Major Settlements in ACA Fraud Case: $135 Million Payment Revealed

In a recent development, companies embroiled in a fraudulent scheme targeting the Affordable Care Act (ACA) have agreed to pay over $135 million to resolve a federal investigation. AssuredPartners of South Florida (APSF), previously linked with AssuredPartners Inc. under Arthur J. Gallagher, pleaded guilty this week and consented to a $27.6 million payment, as confirmed by the U.S. Department of Justice (DOJ). Meanwhile, AssuredPartners, part of a larger insurance brokerage network and not criminally charged, settled for $107 million over alleged False Claims Act violations, according to the DOJ.

The inspector general from the U.S. Department of Health and Human Services highlighted that APSF's manipulation of the ACA marketplace compromised essential healthcare access and negatively impacted consumers relying on federal protections.

Arthur J. Gallagher, a global insurance brokerage firm, quickly issued a statement following the resolutions. It clarified that APSF's fraudulent activities predated Gallagher's acquisition of AssuredPartners in 2025. The statement stressed that these issues were identified during due diligence prior to the acquisition, and APSF was not part of the purchase. The settlement had been factored into the acquisition terms, leaving Gallagher's purchase price for AssuredPartners unaffected by this legal outcome.

The fraudulent operations were initially conducted by Cory Lloyd, a certified insurance broker in Florida, who enlisted homeless and addicted individuals in South Florida for ACA policies to garner significant commissions. Lloyd was sentenced to 20 years in prison in February. According to the DOJ, these unlawful actions began at Lloyd's former company, FloridaCare Insurance, which APSF acquired in early 2021, subsequently appointing Lloyd as its president.

A felony information document filed in Miami's federal court implicates APSF and Fiorella Insurance Agency. Dafud Iza, previously serving as vice president at Fiorella in Stuart, Florida, admitted to his involvement in the operation and received a three-year prison sentence in 2025, agreeing to provide information about his co-conspirators.

A whistleblower, crucial in uncovering the fraudulent scheme, will receive $24.3 million from the financial recovery of the case, as per the DOJ announcement. Further court proceedings will establish any additional penalties related to the plea agreement.