cross Blue Shield, because the insured were most likely self-employed, or learners, or both. Unfortunately, if the charges are true a terrible chilul HaShem has occurred, and all Jews (even you, Archie) will continue to be described as being unethical, conniving and every other adjective contained in the vocabulary of the average, garden-variety bigot.
So Archy, Let me get this straight.
It’s OK to use all your energy to set up multiple sham companies. So that you can commit fraud, since its only a drop higher in premiums?
You mean this Tzaddik, spent years figuring a way to outsmart the system, in order for so many young “frum” co-conspirators who obviously knew it was wrong so that they could save a few dollars?
That is the correct “Torah” way?
Shame on you and shame on each and every one who were a part of this.
When your non Jewish neighbors spill vile talk about the Jews, this is where it comes from. This is a CHILUL HA-SHEM plain and simple.
So UNEDUCATED Archy don’t minimize theft.
I am agahst at you and all of those who condone such action.
It’s not about fraudulent “claims”. Its about fraudulent employees whose genuine medical claims were being paid. Thus the insurance companies were out the difference in premiums.
Let me pose a question How many people do you know who created a so called LLC just to be eligible for health insurance? This ain’t much different…
Another one who took very good care of himself , not caring about the poor slob who had to pay his exorbitant premiums !!!
Why is this called fraudalanat claims. Fraudalanat policies would seem more accurate. Nothing was wrong with the claims, only with the premiums according to the article.
Agreed, that portraying it as $10 million dollar fraud is misleading, as that wasn’t the amount of the theft, but chances are, no one would have otherwise qualified for this insurance, regardless of price, because of:
1) out of state insurers
2) and I’m assuming, out of network coverage
Archy is the arbiter of what constitutes small crimes. Frum jews and Trump associates commit small crimes, immigrants and Clintons commit heinous felonies.
As I asked previously why is it that the Orthodox community has more than their proportionate share of fraud indictments? Doesn’t kosher apply to more than just food?
Wait and let me remind everyone of one more pointer .
The insurance company ” paid. Ten mill in claims “
How much did they earn in premiums over ten years from these guys ?
I am willing to bet they made ten million at least in premiums . ( 50 times 20000 a year )
Net cost = zero dollars
What do you say all you big talkers ? Do u really think blue cross lost money ?
Bad yes . But is it the worse scam ?
Just asking, what difference does it really make for the insurance company if the group that buys insurance works in one company or they just teamed up to have the purchase power of a large group, the law should be changed to have some common sense…
Just a tought.
I fail to understand how Trump comes up in this matter. But there is an important bit of information that is lacking – about the shape of Knopf’s hat. Would someone who knows please fill out the following multiple choice question:
[ ] black hat with knaitch
[ ] flat black hat
[ ] bowler hat
[ ] shtreimel on shabbos
[ ] none of the above
[ ] all of the above
I just love the fact that somehow this fraud perpetrated by Herring & Kugel Fressers is somehow connected to me…. Ha ha ha ha …
I just love it …
Very serious crimes if true.
If left unpunished insurance scams threaten the long term stability of insurance companies upon which much if our financial system is based. Much like crimes which could collapse the banking system if allowed to become common place, crimea against insurance companies are serious felonies that bring serious punishment.
The integrity of the banks, insurance companies, of financial and commodities markets must be is essential for the stability and ultimately the viability of a modern capitalist system.
These lessons were learned the hard way in 1929. A collapse of investors’ faith in the legitimacy of the system today would be cataclysmic. Think the Great Depression on steroids.
So yes, these are allegations of serious crimes that cannot be ignored and if true will likely be severely punished, particularly if the accused is found guilty at trial.
Very serious allegations.
When we came to America we were mevatel chosen mishpat. Surprised daf yomi still learns the Bava masechtas.