Bupa Florida OFAC Settlement: $128.7K (2014)

BIC issued health insurance policies or otherwise provided health insurance coverage to persons designated on the SDN List as SDNTs or SDNTKs. BWW and USAMED provided insurance support services for healthcare policies covering SDNTs and SDNTKs, and processed and paid reimbursement claims made by a policyholder for medical treatments in Cuba. Bupa Florida misinterpreted the scope and application of the regulations administered by OFAC and did not monitor or screen health insurance policyholders, dependents, or providers against the SDN List.

Following the designation of Jorge Mario Paredes Cordova as an SDNTK on June 1, 2007, BIC continued to provide health insurance coverage for Paredes Cordova as a dependent on an existing policy and subsequently renewed the policy on three separate occasions until it was cancelled by the policyholder on January 15, 2011. Although the name, date of birth, and country of residence in BIC's records for Paredes Cordova matched the information on the SDN List, BIC failed to identify Paredes Cordova as an SDNTK.

For a policy issued by a non-U.S. Bupa insurer to Daniel Gonzalez Munoz — designated as an SDNTK on January 12, 2005 — BWW serviced two policies over three policy periods in 2008 and 2009 by transmitting policy documents, maintaining policy records, preparing accounting reports, processing premium payments, and making two claim payments; USAMED provided claims processing services over two of the policy periods, processing four claims in total.

On December 3, 2008, and February 18, 2009, USAMED processed a reimbursement claim made by a policyholder for medical treatments in Cuba, and BWW made a reimbursement payment to the policyholder.

Bupa Florida engaged in 16 apparent violations of the FNKSR (transactional value $51,275.48), 21 apparent violations of the NTSR (transactional value $124,671.20), and two apparent violations of the CACR (transactional value $14,726), occurring between March 26, 2008, and March 1, 2011.

OFAC determined that Bupa Florida voluntarily self-disclosed the apparent violations and that the apparent violations constitute a non-egregious case. The base penalty amount for the apparent violations was $95,337. The settlement amount of $128,704 reflects OFAC's consideration of aggravating and mitigating factors pursuant to the General Factors under OFAC's Economic Sanctions Enforcement Guidelines, 31 C.F.R. part 501, app. A.

Bupa Florida misinterpreted the scope and application of the regulations administered by OFAC and did not monitor or screen health insurance policyholders, dependents, or providers against the SDN List. OFAC identified the absence of an OFAC compliance program at the time of the apparent violations as an aggravating factor. The Paredes Cordova example illustrates the exposure: the name, date of birth, and country of residence in BIC's records matched the information on the SDN List, yet BIC failed to identify him as an SDNTK and continued to provide coverage and renew the policy following his designation.

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