53Bloomberg Businessweek September 23, 2019After hearing out other brokers, she returned to Thiel.
Diaz says Thiel led her to believe that the plan she wanted to
buy, LifeShield STM, was similar to her old one, even though
it cost only about $400 a month, less than her Aetna cover-
age. Had Diaz gone to the ACA marketplace, the family would
have qualified for subsidies, but Thiel didn’t mention that,
Diaz says. She recalls the broker saying the policy had an
impressive coverage limit of “three-quarters of a million dol-
lars” after a maximum $7,500 deductible. Thiel acknowledged
that some things wouldn’t be covered, like prenatal care and
addiction treatment, but, Diaz says, the rest of the disclaimer
went by so quickly she couldn’t follow the details.
By the time of David’s heart attack, the LifeShield plan
had expired, so Thiel had shifted the Diazes to a similar plan
from Everest Reinsurance Co. The new one also had a $7,500
deductible, so Marisia got a credit card with a 0% introductory
rate and, when David was discharged, had Banner-University
Medical Center Phoenix bill that amount to the card.
She thought that would take care of their portion of the
total, but it wasn’t long before bills started to arrive. The
ambulance company wanted $1,171.50. An internist wanted
$1,139 for a day’s care. When the billers requested David’s
insurance information, Marisia provided it. “Sometimes it
takes a while for a claim to be processed and paid,” she says.
“I didn’t think too much of it.” Emergencies such as this were
what insurance was for.
It wasn’t until February 2018 that she really began to
take notice. One of the new letters was stamped “past due.”
Another said “final notice.” Another said “delinquent,” high-
lighted in red. Still another was the “total you owe on all
accounts”—the bill for $244,447.91, three times the value of
the Diazes’ home.
When Marisia called Everest’s claims department, the
representative was blunt: The insurer wouldn’t be paying
anything beyond the $4,000 the plan had already covered.
Marisia dialed Thiel and reminded the broker that the fami-
ly’s plan was supposed to be comprehensive. She remembers
Thiel contradicting herself on the call, at one point saying
there must have been a mistake, perhaps with billing codes,
then later saying Diaz had been told the family’s plan was
very limited and wouldn’t cover such bills.
Marisia soon learned about the policy’s limitations. The
Everest plan didn’t cover preexisting conditions, limited the
number of doctor visits, and capped hospital coverage at
$1,000 a day. It allowed a maximum of $250 per emergency
room visit and $5,000 per surgery, not nearly enough to cover
the usual cost of those services. Most benefits didn’t kick in
until the $7,500 deductible was met. And the listed maximum
total payout of $750,000 was misleading: It didn’t mean the
Diazes’ bills would be covered up to that amount after they
paid the deductible; it just meant that if Marisia underwent,
say, 150 surgeries, she could get $5,000 for each, leaving her
to cover millions of dollars in additional bills.
Once Marisia realized the bills for David’s heart attack
PHOTOGRAPH BY CASSIDY ARAIZA FOR BLOOMBERG BUSINESSWEEK wouldn’t be covered, she frantically called medical offices.
▼ Diaz
M
arisia Diaz found HIIQ when she was forced to go
online to shop for insurance in 2016. In many respects,
she and her husband were just the kind of people the Trump
administration argues Obamacare has left behind. Most morn-
ings, Marisia, an orange-haired 56-year-old who’s a little over
5 feet tall, would wake before dawn to read the Bible and tend
her chickens. She’d quit her job at a local utility to take care
of her grandchildren and started spending her days chasing
them around the lemon, peach, and tangelo trees outside
the family’s modest ranch house. David, a 49-year-old home
remodeling contractor, made a decent living but didn’t get
health insurance through his employer.
For years, the Diazes had paid for comprehensive cover-
age from Aetna, but the insurer had recently announced it
would no longer offer ACA plans in more than two-thirds of
the U.S. counties it served, including the couple’s, citing cost-
control concerns. Eager to avoid the ACA marketplace, which
she’d heard negative stories about, Marisia turned to Google
to find a provider. She wrote down a slew of toll-free num-
bers and called them all, taking notes about their offerings.
Her first call was to HIIQ. She reached a broker named
Linda Thiel, who was working from an office on Friendly
Lane in Haltom City, Texas, for a subsidiary of HIIQ called
American Service Insurance Agency LLC. “She was very
friendly, seemed like she cared, and seemed like she
wanted to give us the best plan for our family,” Diaz recalls.
“I trusted that.”