Parallel investigations by CDI and the U.S. Department of Labor (DOL) revealed that NexGen and Riverstone have been operating as an unauthorized MEWA (Multiple Employer Welfare Association), an arrangement that offers or provides health and welfare benefits to employers and their employees.
The Cease and Desist Order alleges that NexGen and Riverstone were marketing, soliciting, and selling purported “self-insured” health plan arrangements to employers, not health insurance, in violation of California law. NexGen and Riverstone failed to pay medical provider claims totaling approximately $24 million dollars, exposing employers and their employees to risks and significant financial liabilities. The investigation revealed NexGen’s and Riverstone’s business practice of pooling and commingling contributions received from its employer clientele into its own corporate accounts.
“This company and its owners misrepresented their ability to pay medical claims, putting employers and their employees in immediate danger,” said Insurance Commissioner Ricardo Lara. “We took action to stop these illegal practices and ensure the safety of California workers and employers.”
Under CDI’s Cease and Desist Order, NexGen and Riverstone are to immediately stop operating any MEWA directly or indirectly or acting as an insurance agent, producer, insurer, or any other capacity in the State of California for which they do not hold a valid license, permit, or Certificate of Authority to do so. The companies are to immediately cease and desist from receiving any money, commission, fee, rebate, payment, remuneration, or any other valuable consideration whatsoever, directly or indirectly, in connection with any MEWA transactions.