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Note: “An Arm and a Leg” uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.

Dan: Hey there—

This story’s outline may sound familiar, but what’s underneath — what we unravel here: It’s a new kind of thing. And it’s weird. 

And it could become huge.

So: A couple from New York, Sarah and Joe Strohmenger started new businesses, so they needed to buy their own health insurance for the first time..

And Sarah says the New York state marketplace, with Obamacare plans, seemed a little risky: If they got a subsidy, and then their new businesses did well, they might have to pay that subsidy back.

Sarah Strohmenger: As new business owners, we had not a clue of how much we were gonna make in the year.

So we were nervous about. How much we were gonna have to back pay. 

Dan: Looking elsewhere seemed like a cautious thing to do. Google led them to a site that offered quotes for insurance policies — just enter your phone number. They started getting calls from telemarketers, a lot of them, and eventually they picked a plan one of them offered. 

Sarah and Joe thought they were being reasonably careful. After all, Insurance is a regulated business. 

Sarah Strohmenger: We’re thinking it’s monitored. We had no clue that this was kind of like a free for all.

Dan: So as you’ve probably already guessed: Pretty quickly, and very painfully, Sarah and Joe figured out that they’d been hustled. 

But it took a pair of reporters from Bloomberg News to uncover the nature of that hustle. 

Zach Mider: There’s this kind of new breed of people offering health plans to the public that are not, um, not insurance companies at all, 

Dan: That’s one of those Bloomberg reporters, Zach Mider. As Zach and his reporting partner Zeke Faux revealed, this telemarketer had — on paper — made Joe an employee of a company he’d never heard of until those reporters told him about it.

And according to the legal theory underneath all of this, making Joe a certain kind of employee allowed the salesman to sell Joe an insurance plan so skimpy that— as Zach and Zeke’s story says — it would “normally be illegal.”

Zach Mider says these kinds of plans currently operate in a legal grey area, with nobody regulating it — not states, not the feds. 

Zach Mider: So it really is just kind of this weird legal vacuum where, you know, market actors are free to kind of jump in and start trying to do this.

Dan: Which, Zach says, they seem to be doing, more and more. 

Zach Mider: It looks like the numbers are shooting up

Dan: In their Bloomberg story, Zach and Zeke cite hundreds of complaints to the FTC from people who were sold these kinds of health plans.

They also write about meeting the guy who seems to have invented these plans — a former TV sitcom writer who they say actually believes he’s solving an important problem.

Their reporting — in a series called “Health Care Hustlers” — shows something else too: 

How each hustle gets created by a chain of legally-distinct operators — some of them truly operating completely independently of each other — and how, by being just one link in a chain, each operator can say:

“I was just doing a totally legit thing. It’s not my fault if some other guy is shady.”

Basically: These stories are showing us, more clearly than I’ve ever seen, what we’re up against when we take a call from somebody who says they’ve got a great insurance plan for us.

And it’s a totally wild ride. Here we go.

This is An Arm and a Leg, a show about why health care costs so freaking much, and what we can maybe do about it. I’m Dan Weissmann. I’m a reporter, and I like a challenge. So the job we’ve chosen here is to take on one of the most enraging, terrifying, depressing parts of American life — and bring you something entertaining, empowering and useful.

To start, here’s how bad things got for Sarah and Joe Strohmenger.

As they knew: They needed good health insurance. They’ve got pre-existing conditions.

For instance, Joe takes medicine that Sarah says costs 1500 dollars a month. And he’s got a benign brain tumor and has a doctor monitoring it. 

Sarah Strohmenger: That doctor was the most important doctor because it’s a doctor you can’t afford without health insurance.

Dan: Sarah says the monitoring includes periodic bloodwork and MRIs.

So she says when they were picking this plan, they asked about the doctor, about the tests, about the medicine, all their providers.

She says the sales rep for this plan told them, Yes. That is all covered.

Sarah Strohmenger: You know, it sounded great, covered everything that we needed.

Dan: Joe and Sarah paid about 87 hundred dollars upfront— a discount for a full year’s coverage. 

But Sarah says once they tried actually using the plan, things went south. She says their pharmacist told her Joe’s medicine wasn’t covered, and Joe’s doctor said his visits weren’t covered either.

And she says bills arrived that she did not expect.

Sarah Strohmenger: We were getting blood work bills back in the mail, for like $4,000 at a pop at a time, 3000.

Dan: According to the Bloomberg story, Joe called the company they’d bought the policy from— and reached a guy who said upgrading their plan would fix everything. They ultimately paid 20 thousand dollars for insurance that still didn’t cover what they needed.

Sarah says she thinks they also ended up on the hook for 10 to 15 thousand dollars in medical bills. 

Sarah Strohmenger: Within like six months, we stopped going to doctors.

Dan: They couldn’t afford to.

Sarah Strohmenger: We just were like, if we end up in the hospital, we’re basically screwed, you know? So Joe stopped going to all of his doctor’s appointments, he stopped taking his medication, and it was bad.

Dan: Meanwhile, Sarah says they also complained to state regulators about the company that sold them this policy.

The regulators wrote back, saying: We’ve never licensed or approved this entity. So… sorry. Sarah was like, Wait, WHAT? 

Sarah Strohmenger: I lived in a paradox that I didn’t know existed for a year. My mind was blown. 

Dan: I’m telling you — it’s REALLY weird. I’ve seen the letter, that’s what it says. And no: It’s not like there’s some other state office Sarah was supposed to write to. I checked.

Sarah says she and Joe took legal action against the marketing company, but they haven’t recovered any money. She says they paid off all the bills. And she says they signed up for a plan on New York’s Obamacare marketplace, which has been covering what they need. 

But she never understood what the heck had happened — the nature of the hustle — until she sent her story as a tip to Bloomberg News, and Zach Mider got in touch.

As it happened, he’d been digging into exactly this kind of hustle. 

Which has, I have to say, just an amazing number of layers and twists. Starting here:

When Zach looked at Sarah and Joe’s insurance cards, he noticed something that they had missed.

The name of a GROUP at the top — like as if this was a group plan, like you’d get from your job. 

And that was a key to the whole arrangement. That group — Outreach Data Partners Limited Partnership — is not an insurance company.

As Zach puts it, their legal stance is: They haven’t sold insurance to Sarah and Joe — or anybody else. That’s not the relationship.

Zach Mider: They’re claiming they have an employer-employee relationship with the people who buy health plans from them, and therefore, all of the state insurance laws don’t apply. 

Dan: Now, first: It’s actually true that for most people who get health benefits from their employer — like two-thirds — state insurance laws don’t apply. Lots of employers operate plans regulated by the federal Department of Labor.

Which Zach says is how Outreach Data Partners set up the plan Sarah and Joe bought.

All of which was news to Sarah and Joe.

Zach Mider: They just thought they were buying health insurance. 

Dan: And if they’re workers here, what was the JOB supposed to be?

Zach Mider: Yeah, that’s a great question. So, there is some work that is supposed to be done.

Dan: OK, strap in: Zach says to start with, in theory, the company gives you a special browser to use on your phone.

Zach Mider: The idea is if you want to go do something on the internet, you use this special browser and they’re collecting data about people’s browsing habits which then they can turn around and sell that information to advertisers.

Dan: So that’s the “job”: By using this browser, you’re producing value for the company— you’re working for them. Joe and Sarah told Zach they never got any special browser. And of course there’s another thing they might have expected to get from a job, ANY job: A paycheck.

And here’s how Zach says that absence gets explained.

Zach Mider: These data companies have been described to me as sort of, they’re startups, right?

Dan: And here’s where the full name of this company comes into play: ?Outreach Data Partners Limited Partnership. On paper, Joe and Sarah aren’t mere employees, they’re … limited partners— part owners. But in a company that hasn’t started making money yet. 

Zach Mider: Maybe they have a millionth share of the company. And so if the company starts making a lot of money, they will get a check. 

Dan: I don’t think Joe and Sarah are holding their breath for a check from Outreach Data Partners.

According to the Bloomberg story the company doesn’t have a public-facing website, and LinkedIn doesn’t list any employees. But the story also says that in a government filing the company claims 4,800 workers.

Zach and Zeke checked out the company’s headquarters: Box 371 at a UPS store in an Atlanta strip mall — between a dry cleaner and a Vietnamese restaurant. 

They found more than a dozen other companies using the same mailbox as their address — companies with names like Consumer Data Partners. All told, their story says these companies claim more than 30,000 employees.

And when Zach and Zeke started calling people connected to those companies, they ended up talking with the guy who seems to have invented what they call this fake-jobs healthcare setup.

A guy named Bill Bryan.

Zach Mider: Bill Bryan, was a pretty successful sitcom writer in the eighties and nineties. He wrote for Night Court

Judge from Night Court: What’s up Mac?

Mack from Night Court: A little case of disturbing the piece at a Star Trek convention, sir.

Zach Mider: And Coach

Craig Nelson: I didn’t lose the game. The team lost the game. I didn’t.

Zach Mider: And he wrote for a bunch of others. And then he does some real estate deals. He gets involved in some other investments. He ends up being a fairly wealthy guy and looking for new things to invest in, and comes across the idea of doing something with health plans.

Dan: ?Zach says, the idea was this: Obamacare had imposed standards on a lot of health insurance. Minimum stuff that had to be covered. Hospitalization. Mental health services. Prescription drugs. But covering all that stuff is expensive. It means premiums can be high, even with subsidies. And deductibles can be super-high: Thousands of dollars.

So Bill Bryan thought… 

Zach Mider: maybe if there was a way of designing a product that was legal. That covered less stuff than Obamacare, but still gave people what they wanted. You know? Um, it’s a free country. Maybe people should be able to decide what kind of healthcare they wanna buy and not have to meet all these minimum standards that maybe they’re not interested in.

Dan: So the plan that Sarah and Joe got sold, Zach says it does not meet those minimum standards. He says it covers like three doctor visits a year, a couple of lab services, and not a lot else.

Zach Mider: No coverage for hospitalization, no cover for emergency room visits. There is a prescription or there is a pharmacy benefit, but it only covers generics. 

Dan: Zach says Bill Bryan really thinks: that’s a product somebody might prefer to an Obamacare plan with a high deductible. Under the Affordable Care Act, you can’t sell that product as insurance. Actually, if you have a lot of employees, you can’t offer it to them either. 

But as a health-insurance law expert at Georgetown told me: You could maybe offer it to OWNERS of your company.

So by making people like Joe and Sarah LIMITED PARTNERS, maybe you could offer them this kind of super-stripped-down health plan legally.

Zach says: Bill Bryan thinks of this as a way to fix a problem he sees with Obamacare: Full coverage is too expensive for some people. 

Zach Mider: He’s a very smart guy, and so over the years he’s had to fight a lot for this, and I think that’s only kind of strengthened his conviction that it would be a corrective to the Obamacare system to have something that’s more affordable and more accessible for people to get.

Dan:Of course, that’s not what Joe and Sarah wanted – price wasn’t their top concern. They needed insurance that covered their providers, their treatments, their tests, their meds. That’s what they thought they were paying for.

I asked Zach and Zeke, what does Bill Bryan say about the kind of thing that happened to Joe and Sarah? 

Zach Mider: So it, it’s really important to point out here that like Bill Bryan didn’t sell the plan to Joe and Sarah. You know, he doesn’t do the call centers, right? These salespeople are all kind of independent operators who are essentially just selling this stuff for a commission. And so, he certainly doesn’t defend anybody misleading a customer.

Dan: According to Bloomberg’s story, Bryan said he had cut ties with the agency that sold Joe and Sarah their plan — years ago. 

And when he was told that the agency had sold the couple one of his plans much more recently, Bryan said, “That is absolutely news to me. I just don’t have anything more to say about any of these motherfuckers.” 

Zeke Faux: When we were talking with Bryan, though…

Dan: That’s Zach’s reporting partner, Zeke Faux.

Zeke Faux: …he and his colleagues were pretty evasive about exactly how these plans are sold.

Dan: Zeke says the way the plans are sold — specifically, the big commission rates for salespeople — was one of the reasons he and Zach got interested in this story in the first place.

Zeke Faux: Basically, the percentage of whatever the customer’s paying that is going to the salesman and the various middlemen involved is so high that it’s kind of hard to imagine that the customer could be getting a good deal. 

Dan: Even if the plan was cheap. Zach had pulled some data, crunched some numbers. The Bloomberg story says— at least in some cases— all those commissions and fees added up to 74 percent of what people like Joe and Sarah paid for these plans.

Zach Mider: If a person’s paying a dollar almost 74 cents is gonna go to commission to other various middlemen and whatever and only 26 cents is left for actually going into the pool from which medical care is paid out of. 

Dan: 26 cents for medical care. So, just to compare. Obamacare requires insurance plans to spend at least 80 cents of every dollar on medical care.

Everything else — your sales operation, all your admin costs — including the people who deny claims— and your CEO’s pay, and your profits — has to come out of that remaining 20 cents. 

With Bill Bryan’s plans, Zach’s numbers show that ratio can get almost flipped: 26 cents for medical care. 74 cents for commissions, fees, everything else

Zeke says: They brought these issues up to Bill Bryan. 

Zeke Faux: And when we tried to ask about that, Bryan and his colleagues pleaded ignorance, as if it was not really their business how the salesmen got paid.

Dan: And this is a big, big theme in this story: There’s no SINGLE entity doing all of this. It’s a chain of different players, and each one can blame the others.

Bill Bryan blamed the sales outfit for what happened to Joe and Sarah. 

And that company? Their CEO told Zach and Zeke that Outreach Data Partners screwed up, denying claims for the Strohmengers that should’ve been paid. And as the Bloomberg story reports: Bill Bryan dismissed that notion.

But there are more links in this chain than that. For instance, Outreach Data Partners — the company that theoretically made Joe and Sarah limited partners?

Bill Bryan does not run it. He doesn’t run ANY of the companies that employ 30,000 people from a mailbox in an Atlanta strip mall.

Which isn’t to say that he has nothing to do with them. That’s next.

This episode of An Arm and a Leg is produced in partnership with ���ϳԹ��� News. That’s a nonprofit newsroom covering health issues in America. Their journalists do amazing work. We’re honored to be their colleagues.

So, Bill Bryan seems to be the mastermind behind what Bloomberg calls these 30,000 fake-jobs, and the health plans they offer.

But no, he doesn’t run the data companies behind those jobs. That would be illegal. 

Zach Mider: The data companies themselves wouldn’t be allowed under federal labor law to turn a profit on these health plans.

Dan: I mean, that sounds like a good law: Your boss isn’t supposed to make money by selling you a health plan. 

Zach Mider: So it’s all very segregated. They’re very careful to say these data companies are separate from us. The data companies are employing these people and they are sponsoring these health plans. And Bill Bryan’s role is he runs a series of vendors which provides services to the data companies.

Dan: Services like … running a health plan! Which, for a normal company, is a normal arrangement.

Remember how we said: Lots of employer health plans — ones tied to normal jobs— are exempt from state insurance laws?

The way those plans are set up, the employer normally hires a vendor — typically a big insurance company, like Blue Cross or Aetna — to run their health plan.

These data companies, instead of hiring Aetna to administer a health plan — for their 30 thousand “limited partners” — they’re hiring a company that Bill Bryan happens to run.

Zach Mider: I think he’s done a pretty good job of keeping these things formally separate, right? So he’s not formally in control. He doesn’t own the data companies, doesn’t formally direct their activities.

Dan: But Zach says: Bill Bryan seems to have had a hand in getting them set up. So they could offer health plans. That he could run.

Zach Mider: I think it’s fair to say that this was his and his partner’s idea, this whole kind of construct. But he’s tried pretty hard to, as a formal matter, make it compliant with federal labor law.

Zeke Faux: I feel like we should call the data companies and be like, hey, I can see that you have a lot of complaints about your health plan. It might be hurting recruiting. You know, would you like to switch to Aetna? Then we could find out if, uh — how independent they are.

Dan: That’s Zeke again, and yeah: He and Zach wrote in their story that they found HUNDREDS of complaints to the Federal Trade Commission, and the Better Business Bureau, and Apple’s App store about health plans tied to fake jobs.

A graphic that goes with their story shows dozens of quotes, like: This whole thing feels like a big scam that I fell for.

And: I can’t imagine I am the only person who has been lied to and basically stolen from.

And: Stay away at all costs.

Which raises a big question: Is any of this really legal? Isn’t there someone regulating it?

Zach says Bill Bryan wants answers to those questions too. 

Seven years ago, a data company the Bloomberg story describes as “allied with Bryan” went to the Labor Department for clarification— and validation. Basically, they said:

Zach Mider: We want you to sign off on this and confirm to everyone in the marketplace that this is legit. That these are real employees, these limited partner employees who are downloading the web browser are real employees, and that therefore we can sell ’em, these health plans without any problem. And the Department of Labor when push came to shove said, no, these aren’t employees. You’re just trying to sell insurance.

Dan: Bryan’s allies went to court to fight back. 

Zach Mider: And they’re still fighting over it all these many years later. That was 2018 when they were first trying to get this opinion. And um, now it’s 2025 and it’s still unresolved. 

Dan: ?Here’s what’s happened so far: A district judge ruled against the Labor Department, calling its opinion “arbitrary and capricious.” An appeals court later agreed with that conclusion, but sent the case back to the district court to reconsider other details, including: what should happen next.

Zach Mider: So the way it stands, it’s really in a kind of strange limbo, where the Department of Labor really doesn’t get to say, these are legit, or these are not while we wait for the litigation to play out. But it does open the door for other people like Bill Bryan to come into the marketplace and start selling this kind of stuff. 

Dan: And it looks like they have. The Bloomberg story has a chart, showing the number of households enrolled in “fake jobs” plans. After the appeals court ruled against the labor department, the numbers more than doubled.

And meanwhile, NOBODY is regulating these plans. They’re not traditional insurance plans, so state insurance departments don’t have jurisdiction. So with the federal case on hold, people like Sarah and Joe have no one to turn to.

In a letter to the editor that Bloomberg published, Bill Bryan blames what happened to people like Sarah and Joe on the Labor Department, for not validating his model.

“If the department stepped up and played its proper role,” he wrote, “the fraud reported in your story could have very well been prevented.”

He added: “At a minimum, it would give victims someplace to seek recourse.”

So: everybody’s got somebody else to blame. 

Which is one of the themes that connects Bill Bryan’s story with a totally WILD tale that Zeke traced to Florida. One that doesn’t start out sounding like it has anything to do with health insurance.

In 2024, he writes, “if you were poor and online, certain ads were everywhere you looked.”

These ads featured celebrity deepfakes — promising 6 thousand four hundred dollars, if you call a certain phone number. 

Zeke Faux: I mean, it looks like it’s Taylor Swift, and she’s saying…

Fake Taylor Swift: Remember those stimulus checks? Well, there’s a new thing going viral. 

Zeke Faux: Or it’s Dr. Phil and he’s saying..

Fake Dr. Phil: They’re giving out $6,400 to anyone who makes the call 

Zeke Faux: Or Andrew Tate saying…

Fake Andrew Tate: If you don’t act now, you’re basically throwing away $6,400. That’s just stupid.

Zeke Faux: And these ads didn’t even, they might briefly mention health insurance or maybe they don’t say health insurance at all.

Dan: But if you called that number, you’d end up talking with someone ready to sign you up for health insurance. 

Sign you up so quickly that… you might not have any idea that’s what had just happened. 

Or, for that matter, that no, you would not be getting 64 hundred bucks to spend.

This story goes in some WILD directions, but here’s how Zeke describes the connection with the fake-jobs saga. 

Zeke Faux: in reporting both of these stories, I think what we learned is that there is kind of a subculture of call center operators who have turned what seems like a pretty boring business selling health insurance into a get rich quick kind of operation.

Dan: The call centers, the telemarketers. That’s the connection— Bloomberg paired these stories under the heading “Health Care Hustlers.”And those hustlers are always looking for a new angle. 

Which is to say: Zeke and Zach’s stories reinforce a big Arm and a Leg rule: 

If the internet leads you to a phone call with someone who says they’ve got a GREAT health insurance deal for you… be very, very suspicious.

And a lot of people will be looking for deals on health insurance. 

During the Biden Administration, Congress added more-generous subsidies to Obamacare plans, which made them more affordable. 

Unless Congress re-ups them soon— which seems unlikely— those extra subsidies will expire this year. 

People will look for alternatives, and these call centers will offer them.

In a way, it’s back to the future: 

The first Trump Administration loosened certain rules, making it easier to sell short-term plans that didn’t meet Obamacare standards. Zeke says he reported on the results back then.

Zeke Faux: I spoke with people who had bought these plans and then had medical emergencies and been stuck with 50 or a hundred thousand dollar bills, so we’ll be — we’re kinda watching to see what new products emerge or what these call centers start selling. 

Dan: And meanwhile, just — look:  Don’t buy insurance over the phone from somebody you’ve never met. Don’t bother with google. Healthcare dot gov. That’s basically it. 

What you’ll find there, I’m not saying you’ll love it. It’s probably gonna cost more than you want to pay, and deductibles will likely be high. 

But even though subsidies for Obamacare plans aren’t AS generous this year, they still exist. And these policies are regulated. Anything else… like Sarah Strohmenger said, it’s a free-for-all. And there are some hustlers out there. 

Meanwhile: the Trump Administration and Congress have both set up changes to the ACA marketplaces — administrative hassles that will make it harder to get, and keep, your coverage.

The time to start planning for it is now. And we’re gonna have some help for you, starting with next week’s First Aid Kit newsletter. 

My colleague Claire Davenport has been digging into those changes, what they mean for all of us, and how we can start preparing. 

You can sign up on our website at armandalegshow dot com, slash, first aid kit.

By the way: We just launched a new version of our website — with a brand new feature: Starter Packs. 

Here’s where we bring together our best reporting on questions you need answers to, like: How do I shop for health insurance? 

We’ll have a link wherever you’re listening, 

and we’ll be back with a new episode in a few weeks.

Until then, take care of yourself.

This episode of An Arm and a Leg was produced by Emily Pisacreta and me, Dan Weissmann — with help from Lauren Gould—

And edited by Ellen Weiss.

Claire Davenport is our engagement producer. 

Adam Raymonda is our audio wizard.

Our music is by Dave Weiner and Blue Dot Sessions.

Bea Bosco is our consulting director of operations.

Lynne Johnson is our operations manager.

An Arm and a Leg is produced in partnership with ���ϳԹ��� News. That’s a national newsroom producing in-depth journalism about health issues in America — and a core program at KFF: an independent source of health policy research, polling, and journalism.

Zach Dyer is senior audio producer at ���ϳԹ��� News. He’s the editorial liaison to this show.

An Arm and a Leg is Distributed by KUOW — Seattle’s NPR station.

And thanks to the Institute for Nonprofit News for serving as our fiscal sponsor.

They allow us to accept tax-exempt donations. You can learn more about INN at INN.org.

Finally, thank you to everybody who supports this show financially. You can join in any time at Arm and a Leg show, dot com, slash: support.

Thanks! And thanks for listening.