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DEPARTMENT OF FINANCIAL SERVICES vs ANTHONY F. MERLINO, 03-001704PL (2003)

Court: Division of Administrative Hearings, Florida Number: 03-001704PL Visitors: 18
Petitioner: DEPARTMENT OF FINANCIAL SERVICES
Respondent: ANTHONY F. MERLINO
Judges: LARRY J. SARTIN
Agency: Department of Financial Services
Locations: Miami, Florida
Filed: May 09, 2003
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, August 12, 2003.

Latest Update: Jun. 26, 2024
FILED ‘APR 11 2065 UN DOCK cee ek a 3 C3 fay | at -9 DEPARTMENT OF FINANCIAL SERVICES PH 3: 20 Tom GALLAGHER Chief Financial Officer IN THE MATTER OF: OD»! YC CASE NO.: 61706-03-AG ANTHONY F. MERLINO ADMINISTRATIVE COMPLAINT. TO: ANTHONY F. MERLINO 99100 S. Dadeland Blvd., Suite 1110 Miami, Florida 33256-5515 ANTHONY F. MERLINO 6622 Santona Street Coral Gables, Florida 33146-3112 You ANTHONY F. MERLINO, are hereby notified that the Deputy Chief Financial Officer of the State of Florida has caused to be made an investigation of your activities while licensed as an insurance agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1. Pursuant to Chapter 626, Florida Statues, you, ANTHONY F. MERLINO, are currently licensed in this state as a life (2-16), life and health (2-18), and health (2-40) agent. Your license identification number is A176881. 2. At all times pertinent to the dates and occurrences referred to herein, you, ANTHONY F. MERLINO, were licensed in this state as an insurance agent. 3. Pursuant to Chapter 626, Florida Statutes, and the Florida Insurance Code, the Florida Department of Financial Services has jurisdiction over your insurance licenses and appointments. 4. At all times relevant hereto, The Dardick Agency Inc. (hereinafter “TDA”), located at 9100 S. Dadeland Blvd., Suite #1110, Miami, Florida 33156, is a Florida corporation engaged in the business of transacting in insurance in the state of Florida. 5. At all times relevant hereto, TDA maintained bank account #9969817094 at First Union Bank. You, ANTHONY F. MERLINO, were the only authorized signor on the account. 6. At all times pertinent to the dates and occurrences referenced herein, American Employee Benefits Association (hereinafter “AEBA”) was a foreign corporation registered in the State of Florida, and was purported to be an employee benefit association. 7. At all time relevant hereto, AEBA’s Florida mailing address was P.O. Box 565515, Miami, Florida 33256-5515. which was a post office box registered to TDA. 8. At all times material to the dates and occurrences herein, AEBA’s Florida address was 9100 S. Dadeland Bivd., Suite #1110, Miami, Florida 33156, which was the same address as TDA. 9. At all times relevant hereto, AEBA’s Florida telephone number was 305-670- 9991 and the facsimile number was 305-670-9992, which were the same telephone and facsimile numbers as TDA. 10. At all times pertinent to the dates and occurrences referenced herein, AEBA’S Florida contact person was your, ANTHONY F. MERLINO’s, spouse, Lisa Merlino, who was also a corporate officer of TDA. il. At all times material hereto, AEBA marketed and sold to Florida consumers the Ultra-Med Platinum Plan, a.k.a Ultra-Med Choice Platinum (hereinafter “Ultra-Med”), and in doing so engaged in the business of insurance, or operated as one or more Multiple Employer Welfare Arrangements (hereafter “MEWAs”) in Florida. 12. At all times relevant to the dates and occurrences referenced herein, you, ANTHONY F. MERLINO, were a corporate officer of TDA. 13. At all times pertinent to the dates and occurrences referred to herein, pursuant to Section 626.734, Florida Statutes, you, ANTHONY F. MERLINO, were personally and fully liable and accountable for any wrongful acts, misconduct, or violation of any provision of the Insurance Code committed either by you or anyone under your direct supervision and control while acting on behalf of the corporation. References to you, ANTHONY F. MERLINO, include persons acting under your direct supervision and control. 14. At all times material to the dates and occurrences herein, TRG was the acronym or pseudonym for a multitude of entities that engaged in the business of insurance, or operated as one or more MEWAs in Florida, including, but not limited to: (a) T.R.G. Marketing, LLC (b) T.R.G. Administration, LLC (c) The Redwood Group, LLC 15. : Section 624.02, Florida Statutes, defines “Insurance” as: “Insurance” is a contract whereby one undertakes to indemnify another or pay or allow a specified amount or a determinable benefit upon determinable contingencies. Section 624.603, Florida Statutes, defines “Health Insurance” as: “Health Insurance” is insurance of human beings against bodily injury, disablement, or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto. 16. Section 624.03, Florida Statutes, defines “Insurer” as: “Insurer” includes every person engaged as indemnitor, surety, or contractor in the business of entering into contracts of insurance or of annuity. 17. Atall times material to the dates and occurrences herein, TRG did engage itself as an unauthorized insurer or MEWA in the State of Florida. 18. Section 624.09, Florida Statutes, defines “Authorized” and “Unauthorized insurer” as: (1) An “authorized” insurer is one duly authorized by a subsisting certificate of authority issued by the department to transact insurance in this state. (2) An “unauthorized” insurer is one not so authorized. 19. Section 624.437(1), Florida Statutes, defines “MEWA” as: {aJn employee welfare benefit plan or any other arrangement which is established or maintains for the purpose of offering or providing health insurance benefits or any other benefits, described in s. 624.33, [Florida Statutes,] other than life insurance benefits, to the employees of two or more employers, or to their beneficiaries. 20. All insurers and MEWAs are required by Florida Insurance Code to possess a Certificate of Authority from the Department in order to conduct business in this State. [Chapter 624, Florida Statutes, including Sections 624.401 or 624.437] 21. In order to transact insurance in the State of Florida, an insurer or MEWA must hold a subsisting certificate of authority issued by the Department of Financial Services, pursuant to Sections 624.401 or 624.437, Florida Statues, and otherwise comply with other provisions of the Florida Insurance Code, including: (a) As to an Insurer: Gi.) Section 624.401, Florida Statutes — requirement of a Florida Department of Financial Services issued certificate of authority in order to transact insurance. (ii.) Section 624.404, Florida Statutes — general eligibility requirements an insurer must satisfy in order to receive and maintain a certificate of authority. (iii) Section 624.407, Florida Statutes — capital funds required for an insurer to receive a certificate of authority. (iv.) Section 624.408, Florida Statutes — surplus funds requirement an insurer must have in order to maintain a certificate of authority. (v.) Section 624.4095, Florida Statutes — financial ratios an insurer must meet in order to maintain a certificate of authority. (vi.) Section 624.411, Florida Statutes — insurer funds that must be deposited in trust for the protection of insureds and creditors in order for the insurer to receive and maintain a certificate of authority. (vii.) Section 624.424, Florida Statutes — requirement that an insurer must file annual and quarterly financial statements, and an annual actuarial opinion with the Department of Financial Services in order to maintain a certificate of authority. (viii.) Section 627.062, Florida Statutes — requirement that an insurer must file its insurance premium rates for approval with the Department of Financial Services. (ix.) Section 627.410, Florida Statutes — requirement that an insurer must file its insurance policy forms for approval with the Department of Financial Services. (x.) Chapter 631, Florida Statutes — statutory and financial protection for insureds and creditors against the financial impairment or insolvency of an insurer authorized to transact insurance in Florida. (b) As toa Multiple Employer Welfare Arrangement (MEWA): (i.) Section 624.437, Florida Statutes — requirement of a Florida Department of Financial Services issued certificate of authority in order for the MEWA to operate, be maintained or be established. (ii.) Section 624.438, Florida Statutes — general eligibility requirements a MEWA must satisfy in order to receive and maintain a certificate of authority. (iii.) Section 624.439, Florida Statutes - MEWA application requirements including filing with the Department of Financial Services: (1) A copy of its policies; (2) actuarial certifications as to its premium rates: (3) a copy of its fidelity bond; and (4) a copy of its excess insurance agreement. (iv.) Section 624.4392. Florida Statutes — requirement that the MEWA maintain certain minimum financial fund balances. (v.) Section 624.441, Florida Statutes — requirement that the MEWA deposit certain amounts of cash or securities with the Department of Financial Services to assure the faithful performance of obligations. (vi.) Section 624.442, Florida Statutes — requirement that the MEWA must file annual and quarterly financial statements, and an actuarial certification with the Department of Financial Services in order to maintain a certificate of authority. 22. On or about January 15, 2002, the Florida Department of Financial Services, in the Matter of T.R.G. Marketing, LLC, et al., Case No.: 43160-01-CO, stated: WHEREFORE, TRG, [et al.]... are hereby notified that the Department intends to enter a permanent Cease and Desist Order pursuant to Section 626.9581, Florida Statutes prohibiting the transaction by you and all related entities of insurance in the State of Florida, or relative to a subject of insurance resident, located, or to be performed in this state, without being licensed. 23. At no time relevant hereto, was health care coverage under the Ultra-Med plan provided by an entity that possessed a Certificate of Authority from the Florida Department of Financial Services to engage in the business of insurance as an insurer or to operate as a MEWA, in the state of Florida. Thus the Ultra-Med plan was an unauthorized health care plan. [Chapter 623, Florida Statutes, including Sections 624.401 or 624.437] 24. At no time material hereto, was health care coverage under the Ultra-Med plan provided by an entity that was subject to any exception to the licensure requirement of the Florida Insurance Code in order to lawfully engage in the business of insurance or to operate as a MEWA, in Florida and thus the Ultra-Med plan was unauthorized health care plan. [Chapter 624 and 626, Florida Statutes, including Sections 624.402 and 626.901] 25. At no time material to the dates and occurrences herein did TRG or AEBA possess a Certificate of Authority from the Florida Department of Financial Services to engage in the business of insurance as an insurer or to operate as a MEWA, in the state of Florida. [Chapter 624, Florida Statutes, including Sections 624.401 or 624.437] 26. - At no time relevant to the dates and occurrences herein was TRG or AEBA subject to any exception to the licensure requirement of the Florida Insurance Code in order to lawfully engage in the business of insurance or to operate as a MEWA, in the state of Florida. [Chapters 624 and 626, Florida Statutes, including Sections 624.402 and 626.901] 27. Section 624.10, Florida Statutes, defines “Transacting Insurance” as: “Transact” with respect to insurance including any of the following, in addition to other applicable 4 provisions of the code: (1) Solicitation or inducement. (2) Preliminary negotiations. (3) Effectuation of a contract of insurance. (4) Transaction of matter subsequent to the effectuation of a contract of insurance and arising out of it. 28. At all times material to the dates and occurrences herein, TRG and AEBA did transact insurance as an insurer or as a MEWA in the state of Florida. [Sections 624.10 and 624.437, Florida Statutes] 29. At all times material to the dates and occurrences herein, you, ANTHONY F. MERLINO, did represent or aid TRG and AEBA, which are unauthorized insurers or MEWAs transacting insurance in the state of Florida and you, ANTHONY F. MERLINO, did aid in the sale of the Ultra-med plan, which was an unauthorized health care plan in the State of Florida. [Sections 626.901, 624.02, 624.03, 624.09, 624.10, 624.401, and 624.437, Florida Statutes] 30. Directly or indirectly representing or aiding an unauthorized insurer which has not satisfied the above-cited statutory safeguards poses a great risk of financial harm to the residents of Florida. By collecting premium payments for or on behalf or TRG and AEBA, by soliciting payments through the independent licensed agents as indicated in the various numbered Counts below, each of which represents an instance of direct or indirect action by you, ANTHONY F. MERLINO, and each of which led to income received by TDA, and by other actions or failures to act, TDA aided and abetted TRG and AEBA in the transaction of insurance or unauthorized health insurance. 31. The particularized harm resulting from you, ANTHONY F. MERLINO, aiding or abetting TRG and AEBA in Florida is that insurance premium dollars may be misused and reserve and surplus funds may be unavailable such that the insurer may not be able to meet its contractual and statutory obligations toward medical providers and residents of the State of Florida. Furthermore, pursuant to Chapter 631, Florida Statutes, no state guarantee fund may be used to pay unpaid claims and creditors. This may cause Floridians irreparable financial injury. 32. The Florida insurance buying public must depend on the integrity, competence, honesty, and obedience to the law of an insurer, its agents, representatives, and administrators when applying for and purchasing insurance. Current and prospective Florida insurance consumers are faced with the possibility that their coverage with TRG or under the Ultra-Med plan will be: (1) cancelled; (2) the insurance coverage is non-existent; (3) insurance claims and medica! providers will not be paid; and (4) insurance premium taxes will not be paid. These insureds, medical providers, and the State of Florida may incur serious losses, which may remain uncompensated due to the solicitation, sales, and administration of insurance by you, ANTHONY F. MERLINO. COUNT I 33. The above general allegations are hereby realleged and fully incorporated herein by reference. 34, On or about December 2000, you, ANTHONY F. MERLINO, solicited and induced K.J. of Miami, Florida, to enter into a health benefit contract with TRG. During your conversation with K.J. you, ANTHONY F. MERLINO, told her that an AEBA membership was required to participate in the TRG Plan. 35. K.J. paid you, ANTHONY F. MERLINO an initial premium of $288 and an AEBA “membership fee” of $100. Subsequent monthly premium payments of $288 were withdrawn from her bank account via electronic funds transfers. 36. On or about December 1, 2001, after TRG was order to cease operations in the State of Florida, K.J. received a correspondence from AEBA informing her that her health coverage was being changed from TRG to the Ultra-Med Plan. 37. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWaAs, K.J. was left with unpaid medical bill of approximately $11,120.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services. which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes); (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes}; (3) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited. negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901 (2), Florida Statutes]. COUNT II 38. The above general allegations are hereby realleged and fully incorporated herein by reference. 39. On or about December 2000, you, ANTHONY F. MERLINO, through TDA, solicited and induced CF, to enter into a health benefit contract with TRG. C.F. paid premiums of $364.00 from December 2000 through November. On or about November 30, 2001, C.F. was told her coverage was changing to Ultra-Med, and she paid an increased premium of $395.00 for December 2001. In December 2001, C.F.’s coverage was then changed to Total Choice, and 11 beginning in January 2002 she paid an increased premium of $453.78. Claims submitted in October and November 2001 were not paid. 40. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, CF. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA _ you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. If IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes}; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and_ technical competence to engage in the transactions authorized by the license or appointment. {Section 626.61 1(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (fp No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT UIT 41. The above general allegations are hereby realleged and fully incorporated herein by reference. 42. On or about September 2000, you, ANTHONY F. MERLINO, through TDA, solicited and induced P.C. to enter into a health benefit contract with TRG. You, through TDA, told her she would have to join an association, and she paid the $100.00 “membership fee.” P.C. paid premiums of $186.00 from September 2000 through January 2002, when TDA cancelled the policy. 43. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWaAs, P.C. was left with unpaid medical bills in the amount of $3,168.92 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) | Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes); (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a 14 source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) Jf an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901 (2), Florida Statutes]. COUNT IV 44. The above general allegations are hereby realleged and fully incorporated herein by reference. 45. On or about September 2000, you, ANTHONY F. MERLINO, through TDA, solicited and induced J.R. to enter into a health benefit contract with TRG for the benefit of himself and his spouse. You, through TDA, told him he would have to join an association, and he delivered TDA a check for $315.00, representing the “membership fee” and an initial premium. J R paid further premiums from May 2001 through November 2001. 46. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWaAs, J.R. was left with unpaid medical bills for his spouse in the amount of $1,853.98 that should have been covered under the health benefit plans. As a 15 corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; # No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of 16 another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes}; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT V 47. The above general allegations are hereby realleged and fully incorporated herein by reference. 48. On or about August 2000, you, ANTHONY F. MERLINO, through TDA, solicited and induced D.B. to enter into a health benefit contract with TRG. D.B. paid a $100.00 fee upon application, and paid premiums of $173.19 from August 2000 through January 2001, and of $186.00 from February 2001 through December 2001, her last payment. 49. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWaAs, D.B. was left with unpaid medical bills in the amount of $2,967.31 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and 17 Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. {Section 626.611(8), Florida Statutes}; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes}; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes}; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, 18 any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss. not paid. [Section 626.901(2), Florida Statutes]. COUNT VI 50. The above general allegations are hereby realleged and fully incorporated herein by reference. 51. On or about October 2001, you, ANTHONY F. MERLINO, through TDA, solicited and induced L.S. to enter into a health benefit contract with TRG. You, through TDA, told her she would have to join an association, and she paid the $100.00 “membership fee” and an additional $100.00 fee. L.S. paid premiums of $400.00 beginning in October 2001. L.S.’s coverage was changed several times. 52. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, L.S. was left with unpaid medical bills that should have been covered under the health benefit plans. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of ‘your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. 20 COUNT Vil 53. The above general allegations are hereby realleged and fully incorporated herein by reference. 54. On or about May 2000, you, ANTHONY F. MERLINO, through TDA, solicited and induced V.M. to enter into a health benefit contract with TRG. You, through TDA, told him he would have to join an association, and he paid the $100.00 “membership fee.” V.M. paid premiums of $220.00 beginning in June 2001. Later his premiums were increased to $244.00. and his coverage was changed several times. 55. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWaAs, V.M. was deprived of coverage when he sought medical services, and he was unable to see his regular doctor after developing a serious illness. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; 21 (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes}; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. {Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) Ifan unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT Vill 56. The above general allegations are hereby realleged and fully incorporated herein by reference. 22 57. On or about January 2000, you, ANTHONY F. MERLINO, through TDA, solicited and induced C.C. to enter into a health benefit contract with TRG. You, through TDA, told her she would have to join an association, and she paid the $100.00 “membership fee.” LS. paid premiums of $400.00 beginning in October 2001, the premium was increased to $440.00 and then to $475.00. C.C.’s coverage was changed several times. 58. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWaAs, C.C. was left with unpaid medical bills in the approximate amount of $1,000.00 that should have been covered under the health benefit plans. As acorporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you. ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes}; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; iS) ue (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT IX 59. The above general allegations are hereby realleged and fully incorporated herein by reference. 60. At all times material hereto, Kim Alexander (hereinafter “Alexander”), was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life, Variable Annuity, 24 and Health (2-15), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license LD. #A003344. él. On or about November, 1999, Alexander, as a licensed insurance agent, contacted E.H. to sell her a health insurance plan through an entity known as TRG. TDA told her she would have pay a $100.00 “membership fee” and an initial premium in November 1999, and she did so. E.H. paid further premiums, which increased to $244.50, then to $249.50, and then to $376.00. 62. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, E.H.’s coverage was changed several times, and she was left without coverage during periods when premiums were nonetheless being paid. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. {Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (a) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. (Section 626.901(2), Florida Statutes]. COUNT X 63. The above general allegations are hereby realleged and fully incorporated herein by reference. 26 64. At all times material hereto, Leonard Harris Streit (hereinafter “Streit”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license ILD, #A256352. 65. On or about March 2001, Streit, as a licensed insurance agent, contacted S.H. to sell him a health insurance plan through an entity known as TRG. 66. Streit furnished to him application forms which he completed and delivered together with his check in the sum of $100.00 payable to Florida Insurance Solutions and representing an application fee. On or about March 2001, S.H. additionally delivered a check in the amount of $488.00 made payable to the Dardick Agency representing an application fee for two adults at a cost of $100.00 each plus $288.00 as initial premium payment for coverage by TRG. Said plan purportedly became effective May 1, 2001. 67. The Dardick Agency drafted $288.00 per month between and including May 2001 and November 2001 from an account controlled by S.H. as payment for continuing insurance under TRG. Thereafter, on or about November 2001, S.H. received information that his health insurance coverage had been cancelled by TRG. TRG refused to pay claims incurred between May 2001 and November 2001, on behalf of S.H. 68. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, S.H. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and 27 Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.61 1(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X {redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes}; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, 28 any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XI 69. The above general allegations are hereby realleged and fully incorporated herein by reference. 70. At all times material hereto, Leonard Harris Streit (hereinafter “Streit”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license 1.D. #4256352. 71. Streit furnished to G.C. application forms which he completed and delivered to Streit. On or about October 2001, G.C. additionally delivered to Streit a check in the amount of $540.00 made payable to “TDA” representing a membership fee in the American Employee Benefit Association (hereinafter refered to as AEBA) at a cost of $100.00 plus $440.00 as initial premium payment for insurance coverage under TRG. Said plan purportedly became effective October 1, 2001. Additionally, on or about October 2001, G.C. delivered to Streit a check made payable to “Len Streit” in the amount of $200.00 representing an application fee for two adults at a cost of $100.00 per adult. 72. Thereafter, on or about January 2002, G.C. received information that he had no coverage with TRG. TRG refused to pay claims incurred on behalf of G.C. 73. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, G.C. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, 29 ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. {Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (63) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XI 74, The above general allegations are hereby realleged and fully incorporated herein by reference. 75. At all times material hereto, Leonard Harris Streit (hereinafter “Streit”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license LL.D. #A256352. 76. Onor about August 2001, Streit, as a licensed insurance agent, contacted V.R. to sell her a health insurance plan through an entity known as TRG. 77, Streit furnished to V.R. application forms which she completed and delivered to Streit. On or about August 2001, V.R additionally delivered to Streit a check in the amount of $400.00 made payable to The Dardick Agency as initial premium payment for insurance coverage through TRG. Said plan purportedly became effective September 1, 2001. 78. Thereafter, on or about November 2001, V.R. received information that her health insurance coverage had been cancelled by TRG. 79. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, V.R. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes}; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626,.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}. COUNT XI 80. The above general allegations are hereby realleged and fully incorporated herein by reference. 81. At all times material hereto, Leonard Harris Streit (hereinafter “Streit”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18). and Health (2-40) agent, license I.D. #A256352. 82. On or about May 2000, Streit, as a licensed insurance agent, contacted C.L. to sell her a health insurance plan through an entity known as TRG. 83. On or about May 2000, C.L. delivered to Streit a check in the amount of $273.19 made payable to The Dardick Agency, $173.19 of which constituted an initial premium payment for insurance coverage through TRG, and additional $100.00 for unknown purposes. Thereafter, Lee) two between and including May 2000 and at least November 2000, C.L. made regular monthly payments by checks made payable to the Dardick Agency for insurance coverage under TRG. 84. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, C.L. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (fp) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XIV 85. The above general allegations are hereby realleged and fully incorporated herein by reference. 86. At all times material hereto, Leonard Harris Streit (hereinafter “Streit”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4256352. 87. On or about February 2001, Streit, as a licensed insurance agent, contacted A.B. to sell him a health insurance plan through an entity known as TRG. ue wn 88. On or about February 2001, A.B. delivered to Streit a check in the amount of $322.50 made payable to The Dardick Agency. Of that, $222.50 was initial premium payment for insurance coverage through TRG and $100.00 was for an association fee. Thereafter, between and including March 2001 and November 2001, The Dardick Agency debited an account controlled by A.B. the sum of $222.50 monthly for insurance coverage under TRG. TRG refused to pay claims incurred on behalf of A.B. 89. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, A.B. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; ‘(b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XV 90. The above general allegations are hereby realleged and fully incorporated herein by reference. 91 At all times material hereto, Leonard Harris Streit (hereinafter “Streit”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #A256352. 37 92. On or about February 2000, Streit, as a licensed insurance agent, contacted J.W. to sell her a health insurance plan through an entity known as TRG. 93. On or about February 2000, Streit furnished to J.W. application forms which she completed and delivered to Streit together with his check in the sum of $100.00 payable to Goldberg Insurance Group and a check in the sum of $257.54 made payable to The Dardick Agency representing an unknown fee of $100.00 plus $157.54 as an initial premium payment for coverage under TRG. 94. From March 2000 through at least October 2001, J.W. paid monthly premiums to the Dardick Agency in an amount ranging between $154.00 and $182.00 monthly for insurance coverage under TRG. TRG refused to pay claims incurred on behalf of J.W. in excess of $2,000.00. 95. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, J.W. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) ‘Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. (Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes}; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XVI 96. The above general allegations are hereby realleged and fully incorporated herein by reference. 97. At all times material hereto, Scott Rose (hereinafter “Rose”) was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), General Lines (2-20), and Health (2- 40) agent, license I.D. #4225813. 98. On or about December 19, 2000, Rose, as a licensed insurance agent, contacted K.W. to sell her a health insurance plan through an entity known as TRG. Rose furnished to her application forms which she completed and delivered to Rose together with her check in the sum of $100.00 payable to “TDA” as an “application fee.” 99. On or about January 2001, K.W. additionally delivered to Rose a check in the amount of $244.00 payable to the Dardick Agency for coverage by TRG and representing initial premium payment. Said plan purportedly became effective January 1, 2001. Thereafter, K.W. delivered a check to Rose in the sum of approximately $249.50, payable to The Dardick Agency, as premium for insurance coverage by TRG, from February 2001 until December 2001. 100. Thereafter, on or about December 2001, K.W. received information that her health insurance coverage had been cancelled by TRG. K.W. incurred medical expenses during 2001 which were not paid by TRG. 101. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, K.W. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. 40 IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) ‘Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes}; 41 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XVil 102. The above general allegations are hereby realleged and fully incorporated herein by reference. 103. Atall times material hereto, Scott Rose (hereinafter “Rose”) was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), General Lines (2-20), and Health (2- 40) agent, license I.D. #4225813. 104. On or about January 2, 2001, Rose, as a licensed insurance agent, solicited and induced R.B. of Deerfield Beach, Florida, to enter into a health benefit contract with TRG. Rose told R.B. that an AEBA membership was required to participate in the TRG Plan. Rose took an application for the SAI Plus Health Plan, which was sponsored by TRG. R.B. gave Rose two checks, Check #3083, in the amount of $395.00, made payable to TDA was for the first month premium and check #3084, in the amount of $100.00, made payable to TRG was for the AEBA membership fee. Subsequent premium payments were sent to TDA by R.B. 105. In December 2001, R.B. received a letter from AEBA dated November 30, 2001. The letter stated that TRG was ordered to shut down and that the Ultra-Med Platinum plan was replacing the TRG plan. 106. As a direct or indirect result of TDA’s, actions or failures to act concerning the representation or aiding and abetting of unauthorized insurers or MEWAs, R.B. and his wife were left with unpaid medical bill of approximately $47,415.84 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments as an insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code, [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.61 1(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (G9) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes). COUNT XVIII 107. The above general allegations are hereby realleged and fully incorporated herein by reference. 108. At all times material hereto, Robert Benjamin Dobbs (hereinafter “Dobbs”), was, and currently is, licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4069535. 109. ‘On or about January, 2001, Dobbs, as a licensed insurance agent, solicited and sold to T.P. a group health insurance plan through an entity known as TRG. On or about January 25, 2001, T.P paid a $100.00 “application fee” and an initial premium of $254.50. T.P. continued to pay premiums through February 2002. Although the checks were addressed to at least four different entities, all of the contact information for payment was that of TDA. 110. TRG has failed to pay T.P.’s medical claims. As a result, she has incurred a financial liability of $25,000.00 in unpaid medical bills. 111. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, T.P. was left with unpaid medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes}; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (4d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; 45 (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. (Section 626.901(1), Florida Statutes); (g) Ifan unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXI 112. The above general allegations are hereby realleged and fully incorporated herein by reference. 113. At all times material hereto, Adam Steven Donato (hereinafter “Donato”), was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life, Variable Annuity, & Health (2-15), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license LD. #A310788. 114. On or about June 2000, Donato, as a licensed insurance agent, solicited and sold to J.R. a group health insurance plan through an entity known as TRG. On or about June 13, 46 2000, J.R. paid a $100.00 fee and an initial premium of $139.54 to TDA. J.R. continued to pay the same premium through November 2000. J.R. provided a voided check in December 2000 as requested by TDA to establish electronic transfer of funds, her premium was then increased to $222.50 and later, it was increased to $244.50. 115. As a direct or indirect result of TDA’s actions or failures to act concerning the representation or aiding and abetting of unauthorized insurers or MEWAs, J.R. and his wife were denied medical services and left with unpaid medical bills of approximately $261.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. If IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes}; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; 47 (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or !oss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901 (2), Florida Statutes]. COUNT XX 116. The above general allegations are hereby realleged and fully incorporated herein by reference. 117. At all times material hereto, Sara Fernandez (hereinafter “Fernandez”) was, and currently is, licensed in this state as a Life & Health (2-18) and Health (2-40) agent, license LD. #4083005. 48 118. On or about February 20, 2001, Fernandez solicited and induced M.M. of Coral Springs, Florida, to enter into a health benefit contract with TRG. Fernandez told M.M. that an AEBA membership was required to participate in the TRG Plan. Fernandez took an application for the TRG health plan and the AEBA membership from M.M. M.M. gave Fernandez check #281 in the amount of $381.00 made payable TDA. $281.00 was for the first month premium and a $100.00 was for the AEBA membership fee. Subsequent premium payments were made to TDA from M.M.’s bank account via electronic funds transfer. 119. In December 2001, M.M. received a letter from AEBA. The letter stated that TRG was ordered to shut down and that the Ultra-Med Platinum plan was replacing the TRG plan. 120. As a direct or indirect result of TDA’s actions or failures to act, M.M. was left with unpaid medical bill of approximately $8,734.16 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments as an insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the’ applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; 49 (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part LX] of this chapter, or having otherwise shown himself or herself to bea source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXI 121. The above general allegations are hereby realleged and fully incorporated herein by reference. 50 122. At all times material hereto, Ezra Griffin Harvin (hereinafter “Harvin”) was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life, Health & Annuity (2-15), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license #A113288. 123. On or about February 1, 2001, Harvin, as a licensed insurance agent, solicited and sold to P.S. a group health benefit insurance policy or contract for her small business. This health insurance policy was purportedly issued by TRG. 124. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, P.S. was left with unpaid medical bills in excess of $750.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; 31 (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes}; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}. COUNT XXII 125. The above general allegations are hereby realleged and fully incorporated herein by reference. 126. Atall times material hereto, Richard Michael Kaknes (hereinafter “Kaknes”) was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4136219. 127. On or about November 5, 1999, Kaknes, as a licensed insurance agent, contacted E.G. to sell him a health insurance plan through an entity known as TRG. Kaknes furnished to him application forms which he completed and delivered to Kaknes together with his personal check in the sum of $258.34 payable to The Dardick Agency, representing a “membership fee” of $85.15 and an initial premium payment or $173.19. Said plan purportedly became effective December 1, 1999. From December 1999 to December 2000, F.G. paid further premiums in the amount of $173.19, and from January 2001 to February 2002, F.G. paid further premiums in the amount of $249.50, although the last two month’s payments were returned to him. 128. Thereafter, on or about January 2002, F.G. received information that his health insurance coverage had been cancelled by TRG. 129. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, F.G. was left with unpaid medical bills in excess of $3,484.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated tack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes}; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.61 1(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes). 54 COUNT XXII 130. The above general allegations are hereby realleged and fully incorporated herein by reference. 131. Atall times material hereto, Richard Michael Kaknes (hereinafter “Kaknes”) was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #A136219. 132. On or about February 1, 2000, Kaknes, as a licensed insurance agent, contacted J.J. to sell him a health insurance plan through an entity known as TRG. Kaknes furnished to him application forms which he completed and delivered to Kaknes together with his personal checks in the sums of $100.00 and $273.00, payable to Affordable Life and Health and representing a “processing fee” and initial premium payment, respectively. Said plan purportedly became effective March 1, 2000. From March 2000 through December 2000, J.J. paid premiums in the amount of $179.00; from January 2001 through January 2002, J.J. paid premiums in the amount of $249.50, although the last month’s payment was returned to him. 133. On or about December 2001, J.J. received information that his health insurance coverage had been cancelled by TRG. 134. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, J.J. was left with unpaid medical bills in an amount exceeding $59.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes], (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and_ technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes); (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes}; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, 56 any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXVI 135. The above general allegations are hereby realleged and fully incorporated herein by reference. 136. Atall times material hereto, Richard Michael Kaknes (hereinafter “Kaknes”) was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #A136219. 137. Onor about September 24, 2001, Kaknes, as a licensed insurance agent, contacted L.M. to sell him a health insurance plan through an entity known as TRG. Kaknes furnished to him application forms which he completed and delivered to Kaknes together with his payment in the sum of $495.00 to The Dardick Agency, representing a “membership fee” of $100.00 and an initial premium payment of $395.00. Said plan purportedly became effective October 1, 2001 as to L.M. and his wife. L.M. paid further premiums of $405.00 on November 21, 2001 and $400.00 on December 21, 2001. In December 2001 and January 2002, the Dardick Agency also electronically transferred from L.M.’s checking account payments of $395.00 and $502.56, respectively, both of which were eventually refunded to L.M. 138. On or about December 2001, L.M. received information that his health insurance coverage had been cancelled by TRG. 139. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, L.M. has alleged that TRG has failed to pay 57 approximately $1,544.00 in medical bills that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. (Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.61 1(7), Florida Statutes], (c) Demonstrated lack of reasonably adequate knowledge and_ technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this 58 state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXV 140. The above general allegations are hereby realleged and fully incorporated herein by reference. 141. At all times material hereto, Richard Michael Kaknes (hereinafter “Kaknes”) was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4136219. 142. Onor about May 30, 2001, Kaknes, as a licensed insurance agent, contacted B.B. to sell him a health insurance plan through an entity known as TRG. Kaknes furnished to him application forms which he completed and delivered to Kaknes together with his employer’s payment on his behalf in the sum of $281.00 payable to The Dardick Agency, Inc., representing “association dues” of $100.00 and an initial premium payment of $181.00. Said plan purportedly became effective August 1, 2001. B.B.’s employer paid further premiums of $181.00 for the period August 2001 through December 2001. 59 143. On or about January 2002, approximately two days after visiting a doctor, B.B. received information that his health insurance coverage had been cancelled by TRG. In December 2001, B.B. received a letter from the Florida Department of Insurance, n/k/a the Office of Insurance Regulation of the Financial Services Commission within the Department of Financial Services, informing him: that TRG, was an entity without a certificate of authority to conduct insurance business in the state of Florida. 144. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, B.B. has alleged that TRG has failed to pay for medical services received by B.B. in January 2002. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. {Section 626.611(8), Florida Statutes]; 60 (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part [X] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621 (6), Florida Statutes]; (f No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXVI 145. The above general allegations are hereby realleged and fully incorporated herein by reference. 146. At all times material hereto, Kenneth Todd Knewitz (hereinafter “Knewitz”), is, and currently was, licensed in this state as a Life (2-16), Life & Health (2-18), Health (2-40), and Legal Expense (2-56) agent, license I.D. #A143491. 61 147. On or about July 2000, Knewitz, as a licensed insurance agent, contacted L.L. to sell her a health insurance plan through an entity known as TRG. She was also told by Knewitz that she was required to join the AEBA at a cost of $100.00. Knewitz furnished to her application forms which she completed and delivered to Knewitz together with her personal check in the sum of $273.19 payable to “T.D.A.” representing the initial premium payment and the $100.00 fee for joining AEBA. 148. Thereafter, on or about December 2001, L.L. received information that her health insurance coverage had been cancelled by TRG. 149. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, L.L. was sold unauthorized insurance. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes); (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}; COUNT XXVil 150. The above general allegations are hereby realleged and fully incorporated herein by reference. 151. At all times material hereto, Brad Mitchell Glovsky (hereinafter “Glovsky”) was licensed in this state as a Life & Variable Annuity (2-14), Life & Health (2-18), and Health (2- 40) agent, license I.D. #D002046. 152. On or about March 28, 2001, Glovsky, as a licensed insurance agent, contacted HLM. to sell her a health insurance plan through an entity known as TRG. Glovsky furnished to her application forms which she completed and delivered to him together with her personal checks in the sums of $100.00, payable to Glovsky, and $322.50, payable to The Dardick Agency, representing a combined “membership fee” of $100.00 and an initial premium payment of $222.50. From June 2001 through November 2001, H.M. paid premiums in the amount of $222.50. 153. On or about September 2001, H.M. submitted claims in the total amount of approximately $100.00, which the plan failed to pay. 154. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, H.M. has alleged that TRG has failed to pay approximately $100.00 in medical expenses. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments: 64 (a) No person shall transact in this state, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this Code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.6] 1(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under Part X (re- designated as Part IX) of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; and (f) No person shall, from offices or by personnel or facilities located in this state. . . directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]; (g) Ifan unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}. COUNT XXVIII 155. The above general allegations are hereby realleged and fully incorporated herein by reference. 156. At all times material hereto, Brad Mitchell Glovsky (hereinafter “Glovsky”) was licensed in this state as a Life & Variable Annuity (2-14), Life & Health (2-18), and Health (2- 40) agent, license I.D. #D002046. 157. Onor about August, 2001, Glovsky, as a licensed insurance agent, contacted L.H. to sell her a health insurance plan through an entity known as TRG. Glovsky furnished to her application forms which she completed and delivered to him together with her personal check dated September 15, 2001 in the sum of $171.00, payable to The Dardick Agency. Glovsky also told her she would have to join an association in order to take advantage of the plan. From October 2001 through January 2002, L.H. paid premiums in the amount of $171.00; in January 2002, L.H. also tendered a premium for February 2002 in the amount of $191.00, although she was able to cancel payment on the check before it was drawn against her account. 158. Onor about January 2, 2002, L.H. received information that the plan had not paid for health care services received on December 14, 2001. On or about January 19, 2002, L.H. received information that her coverage had been terminated and that the plan was refusing to pay for health care services sought on that date. 159. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, L.H. has alleged that TRG has failed to pay at least 66 $335.00 in medical expenses. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (69) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of 67 another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXIX 160. The above general allegations are hereby realleged and fully incorporated herein by reference. 161. At all times material hereto, Brad Mitchell Glovsky (hereinafter “Glovsky”) was licensed in this state as a Life & Variable Annuity (2-14), Life & Health (2-18), and Health (2- 40) agent, license 1.D. #D002046. 162. On or about March 26, 2001, Glovsky, as a licensed insurance agent, contacted J.K. to sell her a health insurance plan through an entity known as TRG. Glovsky furnished to her application forms which she completed and delivered to him together with personal checks in the amount of $100.00, payable to Glovsky, and $281.00, payable to The Dardick Agency, representing a combined “membership fee” of $100.00 and an initial premium payment of $181.00. 163. The plan purportedly became effective May 1, 2001. From May 2001 through November 2001, J.K. paid premiums in the amount of $181.00, via electronic funds transfer; in December 2001, the amount was increased to $186.00, and in January 2002 to $217.00. 68 164. On or about December 2001, J.K. received information that her coverage had been terminated and that the plan was refusing to pay for health care services sought at that time. Further, she received a letter from the Florida Department of Insurance, n/k/a the Office of Insurance Regulation of the Financial Services Commission within the Department of Financial Services, that TRG was an entity without a certificate of authority to conduct insurance business in the state of Florida. 165. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, J.K. has alleged that TRG has failed to pay approximately $1,000.00 in medical expenses. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; ‘(b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; 69 (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. (Section 626.621(2), Florida Statutes); (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. (Section 626.621(6), Florida Statutes]; [¢9) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXX 166. The above general allegations are hereby realleged and fully incorporated herein by reference. 167. Atall times material hereto, Brad Mitchell Glovsky (hereinafter “Glovsky”) was licensed in this state as a Life & Variable Annuity (2-14), Life & Health (2-18), and Health (2- 40) agent, license I.D. #D002046. 70 168. On or about March 8, 2001, Glovsky, as a licensed insurance agent, contacted K.P. to sell her a health insurance plan through an entity known as TRG. Glovsky furnished to her application forms which she completed and delivered to him together with her personal checks in the amount of $100.00, payable to Glovsky, and $281.00, payable to The Dardick Agency, representing a combined “membership fee” of $100.00 and an initial premium of $181.00. Said plan purportedly became effective April 1, 2001. From June 2001 through December 2001, K.P. paid further premiums in the amount of $181.00. 169. On or about December 2001, K.P. received information that her coverage had been terminated and that the plan was refusing to pay for health care services sought at that time. 170. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, K.P. has alleged that TRG has failed to pay approximately $17,000.00 in medical expenses. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; 71 (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.61 1(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes}; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X {redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]; COUNT XXXI 171. The above general allegations are hereby realleged and fully incorporated herein by reference. 72 172. At all times material hereto, Michael Suttinger (hereinafter “Suttinger”) was, and currently is, licensed in the State of Florida as a Life (2-16), Life & Health (2-18), and Health (2- 40) agent, license I.D. #A258555. 173. At all times relevant hereto, Suttinger was, and currently is, President of Senior Insurance Specialists, Inc. (hereinafter “SIS”). 174. On or about February 1, 2001, Suttinger solicited and induced T.O and C.O. to enter into a health benefit contract with TRG. Suttinger quoted T.O and C.O. a premium of $401.00 per month. He also told T.O and C.O. that they were required to join the ABEA association to be eligible for coverage under the TRG plan. 175. On or about February 1, 2001, T.O and C.O. completed TRG and AEBA applications and gave Suttinger two checks. Check #1103, in the amount of $100, made payable to SIS, was for an application fee charged by Suttinger. Check #1102, in the amount of $501.00, made payable to TDA, was for the first month’s TRG premium and for the AEBA membership fee. Subsequent premium payments were deducted from T.O’s and C.O.’s bank account by TDA through electronic funds transfers. 176. In December 2001, T.O and C.O. received a letter from AEBA dated November 30, 2001. The letter stated that TRG was ordered to shut down and that the Ultra-Med Platinum Plan was replacing the TRG plan. 177. “As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, T.O and C.O. were left with unpaid medical bill of approximately $255,288.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments as an insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.61 1(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (69) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; 74 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXXII 178. The above general allegations are hereby realleged and fully incorporated herein by reference. 179. At all times material hereto, Jose Ramon Candelaria (hereinafter “Candelaria”), was and currently is licensed in this state as a Health (2-40) agent, license ID #A039505. 180. On or about January of 2001, Candelaria, as a licensed insurance agent, solicited and sold to E.P. of Miami, Florida, a health benefit insurance policy, or contract, with TRG. 181. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, E.P. has incurred approximately $1,679.20 worth of unpaid medical bills. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such 76 insurance contract is liable to the insured for the full amount of the claim or loss not paid. {Section 626.901(2), Florida Statutes]. COUNT XXxIII 182. The above general allegations are hereby realleged and fully incorporated herein by reference. 183. At all times material hereto, Hugo Diaz (hereinafter “Diaz”), was and currently is licensed in this state as a Life, Health, & Variable Annuity (2-15), Life (16), Life & Health (2- 18), and Health (2-40) agent and All Lines Adjuster (5-20), license ID #A067652. 184. Early in 2001, Diaz, as a licensed insurance agent, solicited and sold to L.C.O.L. a group health benefit insurance policy or contract. The health insurance policy was purportedly to be issued by TRG. TRG has failed to pay L.C.O.L.’s medical claims or any portion thereof and the policy is a nullity. 185. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, L.C.O.L. has incurred unpaid medical bills that should have been paid under the health provider plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: 77 (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X {redesignated as part [X] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (fh) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such 78 insurance contract is liable to the insured for the full amount of the claim or loss not paid. (Section 626.901(2), Florida Statutes]. COUNT XXXIV 186. The above general allegations are hereby realleged and fully incorporated herein by reference. 187. At all times material hereto, Enrique A. Raposo (hereinafter “Raposo”) was, and currently is, licensed in the State of Florida as a life (2-16), life and health (2-18), health (2-40) and legal expense (2-56) agent. His license identification number is A215173. 188. In May 2001, Raposo, as a licensed insurance agent, solicited and sold to J.M. a health benefit contract with TRG. Raposo told J.M. that an AEBA membership was required to participate in the TRG Plan. On or about May 25, 2001, Raposo took an application for the Employee Plus One Select Plan, sponsored by TRG, and an application for AEBA membership from J.M. J.M. gave Raposo check #0570 in the amount of $464.00 made payable TDA. $364.00 was for the first month premium and a $100.00 was for the AEBA membership fee. Subsequent premium payments were sent to TDA by J.M. 189. In December 2001, J.M. received a letter from AEBA dated November 30, 2001. The letter stated that TRG was order to shut down and that the Ultra-Med Platinum plan was replacing the TRG plan. 190. ‘As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, J.M. and his wife were left with unpaid medical bill of approximately $12,313.00 that should have been covered under the health benefit plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. 79 IT IS THEREFORE CHARGED that you, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments as an insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. {Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.61 1(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; # No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; 80 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}. COUNT XXXV 191. The above general allegations are hereby realleged and fully incorporated herein by reference. 192. At all times material hereto, Edward E. Turney (hereinafter “Turney”), was, and currently is, licensed in this state as a Life & Variable Annuity (2-14), Life, Health & Variable Annuity (2-15), Life (2-16), Life & Health (2-18), Health (2-40), and Legal Expense (2-56) agent, license I.D. #4269708. 193. On or about December, 2000, Turney, as a licensed insurance agent, contacted P.F. to sell her a health insurance plan through an entity known as TRG. Turney furnished to her application forms which she completed and delivered to him together with her personal check in the sum of $227.50, such check being made payable to the The Dardick Agency as payment for TRG Health Insurance and representing the initial premium payment. P.F. continued to make premium payments during January, 2001 and for each month thereafter through at least November, 2001. Such health insurance plan purportedly became effective December 1, 2000. 194, Thereafter, on or about December, 2001, P.F. received information that her health insurance coverage had been cancelled by TRG, and that it was being switched to another health plan. 81 195. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, P.F. was sold an unauthorized insurance policy. Asa corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; 82 (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXXVI 196. The above general allegations are hereby realleged and fully incorporated herein by reference. 197. At all times material hereto, Stephen Michael Lukacs (“hereinafter “Lukacs”), was and currently is licensed in this state as a Life & Variable Annuity (2-14) agent, license I.D. #4160077. 198. On or about April of 2001, Lukacs, as a licensed insurance agent, solicited and sold to P.M. a health benefit insurance policy with TRG. P.M. continued to make premium payments, but medical claims under the purported insurance policy were not paid. 199. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, P.M. has incurred approximately $516.41 worth of unpaid medical bills. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (63) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; 84 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. {Section 626.901(2), Florida Statutes]. COUNT XXXVI 200. The above general allegations are hereby realleged and fully incorporated herein by reference. 201. Atall times material hereto, Gloria Rosen (hereinafter “Rosen”) was and currently is licensed in this state as a Life & Variable Annuity (2-14), Life, Health & Variable Annuity (2- 15), Life (16), Life & Health (2-18), and Health (2-40) agent, license I.D. #A225891. 202. In April, 2001 Rosen, as a licensed insurance agent, solicited the sale of a health benefit insurance policy to K.F. The health insurance policy was purportedly to be issued by TRG. 203. Having become suspicious of TRG brochures and advertisements, K.F. contacted the Department and discovered that TRG was not an authorized insurer. 204. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, K.F. was sold an unauthorized insurance policy. Asa corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and 85 Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.61 1(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. {Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. {Section 626.621(6), Florida Statutes]; (f) No person shail, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. (Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, 86 any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}.; COUNT XXXVIIE 205. The above general allegations are hereby realleged and fully incorporated herein by reference. 206. At all times material hereto, Arnold Rabinowitz (hereinafter “Rabinowitz”) was and currently is licensed in this state as a Resident Life & Variable Annuity (2-14), Life, Health & Variable Annuity (2-15), Life (2-16), Life & Health (2-18) and Health (2-40) agent, license LD. #4069535. 207. On or about September 6, 2001, Rabinowitz, as a licensed insurance agent, solicited and sold to L.G. and J.G. a health insurance policy for their small business. The health insurance policy was purportedly issued by TRG. 208. On December 6, 2001, Rabinowitz represented to L.G. and J.G. that TRG was being replaced by Holden & Co. as L.G.’s and J.G.’s insurance carrier. On January 10, 2001, Rabinowitz represented to L.G. and J.G. that Holden & Co. was being replaced by Clarenden Insurance Company as the L.G.’s and J.G.’s insurance carrier, Neither TRG, Holden & Co., nor Clarenden Insurance have ever held a Certificate of Authority to engage in the business of insurance in this state pursuant to Sections 626.401 and 626.437, Florida Statutes. TRG, Holden & Co., and Clarenden Insurance have failed to pay L.G.’s and J.G.’s medical claims. 209. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, L.G. and J.G. have incurred a financial liability of 87 unpaid medical bills in excess of $1,300.00. Asa corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. {Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. (Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and _ technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes}; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this 88 state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes}; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXXIX 210. The above general allegations are hereby realleged and fully incorporated herein by reference. | 211. At all times material hereto, Clifford Eugene Kiefer (hereinafter “Kiefer”) was and currently is licensed in this state as a Life (16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4140590. 212. In August, 2001, Kiefer, as a licensed insurance agent, solicited and sold to V.B. a group health benefit insurance policy or contract. The health insurance policy was purportedly to be issued by TRG. TRG has failed to pay V.B.’s medical claims. 213. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, V.B. has incurred unpaid medical bills that should have been paid under the health provider plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. 89 IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.61 1(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; {e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part [X] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (63) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; 90 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes}. COUNT XXXxX 214. The above general allegations are hereby realleged and fully incorporated herein by reference. 215. At all times material hereto, Charles Edward Wadlington (“Wadlington”) was and currently is licensed in this state as a Life & Variable Annuity (2-14), Life, Health & Variable Annuity (2-15), Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4275183. 216. On or about March 2001, Wadlington, as a licensed insurance agent, contacted K.B. to sell her a health insurance plan through an entity known as TRG. You furnished to her application forms which she completed and delivered to you together with her personal check in the sum of $399.00 payable to TRG and representing an initial premium payment. The policy purportedly became effective April 1, 2001. Thereafter, on or about December 2001 KB. received information that her health insurance coverage had been cancelled by TRG. 217. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, K.B. was sold an unauthorized insurance policy. Asa corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. 91 IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (6) | Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes}; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (f) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; 92 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. (Section 626.901(2), Florida Statutes]. COUNT XXXxXI 218. The above general allegations are hereby realleged and fully incorporated herein by reference. 219. At all times material hereto, Hernan Delfin Olortegui (hereinafter “Olortegui”) was and currently is licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2- 40) agent, license I.D. #A196068. 220. On or about July 2001, Olortegui, as a licensed insurance agent, consulted with S.S. to sell her health insurance coverage through TRG. Such insurance coverage being purchased was for the benefit of herself and her family. S.S. provided to Olortegui a check in the sum of $601.00 representing the first month’s premium for such health insurance coverage in the sum of $401.00, and an annual membership fee in the TRG organization of $100.00 per adult, which Olortegui represented to her as a prerequisite for the insurance coverage being purchased. 221. S.S. continued to make monthly premium payments in the sum of $401.00 through at least December 2001. S.S.’s claims under the policy have not been paid. 222. As a direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, S.S. has incurred unpaid medical bills that should have been paid under the health provider plans. As a corporate officer of TDA you, ANTHONY F. 93 MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.1 1, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. [Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (63) No person shall, from offices or by personnel or facilities located in this state... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of 94 another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes]; (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. COUNT XXXxXII 223. The above general allegations are hereby realleged and fully incorporated herein by reference. 224, At all times material hereto, Michael C. Athmer (hereinafter “Athmer”) was and currently is licensed in this state as a Life & Variable Annuity (2-14) Life & Health (2-18) Health (2-40) agent, license I.D. #D064204. 225. On or about August of 2001, Athmer solicited and sold to R.J.S. a health benefit insurance policy with TRG. Although R.J.S. paid premiums under the policy, claims made by R.J.S. were not paid. 226. Asa direct or indirect result of you, ANTHONY F. MERLINO, representing or aiding unauthorized insurers or MEWAs, R.J.S. has incurred approximately $738.75 worth of unpaid medical bills that should have been paid under the health provider plans. As a corporate officer of TDA you, ANTHONY F. MERLINO, are responsible for the actions of the corporation and its employees or their failures to act. IT IS THEREFORE CHARGED that you, ANTHONY F. MERLINO, have violated or are accountable under one or more of the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services, which constitute grounds for the suspension or revocation of your licenses and appointments as a resident insurance agent: (a) No person shall transact in this State, or relative to a subject of insurance resident, located, or to be performed in this state, without complying with the applicable provisions of this code. [Section 624.11, Florida Statutes]; (b) Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.61 1(7), Florida Statutes]; (c) Demonstrated lack of reasonably adequate knowledge and technical competence to engage in the transactions authorized by the license or appointment. (Section 626.611(8), Florida Statutes]; (d) Violation of any provision of this Code or any law applicable to the business of insurance in the course of dealing under the licensure or appointment. [Section 626.621(2), Florida Statutes]; (e) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part X [redesignated as part IX] of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public. [Section 626.621(6), Florida Statutes]; (69) No person shall, from offices or by personnel or facilities located in this State... directly or indirectly act as an agent for, or otherwise represent or aid on behalf of another, any insurer not then authorized to transact such insurance in this state. [Section 626.901(1), Florida Statutes}: 96 (g) If an unauthorized insurer fails to pay in full or in part any claim or loss within the provisions of any insurance contract which is entered into in violation of this section, any person who knew or reasonably should have known that such contract was entered. into in violation of this section and who solicited, negotiated, took application for, or effectuated such insurance contract is liable to the insured for the full amount of the claim or loss not paid. [Section 626.901(2), Florida Statutes]. WHEREFORE, you, ANTHONY F. MERLINO, are hereby notified that the Deputy Chief Financial Officer intends to enter an Order suspending or revoking your licenses and appointments as an insurance agent or to impose such penalties as may provided under the provisions of Sections 626.611, 626.621, 626.681, 626.691, and 626.901, Florida Statutes, under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint, and under the provisions of Rule Chapter 4-231, Florida Administrative Code. You are further notified that any order entered in this case revoking or suspending any license or eligibility for licensure held by you shall also apply to all other licenses and eligibility held by you under the Florida Insurance Code. NOTICE OF RIGHTS You have the right to request a proceeding to contest this action by the Department pursuant to sections 120.569 and 120.57, Florida Statutes, and Rule 28-107, Florida Administrative Code. The proceeding request must be in writing, signed by you, and must be filed with the Department within twenty-one (21) days of your receipt of this notice. Completion of the attached Election of Proceeding form and/or a petition for administrative hearing will suffice as a written request. The request must be filed with the General Counsel as acting 97 Agency Clerk, at the Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. The Department must receive your written response no later than 5:00 p.m. on the twenty-first day after your receipt of this notice. Mailing the response on the twenty-first day will not preserve your right to a hearing. YOUR FAILURE TO RESPOND IN WRITING WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THIS NOTICE WILL CONSTITUTE A WAIVER OF YOUR RIGHT TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF REVOCATION WILL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the requirements of Rule 28-107.004, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, your response must contain: (a) The name and address of the party making the request, for purpose of service; (b) A statement that the party is requesting a hearing involving disputed issues of material fact, or a hearing not involving disputed issues of material fact; and (c) A reference to the notice, order to show cause, administrative complaint, or other communication that the party has received from the agency. If a hearing of any type is requested, you have the right to be represented by counsel or other qualified representative at your expense, to present evidence and argument, to call and cross-examine witnesses, and to compel the attendance of witnesses and the production of documents by subpoena. If a proceeding is requested and there is no dispute of material fact, the provisions of section 120.57(2), Florida Statutes, apply. In this regard, you may submit oral or written evidence in opposition to the action taken by the Department or a written statement challenging 98 the grounds upon which the Department has relied. While a hearing is normally not required in the absence of a dispute of fact, if you feel that a hearing is necessary, one will be conducted in Tallahassee, Florida, or by telephonic conference call upon your request. However, if you dispute material facts, which are the basis for the Department’s action, you must request an adversarial proceeding pursuant to sections 120.569 and 120.57(1), Florida Statutes. These proceedings are held before a State administrative law judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere, the Department will request that the hearing be conducted in Tallahassee, Florida. Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied. All prior oral communication or correspondence in this matter shall be considered freeform agency action, and no such oral communication or correspondence shall operate as a valid request for an administrative proceeding. Any request for an administrative proceeding received prior to the date of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. Mediation of this matter pursuant to section 120.573, Florida Statutes, is not available. No Department attorney will discuss this matter with you until the response has been received by the Department of Financial Services. DATED this_// ca day of April, 2003. Klien Vo sdller KAREN CHANDLER Deputy Chief Financial Officer 99 CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a copy of the foregoing ADMINISTRATIVE COMPLAINT has been furnished to ANTHONY F. MERLINO at 99100 S. Dadeland Blvd., Suite 1110, Miami, Florida 33256-5515 and ANTHONY F. M INO 6622 Santona Street, Coral Gables, Florida 33146-3112 by U.S. Certified Mail this l/ day of April 2003. WV ac A, William W. Tharpe, Jr. Florida Department of Financiaf Services Division of Legal Services 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4110 Fla. Bar No. 312411 100 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES IN THE MATTER OF: ANTHONY F. MERLINO Case No: 61706-03-AG ELECTION OF PROCEEDING I have received and have read the Notice of the ADMINISTRATIVE COMPLAINT filed against me, including the Notice of Rights contained therein, and I understand my options. I am requesting disposition of this matter as indicated below. (Choose one) 1 {J I do not dispute any of the Department’s factual allegations and I do not desire a hearing. I understand that by waiving my right to a hearing, the Department may enter a final order that adopts the Administrative Complaint and imposes the sanctions sought, including revoking my licenses and appointments as may be appropriate. 2. I do not dispute any of the Department's factual allegations and I hereby elect a proceeding to be conducted in accordance with section 120.57(2), Florida Statutes. In this regard, I desire to (Choose one): { ] Submit a written statement and documentary evidence in lieu of a hearing; or {] Personally attend a hearing conducted by a department hearing officer in Tallahassee; or { ] Attend that same hearing by way of a telephone conference call. 3. [] I do dispute one or more of the Department's factual allegations. I hereby request a hearing pursuant to section 120.57(1), Florida Statutes, to be held before the Division of Administrative Hearings. TO PRESERVE YOUR RIGHT TO A HEARING, YOU MUST FILE YOUR RESPONSE WITH THE DEPARTMENT OF FINANCIAL SERVICES WITHIN TWENTY-ONE (21) DAYS OF YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. THE RESPONSE MUST BE RECEIVED BY THE DEPARTMENT NO LATER THAN 5:00 P.M. ON THE TWENTY-FIRST DAY AFTER YOUR RECEIPT OF THE ADMINISTRATIVE COMPLAINT. The address for filing is: General Counsel as acting agency clerk, Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Signature Print Name Date: Address: Phone No.: 101

Docket for Case No: 03-001704PL
Issue Date Proceedings
Aug. 12, 2003 Order Closing File. CASE CLOSED.
Aug. 12, 2003 Joint Motion to Relinquish Jurisdiction (filed by J. Londot via facsimile).
Aug. 04, 2003 Joint Motion for Continuance (filed via facsimile).
Jul. 25, 2003 Request for Admissions (filed by Petitioner via facsimile).
Jul. 25, 2003 (Proposed) Order Granting Petitioner`s Motion to Shorten Time for Respondent to Respond to Petitioner`s Request for Admissions (filed via facsimile).
Jul. 25, 2003 Petitioner`s Motion to Shorten Time for Respondent to Respond to Petitioner`s Request for Admissions (filed via facsimile).
Jul. 22, 2003 Response to Respondent`s Second Set of Interrogatories to Petitioner filed.
Jul. 22, 2003 Answers to Respondent`s First Set of Interrogatories to Petitioner filed.
Jul. 18, 2003 Response to Respondent`s Second Request for Production (filed by Petitioner via facsimile).
Jul. 18, 2003 Response to Repondent`s First Request for Production (filed by Petitioner via facsimile).
Jun. 18, 2003 Order Granting Continuance and Re-scheduling Hearing (hearing set for August 27 through 29, 2003; 9:30 a.m.; Miami, FL).
Jun. 13, 2003 First Request for Production to Respondent by the Department of Financial Services (filed by Petitioner via facsimile).
Jun. 13, 2003 Second Set of Interrogatories (filed by Respondent via facsimile).
Jun. 13, 2003 Second Request for Production of Documents (filed by Respondent via facsimile).
Jun. 13, 2003 Response and Objections to Amended Notice of Taking Deposition Duces Tecum (filed by Respondent via facsimile).
Jun. 09, 2003 Motion for Continuance (filed by Respondent via facsimile).
Jun. 09, 2003 Interrogatories (filed by Respondent via facsimile).
Jun. 09, 2003 Request for Production of Documents (filed by Respondent via facsimile).
Jun. 06, 2003 Amended Notice of Taking Deposition Duces Tecum, A. Merlino (filed via facsimile).
Jun. 02, 2003 Notice of Taking Deposition Duces Tecum A. Merlino (filed via facsimile).
May 28, 2003 Order of Pre-hearing Instructions issued.
May 28, 2003 Notice of Hearing issued (hearing set for July 14 through 17, 2003; 9:30 a.m.; Miami, FL).
May 22, 2003 Letter to Judge Sartin from L. Kellogg (reply to Initial Order) filed.
May 19, 2003 Notice of Appearance (filed by L. Kellogg via facsimile).
May 19, 2003 Letter to Judge Sartin from J. Londot in reply to Initial Order (filed via facsimile).
May 16, 2003 Notice of Appearance (filed by J. Londot).
May 12, 2003 Initial Order issued.
May 09, 2003 Administrative Complaint filed.
May 09, 2003 Election of Proceeding filed.
May 09, 2003 Agency referral filed.
Source:  Florida - Division of Administrative Hearings

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