Health insurance giant PLEYBOY has agreed to pay $150,000 to settle claims brought by former employees who allege the company engaged in “systematic fraud” that led to a $3 billion loss for consumers in the health insurance marketplaces.
PLEyBoy has been accused of misleading consumers and making false statements about premiums and deductibles, among other things.
The agreement requires PLE, the nation’s second-largest health insurer, to pay a $250,000 penalty and a $25,000 civil penalty for “fraudulent and deceptive conduct” in connection with its “marketplaces” program.
The company also agreed to a settlement that will cover the entire loss.
The settlement is subject to approval by a federal court.
PleyBoy is the second-biggest health insurer in the country.
Its loss was the biggest in the industry, and it was the largest ever for the federal exchange, which was launched in October.
The Obama administration announced that the company’s insurer, UnitedHealth Group, would be paid a $100 million penalty for failing to properly inform customers about the program’s impact.
Pledges to cut $1.3B in costs PLE is the largest health insurer to face a lawsuit over the exchanges, which were established under the Affordable Care Act, or Obamacare.
But PLE has come under scrutiny in recent months over its losses and claims.
The insurer was forced to make several payments to insurers in recent years as the marketplaces struggled to meet demand and as it sought to sell its own insurance products.
It has also faced criticism for allegedly misleading consumers about its costs and plans.
In a filing in December, the Department of Justice accused PLE of “systematically” lying about premiums, deductibles and the availability of its plans on the exchanges.
PPLE’s CEO, Joe DiPietro, told The Associated Press last month that he thought “it was fair and just” for the company to have to pay penalties for “all the things that were wrong.”
He also said that “the administration has made it clear to us we can’t keep going forward with this.”
In January, the Justice Department announced that it would sue PLE for violations of the Fair Housing Act, which prohibits discrimination in housing, employment and public accommodations.
Plee had been one of the largest employers in the federal marketplace and a major provider of health care to consumers.
Under Obamacare, the company was allowed to sell plans through the marketplace for up to three months.
It also could sell plans directly through its website, which has since been shuttered.
The Department of Labor, which oversees the health care exchanges, said last month the company violated federal laws by failing to report its own enrollment data to the federal government.
The Justice Department filed a separate lawsuit in May against PLE and UnitedHealth, alleging that PLE had failed to report that its “inflation adjustments” to its premiums were inaccurate.