DEPARTMENT OF FINANCIAL SERVICES TomM GALLAGHER CHIEF FINANCIAL OFFICER IN THE MATTER OF: O- 459 DL SUSAN HOPE PINE CASE NO.: 62755-03-AG TO: ADMINISTRATIVE COMPLAINT SUSAN HOPE PINE 1490 104" Avenue Plantation, Florida 33322 Business Addresses: SUSAN HOPE PINE 8181 West Broward Boulevard, Suite 204 Plantation, Florida 33324 ~or- SUSAN HOPE PINE 1370 N. University, #1370C Plantation, Florida 33322 ; You, SUSAN HOPE PINE, are hereby notified that the 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 Statutes, you, SUSAN HOPE PINE, are currently licensed in this state as a Life (2-16), Life & Health (2-18), and Health (2-40) agent, license I.D. #4207606. 2. At all times pertinent to the dates and occurrences referred to herein, you, SUSAN HCPE PINE, were licensed in this state as an insurance agent. 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Financial Services (“DFS”) has jurisdiction over your insurance licenses and appointments. 4. At all time material to the dates and occurrences specified herein, the United States Workers of America Local 16 National Health Fund a/k/a or d/b/a TAWU National Health Fund; Local 16 National Health (“Local 16”), engaged in the business of insurance, or operated as one or more MEWAs in Florida. 5. On or about January 15, 2002, the United States Bankruptcy Court for the District of New Jersey (Newark), in Case Number 01-4288}, entered a Notice of Chapter 7 Bankruptcy relative to Local 16. 6. At all times material to the dates and occurrences specified herein, Employers Mutual, L.L.C. (“Employers Mutual”), engaged in the business of insurance, or ostensibly operated as one or more MEWAs in Florida, by or through the following , associations (non-exhaustive): (a) | American Association of Agriculture (b) Association of Automotive Dealers & Mechanics (c) Association of Barristers & Legal Aids (d) | Communication Trade Workers Association (e) Construction Trade Workers Association () American Coalition of Consumers (g) Association of Cosmetologists (h) Culinary and Food Services Workers Association (i) Association of Educators Gg) Association of Health Care Workers (k) National Alliance of Hospitality & Innkeepers r¢)) Association Manufactures & Wholesalers (m) Association of Real Estate Agents (n) Association of Retail Sellers (0) National Association of Transportation Workers (p) National Association of Independent Truckers. 7. On or about February 1, 2002, the United States District Court District of Nevada in Elaine Chao v. James Graf, Employers Mutual, et al., CV-N-01-0698-DWH (RAM) ruled that Employers Mutual and its related associations were not ERISA- qualified employee welfare benefit plans and therefore were not preemptively exempt from state insurance codes, and ordered that a Court Receiver or Independent Fiduciary administer Employers Mutual and its related associations, and, if necessary, implement their orderly termination. Furthermore, the Court ordered that the Independent Fiduciary collect, marshal, and administer the assets of Employers Mutual and its related associations, process the health benefit claims, and pay those that are found to be legitimate. 8. On or about August 14, 2001, DFS (then known as the Florida Department of Insurance) in Jn the matter of: Employers Mutual, L.L.C., et al., Case No. 42660-01- CO, stated: WHEREFORE, Employers Mutual, L.L.C., [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. 9. At all times material to the dates and occurrences specified 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) TRG. Administration, LLC (c) The Redwood Group, LLC. 10. On or about January 15, 2002, DFS (then known as the Florida Department of Insurance), in In the matter of: T.R.G. Marketing, L.L. C., et al, Case No.: 43 160-O1-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. 11. Inaddition, other states have acted against TRG, including as follows: (a) Kentucky issued a Restraining Order on November 2, 2001, (b) Nevada issued a Cease and Desist Order on February 1, 2002; and (c) Arkansas issued a Cease and Desist Order on July 23, 2002. 12. At all times material to the dates and occurrences specified herein American Benefit Plans (“ABP”) engaged in the business of insurance, or operated as one or more MEWAs in Florida, by or ostensibly through the various entities, associations, or individuals, including, but not limited to: United Employers Voluntary Employee © Beneficiary Association (““UEVEBA”), Robert David Neal (individually and d/b/a American Benefit Plans) (“Neal”), and the National Association of Working Americans (NAWA”) — all of which are hereinafter sometimes collectively referred to as “UEVEBA.” The aforementioned are and have been identified with an ostensible health benefit plan known as the UltraMed Choice Major Medical Plans. 13. Welfare Benefits Administration, in a letter to the Commissioner of the Arkansas On or about March 1, 2002, the U.S. Department of Labor, Pension and Department of Insurance, concluded: 14. Welfare Benefits Administration, in a letter to the Commissioner of the Texas Accordingly, in the [Department of Labor] view, {UEVEBA] is a MEWA ... Therefore, ERISA’s preemption provisions do not apply with respect to the UEVEBA arrangement (as distinguished from any individual ERISA- covered plans that obtain benefits through UEVEBA), and Arkansas is free to regulate the UEVEBA arrangement in accordance with applicable state law. Further, even if it [sic] the UEVEBA arrangement were itself found to be an ERISA-covered plan, Title I of ERISA does not preclude the application of Arkansas insurance law or regulations to the UEVEBA arrangement in accordance with Section 514(b)(6)(A) [29 U.S.C.A. 1144(b)(6)(A)] of ERISA. On or about March 18,°2002, the U.S. Department of Labor, Pension and Departmen: of Insurance, concluded: 15. Plans; United Employers Voluntary Employee Beneficiary Association, Robert David, Accordingly, in the (Department of Labor] view, (UEVEBA] is a MEWA ... Therefore, ERISA’s preemption provisions would not apply with respect to the UEVEBA arrangement (as distinguished from any individual ERISA- covered plans that obtain benefits through UEVEBA), and Texas may regulate the UEVEBA arrangement in accordance with applicable state insurance law. Further, even if the UEVEBA arrangement were itself found to be an ERISA-covered plan, Title I of ERISA does not preclude the application of Texas insurance law or regulations to the UEVEBA arrangement in accordance with Section 514(b)(6)(A) [29 U.S.C.A. 1144(b)(6)(A)] of ERISA as described in our March 1, 2002, letter to the Arkansas Commissioner of Insurance. On or about April 25, 2002, DFS, in In The Matter of: American Benefit individually and doing business as American Benefit Plans, National Association for Working Americans [collectively referred to as “UEVEBA"], et al, Case No. 43161-02- CO, ordered: The Respondents [including UEVEBA\, whether acting in the State of Florida as an insurer, a Multiple Employer Welfare Arrangement, insurance agents, insurance agencies, insurance adjuster, third-party administrators, managing general agents, or otherwise engaging in the business of insurance, either directly or indirectly through named and unnamed persons, entities, agents, or otherwise, shall forthwith CEASE AND DESIST from the transaction of any new or renewal insurance business as or on behalf of unauthorized insurers. 16. | Onor about May 25, 2002, DFS, in Case No. 43163-02-CO, stated: WHEREFORE, the Respondents [UEVEBA] 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. 17. Onor about May 28, 2002, the District Court of Travis County, Texas in Texas v. American Benefit Plans; United Employers Voluntary Employee Beneficiary Association; Robert David Neal, individually and doing business as American Benefit Plans, et al., Cause No. GV200903, ruled, in its Final Judgment, Permanent Injunction and Order Appointing Permanent Receiver, at paragraph 4, that: Defendants have participated in the creation, marketing and sale of unauthorized health care insurance plans. Defendants have collected money, variously labeled as “premiums,” “contributions,” “dues,” or other titles, from employers and employees under these fraudulent health care plans, and failed to pay claims of such employees and other beneficiaries and their health care providers. Defendants further participated in the creation of sham trusts in the name of United Employee Voluntary Employee Beneficiary Association (SUEVEBA”) and United Employers Voluntary Employee Beneficiary Association I (UEVEBA), into which money from employers, employees, and others were deposited and commingled. Defendants further participated in procuring reinsurance in connection with such health care plans from entities that do not hold certificates of authority to act as an insurer or reinsurer in Texas. The activities described above shall be collectively referred to as the “Unauthorized Health Care Program.” 18. At all times material to the dates and occurrences specified herein, Highmark Blue Cross Blue Shield (“Highmark BC/BS”) was not authorized to engage in the business of insurance in Florida and not authorized to operate as a MEWA in Florida. 19. At all times material to the dates and occurrences herein, Local 16, Employers Mutual, TRG, ABP, UEVEBA, and Highmark BC/BS transacted insurance as “unauthorized insurers or MEWAs in the State of Florida. 20. At all times relevant hereto, Quik Quote Insurance Brokers, Inc., a/k/a or fik/a Quick Quote, MGA Insurance Solutions, Inc., or Women’s Insurance Planning Center, Inc. (hereinafter “Quik Quote” or “MGA Insurance Solutions”), was a Florida corporation engaged in the business of transacting insurance in Florida. Quik Quote maintained offices at all times relevant hereto at 8181 West Broward Boulevard, Suite 204, Plantation, Florida 33324, 1370 N. University, #1370C, Plantation, Florida 33322, or 7860 Peters Road, #111F, Plantation, Florida 33324-4027. In addition, Quik .Quote |, acted through an entity or entities that shared Quik Quote’s addresses and were known variously as the Bertany Association for Travel and Leisure, Inc., the Business Association for Trade and Labor, Inc., or BAFTAL (hereinafter collectively referred to as “BAFTAL”). 21. At no time material to the dates and occurrences herein did Local 16, Employers Mutual, TRG, ABP, UEVEBA, or Highmark BC/BS possess Certificates of Authority from DFS to engage in the business of insurance or to operate as MEWAs in Florida. 22. Neither Local 16, Employers Mutual, TRG, ABP, UEVEBA, or Highmark BC/BS are subject to any exception to the licensure/Certificate of Authority requirement of the Florica Insurance Code in order to lawfully engage in the business of insurance or to operate as MEWAs in Florida. 23. At all times material to the dates and occurrences specified herein, Local 16, Employers Mutual, TRG, ABP, UEVEBA, and Highmark BC/BS transacted the business of insurance as insurers or operated as MEWAs in the State of Florida from or through the common business premises of BAFTAL, Quik Quote, and MGA Insurance Solutions. 24. At all times relevant hereto, you, SUSAN HOPE PINE, were a corporate officer of BAFTAL, Quik Quote, and MGA Insurance Solutions. 25. At all times material to the dates and occurrences herein, you, SUSAN HOPE PINE, did directly or indirectly represent or aid Local 16, Employers Mutual, TRG, ABP, UEVEBA, and Highmark BC/BS, unauthorized insurers or MEWAs, to transact insurance in the State of Florida, or did directly or indirectly aid agent Susan 4 Pine or independent licensed agents as indicated in the numbered Counts below to unlawfully transact insurance in the State of Florida. 26. The particularized harm resulting from you, SUSAN HOPE PINE, directly or indirectly aiding or representing Local 16, Employers Mutual, TRG, ABP, UEVEBA, and Highmark BC/BS in the State of 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. 27. 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. Insureds, medical providers, znd the State of Florida may incur and/or have incurred serious losses that may remain uncompensated due to the solicitation, sales, and administration of unauthorized insurance by you, SUSAN HOPE PINE. 28. At all times pertinent to the dates and occurrences referred to herein, pursuant to Section 626.592 and/or Section 626.839, Florida Statutes, you, SUSAN HOPE PINE, were personally and fully liable and accountable for any wrongful acts, misconduct, or violations of any provision of the Insurance Code committed either by you or anyone under your direct supervision and control while acting on behalf of Quik Quote. 29. Directly or indirectly representing or aiding an unauthorized insurer which , has not setisfied the statutory safeguards poses a great risk of financial harm to the residents of Florida. By collecting premium payments for or on behalf of unauthorized insurers or by soliciting payments through fellow officers of BAFTAL, Quik Quote, or MGA Insurance Solutions or through independent licensed agents, each occurrence of which represents direct or indirect action by you, SUSAN HOPE PINE, you aided and abetted the transaction of unauthorized health insurance in the State of Florida. 30. References to you, SUSAN HOPE PINE, include persons acting under your direct supervision and control and those whom you aided and abetted to commit violations of the Insurance Code. COUNTI 31. The above general allegations are hereby realleged and fully incorporated herein by reference. 32. On or about March 12, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to L.T., of Hollywood, Florida, a health insurance plan through TRG. You furnished L.T. with application forms which were completed and delivered to you, and you began to collect fees on premiums paid by L.T. You induced L.T. to believe he was properly covered by health insurance under the plan. 33. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, L.T. was sold an unauthorized health insurance plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), Florida Statutes]; 10 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 (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]; 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]. COUNT I 34. The above general allegations are hereby realleged and fully incorporated 4 herein by reference. 35. On or about January 15, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to C.M., of Sunrise, Florida, a health insurance plan through TRG. You furnished C.M. with application forms which were completed and 11 delivered to you, and you began to collect fees on premiums paid by C.M. You induced CM and he: husband to believe they were properly covered by health insurance under the plan. 36. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, C.M. was sold an unauthorized health insurance plan. IT I$ THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 12 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}; 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]. COUNT Il 37. The above general allegations are hereby realleged and fully incorporated herein by reference. 38. On or about January 15, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to V.R., of Pembroke Pines, Florida, a health insurance plan through TRG. You furnished V.R. with application forms which were completed and delivered to you, and you began to collect fees on premiums paid by V.R. You induced V.R. to believe she was properly covered by health insurance under the plan. 39. As a direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRS, an unauthorized insurer or MEWA, V.R. was sold an unauthorized health insurance plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or f are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocatior of your licenses and appointments: 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 cf this Code. [Section 624.11(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 (re-designated as Part IX) of this chapter, or having otherwise shown himself or ‘aerself 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 being authorized to transact such business in this state. [Section , 626.901(1), Florida Statutes]. COUNT IV 40. The above general allegations are hereby realleged and fully incorporated herein by reference. 14 41. On or about January 15, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to M.D. a health insurance plan through TRG. You furnished M.D. with application forms which were completed and delivered to you, and you began to collect fees on premiums paid. You induced M.D. to believe she was properly covered by health insurance under the plan. 42. As a direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, M.D. was sold an unauthorized health insurance plan, and has alleged that TRG has failed to pay medical bills in an approximate amount of $30,000.00 that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 625.611(8), Florida Statutes}; 15 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 ‘aerself 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, anv insurer not being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]. COUNT V 43. The above general allegations are hereby realleged and fully incorporated herein by reference. 44, On or about February 16, 2001 you, SUSAN HOPE PINE, as a licensed insurance azent, caused to be sold to M.A., of Miami Beach, Florida, a health insurance plan through TRG. You furnished M.A. with application forms which were completed and delivered to you, and you began to collect fees on premiums paid by M.A. You ‘ induced M..A., to believe he was properly covered by health insurance under the plan. 45. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, M.A. was sold an unauthorized health insurance plan. 16 IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 62€.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]; 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 17 another, any insurer not being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]. COUNT VI 46. The above general allegations are hereby realleged and fully incorporated herein by reference. 47, On or about December 17, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to Mull & Associates, P.A., and its employees P.M., D.P., D.S., C.F., M.N., and K.K., of Tavernier, Florida, health insurance plans through TRG. You furnished the employees with application forms which were completed and delivered to you, and you began to collect fees on premiums paid by the employees. You induced the employees and their families to believe they were properly covered by health insurance under the plans. 48. As adirect or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, Mull & Associates, P.A. and its six employees were sold unauthorized health insurance plans. IT [S THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), Florida Statutes]; 18 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 (re-designated 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 being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]. COUNT VIt 49. The above general allegations are hereby realleged and fully incorporated © herein by reference. 50. On or about January 9, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to H.N., of Wesley Chapel, Florida, a health insurance plan through TRG. You furnished H.N. with application forms which were completed 19 and delivered to you, and you began to collect fees on premiums paid. You induced H.N. to believe she was properly covered by health insurance under the plan. 51. | Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, H.N. was sold an unauthorized health insurance plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 (re-designated as Part IX) of this chapter, or having otherwise shown 20 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 being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]. COUNT VIII 52. The above general allegations are hereby realleged and fully incorporated herein by reference. 53. In or about August 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to M.S., of Pensacola, Florida, a health insurance plan through TRG. You induced MS. to believe he was properly covered by health insurance under the plan. 54. As adirect or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, M.S. was sold an unauthorized health insurance plan, and has alleged that TRG has failed to pay medical bills in an approximate amount of $1,200.00 that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accounteble under 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: 21 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(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 (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]; 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]. COUNT IX 55. The above general allegations are hereby realleged and fully incorporated herein by reference. ’ ? 56. Prior to May 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to D.G., of Rockledge, Florida, a health insurance plan through TRG. You induced D.G. to believe she and her husband were properly covered by health insurance under the plan. 57. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, D.G. was sold an unauthorized health insurance plan, and has alleged that TRG has failed to pay medical bills that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation o7 your licenses and appointments: 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(1), 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 (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]; 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]. COUNT X 58. The above general allegations are hereby realleged and fully incorporated herein by reference. 59. In or about January 2001 you, SUSAN HOPE PINE, as a licensed insurance egent, caused to be sold to Total Communications Service, Inc. and its employees B.N., Z.N., D.N., and J.B, of Melbourne, Florida, a health insurance plan through TRG. You began to collect fees on premiums paid on the employees’ enrollment. You induced the employees and their family members to believe they were properly covered by health insurance under the plan. 60. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or 4 aiding TRG, an unauthorized insurer or MEWA, Total Communications Service, Inc. and its employees were sold an unauthorized health insurance plan, and have alleged that TRG has failed to pay medical bills that should have been paid under the plan. 24 IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountab:e under 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: 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(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 (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]; 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). COUNT XI 61. The above general allegations are hereby realleged and fully incorporated herein by reference. 62. In or about September 11, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to Moultin Layne, P.L. and its employees, D.M., B.P., and S.L, of Vero Beach, Florida, health insurance plans through TRG. You began to collect fees on premiums paid on the employees’ enrollment. You induced them to believe they were properly covered by health insurance under the plans. 63. As a direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, D.M., B.P., and S.L. were sold unauthorized health insurance plans, and have alleged that TRG has failed to pay medical bills that should have been paid under the plans. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), Florida Statutes]; b. Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; 26 , / 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 625.621(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]; 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]. COUNT XI 64. The above general allegations are hereby realleged and fully incorporated herein by reference. 65. On or about October 1, 2001 you, SUSAN HOPE PINE, as a licensed ‘ insurance agent, caused to be sold to A.D., of Wellington, Florida, a health insurance plan through TRG. You began to collect fees on premiums paid on A.D.’s enrollment. You induced A.D. and his wife to believe they were properly covered by health insurance under the plan. 66. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, A.D. was sold an unauthorized health insurance plan, and has alleged that TRG have failed to pay medical bills in an approximate amount of $200.00 that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 62€.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 28 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 being authorized to transact such business in this state. (Section 626.901(1), Florida Statutes]. COUNT XII 67. The above general allegations are hereby realleged and fully incorporated herein by reference. 68. On or about November 28, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to D.M. Salon & Spa, Inc., and at least eight of its employees and their family members, including D.M. and her spouse A.M., of Stuart, Florida, a health insurance plan through TRG. You began to collect fees on premiums paid on the employees’ enrollment. You induced the employees and family members to believe they were properly covered by health insurance under the plan. 69. As a direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, unauthorized insurers or MEWaAs, D.M. Salon & Spa, Inc. was sold an unauthorized health insurance plan, and has alleged that TRG have failed to pay medical bills in an approximate amount of $2,000.00 that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), 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 625.611(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 625.621(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]; 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]. COUNT XIV 70. The above general allegations are hereby realleged and fully incorporated herein by reference. 71. In or about August 1, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to V.B., of Jacksonville, Florida, a health insurance plan through TRG You induced V.B. to believe she was properly covered by health insurance under the plan. 72. Asadirect or indirect result of you, SUSAN HOPE PINE, representing or aiding TRC, unauthorized insurers or MEWAs, V.B. was sold an unauthorized health insurance plan and has alleged that TRG have failed to pay medical bills in an’ approximate amount of $505.00 that should have been paid under the plan. IT 1S THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 (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]; 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]. COUNT XV 73. The above general allegations are hereby realleged and fully incorporated herein by reference. 74. On or about September 11, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to Comprehensive Billing Solutions, Inc. and its employees S.C. and D.R., of Sarasota, Florida, a health insurance plan through TRG. You induced S.C. and her husband and D.R to believe they were properly covered by health insurance under the plan. 75. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, unauthorized insurers or MEWAs, S.C. and D.R. were sold an unauthorized © health insurance plan, and have alleged that TRG has failed to pay medical bills that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), 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 625.611(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 625.621(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}; 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]. a Go COUNT XVI 76. The above general allegations are hereby realleged and fully incorporated herein by reference. 77. In or about April 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to J.R., of Cocoa, Florida, a health insurance plan through TRG. You induced J.R. and his wife to believe they were properly covered by health insurance under the plan. 78. Asa direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRC, an unauthorized insurer or MEWA, J.R. was sold an unauthorized health insurance plan, and has alleged that TRG has failed to pay medical bills in an approximate amount of $15,000.00 that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 625.611(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 626.521(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]; 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]. COUNT XVII 79. The above general allegations are hereby realleged and fully incorporated herein by refeence. 80. In or around June 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, solicited agent R.S., of Miami, Florida, to sell a health insurance plan through Employers Mutual. You provided R.S. with marketing materials in support of soliciting the public to enroll in the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Departraent of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments: 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 chis Code. [Section 624.11(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 626.511(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 626.521(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 Statues]; 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]. COUNT XVIII 81. | The above general allegations are hereby realleged and fully incorporated herein by reference. 36 82. In or around May 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, solicited agent J.B., of Tequesta, Florida, to sell a health insurance plan through Employers Mutual. You provided J.B. with marketing materials in support of soliciting the public to enroll in the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 62€.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]; 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). COUNT XIX 83. The above general allegations are hereby realleged and fully incorporated herein by reference. 84, On or about December 1, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to R.H., of Tavernier, Florida, a health insurance plan through TRG. You furnished R.H. with application forms which were completed and delivered to you, and you began to collect fees on premiums paid. You induced R.H. and his wife to believe they were properly covered by health insurance under the plan. 85. As a direct or indirect result of you, SUSAN HOPE PINE, representing or aiding TRG, an unauthorized insurer or MEWA, R.H. was sold an unauthorized health insurance plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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 (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]; 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]. COUNT XX 86. | The above general allegations are hereby realleged and fully incorporated herein by reference. 39 87. On or about January 11, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to R.M. a health insurance plan through Local 16. You furnished R.M. with application forms, and you began to collect fees on premiums paid. You induced R.M. and his wife to believe they and their family were properly covered by health insurance under the plan. 88. As adirect or indirect result of you, SUSAN HOPE PINE, representing or aiding AEBA/Local 16, unauthorized insurers or MEWAs, R.M. was sold an unauthorized health insurance plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), 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]; 40 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 kerself 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 being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]. COUNT XxI 89. The above general allegations are hereby realleged and fully incorporated herein by reference. 90. On or about January 25, 2002 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to R.S., of Jupiter, Florida, a health insurance plan through ABP. You furnished R.S. with application forms which were completed and delivered to you, and you began to collect fees on premiums paid on R.S.’s enrollment. You induced R.S. to believe she was properly covered by health insurance under the plan. 91. — As adirect or indirect result of you, SUSAN HOPE PINE, representing or aiding ABP, unauthorized insurers or MEWAs, R.S. was sold an unauthorized health insurance plan, and has alleged that ABP have failed to pay medical bills in excess of $1,625.00 that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules 41 of the Department of Financial Services which constitute grounds for the suspension or revocation cf your licenses and appointments: 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 cf this Code. [Section 624.11(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 625.611(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 625.621(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]; 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]. 42 COUNT XXII 92. The above general allegations are hereby realleged and fully incorporated herein by reference. 93. Prior to December 1, 2001 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to B.E., of Jackson, Mississippi, a health insurance plan through ABP. You induced B.E. to believe she was properly covered by health insurance under the plan. 94. As a direct or indirect result of you, SUSAN HOPE PINE, representing or aiding ABP, an unauthorized insurer or MEWA, B.E. was sold an unauthorized health insurance plan, and has alleged that ABP have failed to pay medical bills that should have been paid under the plan. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(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]; 43 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]; f. No person shall, from offices or by personnel or facilities located in this state... direc‘ly 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]. COUNT XXIII 95. The above general allegations are hereby realleged and fully incorporated herein by reference. 96. In or about February-March 2003 you, SUSAN HOPE PINE, as a licensed insurance agent, aided and abetted agent Paul McCarthy in soliciting or enrolling Florida consumers in a health insurance plan through Highmark BC/BS, an unauthorized insurer or MEWA. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountasle under 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: 44 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(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]; €. 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]; 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]. COUNT XXIV 97. The above general allegations are hereby realleged and fully incorporated herein by reference. 98. In or about February-March 2003 you, SUSAN HOPE PINE, as a licensed insurance agent, directly or indirectly representing or aiding Highmark BC/BS, caused to be solicited to numerous insurance agents, including Manuel Arias, Jose Berrinquer, Ed Pauley, Tony Donato, Joy Herro, and Sylvester Cuffy, a health insurance plan through Highmark BC/BS, an unauthorized insurer or MEWA, for sale to Florida consumers. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), 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 ‘+o 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 46 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 being authorized to transact such business in this state. [Section 626.901(1), Florida Statutes]. COUNT XXV 99. The above general allegations are hereby realleged and fully incorporated herein by reference. 100. In or about February-March 2003 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to K.B., of Ellenton, Florida, a health insurance plan through Highmark BC/BS, an unauthorized insurer or MEWA. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Financial Services which constitute grounds for the suspension or revocation cf your licenses and appointments: 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(1), Florida Statutes]; b. Demonstrated lack of fitness or trustworthiness to engage in the business of insurance. [Section 626.611(7), Florida Statutes]; 47 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]; €. 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]; 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]. COUNT XXVI 101. The above general allegations are hereby realleged and fully incorporated herein by reference. 102. In or about March 2003 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to J.B., of Sebastian, Florida, a health insurance plan through Highmark BC/BS, an unauthorized insurer or MEWA. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules 48 of the Department of Financial Services which constitute grounds for the suspension or revocation of your licenses and appointments: 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 cf this Code. [Section 624.11(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 (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]; 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]. 49 COUNT XXVH 103. The above general allegations are hereby realleged and fully incorporated herein by reference. 104. In or about February-March 2003 you, SUSAN HOPE PINE, as a licensed insurance agent, caused to be sold to D.R., of Hollywood, Florida, a health insurance plan through Highmark BC/BS, an unauthorized insurer or MEWA. IT IS THEREFORE CHARGED that you, SUSAN HOPE PINE, have violated or are accountable under 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: 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(1), 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 625.611(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 625.621(2), Florida Statutes]; 50 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]; 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]. WHEREFORE, you, SUSAN HOPE PINE, are hereby notified that the 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 be provided under the provisions of Sections 626.611, 626.621, 626.681, 626.691, and 626.901, Florida Statutes, and under the other referenced Sections of the Florida Statutes as set out in this Administrative Complaint. 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 Agency Clerk, at the Florida Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 32399-0333. Your written response must be received by the Department 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 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 corresponder.ce 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. R \ DATED and SIGNED this 30> day of May, 2003. Lal Vadlles KAREN CHANDLER Deputy Chief Financial Officer 54 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF PROCEEDING has been furnished to the following: SUSAN HOPE PINE, 1490 104 Avenue, Plantation, Florida 33322; SUSAN HOPE PINE, 8181 West Broward Boulevard, Suite 204, Plantation, Florida 33324; SUSAN HOPE PINE, 1370 N. University, #1370C, Plantation, Florida 33322 by Certified Mail this Sac day of June, 2003. \ cee William _W_Pharpe, Jr. Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-0333 (850) 413-4110 Florida Bar Number 312411 55

Docket for Case No: 03-002452PL