ALJDEC - Licensing
25A-042-INS · Department of Insurance and Financial Institutions - Insurance · 2025-10-15
IN THE OFFICE OF ADMINISTRATIVE HEARINGS
In the Matter of:
Adriana Garcia
(National Producer Number 19878539)
Respondent.
No. 25A-042-INS
ADMINISTRATIVE LAW JUDGE DECISION
HEARING: September 25, 2025
APPEARANCES: Assistant Attorney General Raya Gardner appeared
on behalf of the Department of Insurance and Financial Institutions - Insurance
(hereinafter, “Department”). Respondent Adriana Garcia did not appear.
ADMINISTRATIVE LAW JUDGE: Velva Moses-Thompson
EXHIBITS ADMITTED INTO EVIDENCE: Department’s Exhibits 1 through 14.
_____________________________________________________________________
FINDINGS OF FACT
On May 21, 2025, the Department issued a Notice of Hearing and
Complaint setting the above-captioned matter for hearing at 9:00 a.m. on June 26, 2025 at the Office of Administrative Hearings (hereinafter “OAH”) in Phoenix, Arizona.
2. The matter was continued to September 25, 2025.
3. On July 28, 2025, the OAH issued an order notifying the parties at their addresses of record that the hearing was continued, and would convene at 9:00 a.m. on September 25, 2025 through Google Meet.
4. A hearing was held on September 25, 2025.
5. Respondent did not appear at the scheduled time and the matter was
convened in her absence at about 9:15 a.m. No communication was received by OAH on behalf of Respondent to provide notice of unavailability or to continue the hearing to a later date. There is no evidence that Complainant subsequently contacted OAH to provide an explanation for not appearing at the scheduled hearing.
6. At hearing, the Department presented the testimony of its Insurance Analyst
Investigator, Jennifer Cox (hereinafter “Investigator Cox”).
7. Respondent is a licensed Arizona non-resident insurance producer, National Producer Number 19878539.
8. On December 13, 2022, the Department issued to Respondent an Arizona non-resident insurance producer license with a line of authority in accident and health or sickness.
9. Respondent’s license is scheduled to expire on November 30, 2026.
10. Respondent’s home state is Florida.
11. Respondent’s business and mailing address of record with the
Department is 132 NW 59th Ave., apt. 102 Khalia, FL 33015. Respondent’s email address of record is [email redacted].
12. On June 8, 2023, Lori Lomen (hereinafter “Lomen”), an Arizona resident
submitted a complaint to the Department, alleging that Respondent on more than three occasions enrolled her in coverage through the marketplace without her knowledge or consent.
13. In a narrative statement to the Department on June 20, 2023, Lomen stated that her previous plan to the marketplace was expiring at the end of 2022, and beginning in January 2023, she was going to have a plan through her employer. Lomen’s June 20, 2023 narrative statement provided in relevant part, “I reached out to the marketplace to discontinue any need. I received the notice that I was enrolled into United Healthcare plan.” Lomen’s June 20, 2023 narrative statement further provided the following:
Lomen called United Healthcare in January 2023. United Healthcare. connected Lomen with the marketplace so that she could cancel the plan.
Lomen was told that the plan had been canceled.
Lomen later received another statement saying that she had been enrolled in March.
Lomen called back to the marketplace to again cancel the policy. Lomen was told that her application had been resubmitted five times in March, but they the marketplace would cancel and send her complaint to the escalation team the next month.
Lomen repeated the same action by reenrolling all over again: re-enrollment and cancellation.
Lomen was told that they couldn't go to escalation until the first had been resolved.
Lomen repeated the same process in May.
During Lomen’s call with the marketplace, she was provided with the broker's name “Adriana Garcia”, who was enrolling her in the United Healthcare plan on June 13, 2023.
14. The Department emailed Respondent notifying her of the complaint and
requested that she provide a response by July 7, 2023.
15. On July 5, 2023, Melina Brooks, an Arizona resident, submitted a
complaint to the Department alleging that Respondent enrolled her and her son in the marketplace without their knowledge or consent.
16. In the July 5, 2023 complaint, Brooks stated, “I received a letter from the
United healthcare, alerting me that I owed $570.25 for joint healthcare insurance for my son and myself. I did not purchase a policy and my son 22 years old is in short independently and has been with his insurance for over three years. I contacted United Healthcare. They directed me to the marketplace. The marketplace representative found out that this joint insurance was produced by agent Andrianna Garsia [sic] number 19878539. I have not spoken with this person and my son nor myself have signed any insurance policy documents pertaining to this insurance.”
17. On July 14, 2023 the Department sent an email to Respondent stating that
it had received a second complaint against her from another Arizona resident, alleging that Respondent accessed their insurance information via the marketplace, and then rolled them in a plan without their knowledge or consent.
18. The Department requested that Respondent provide a narrative response
no later than July 21, 2023.
19. On October 17, 2023, Respondent sent a response to the Department
that provided, in relevant part, as follows:
Based on my records, I spoke with the client on 123122. This was a lead
from one of my vendors I work with. It came form [sic] an inbound call based on my notes. She had been auto renewed by the marketplace and she was searching for better plan options as she wasn't convinced with the benefits on her current plan. I went over the needs analysis. I do with every single client based on my notes, we weren't able to find anything else so she decided to stay on the same plan with the client's verbal consent I took over as the agent on record, but I made no changes to the plan. I will attach a screenshot of health Sherpa, where it shows that she was auto-enrolled by the marketplace on 1221, which is common for clients who don't renew their plan.
20. After receiving the October 17th, 2023 email, the Department sent
Respondent another email that same afternoon, asking if she could provide a copy of the auto enrollment document on November 6, 2023.
21. Respondent sent an email response to the Department using the same
verbiage that was used in her October 17th, 2023, response to the Lomen complaint.
22. On December 7, 2023, at 9:26 a.m., the Department received an email
response from Respondent using the same verbiage that was used in the October 17th and November 6, 2023 email responses, except for the date Respondent said she spoke with the customer. In this email, Respondent said she spoke with the customer on “12/30/22.”
23. On December 7, 2023 at 9:37 a.m., Respondent sent an email to the
Department stating in part, “[f]irst, I want to apologize in advance for the delay in sending your request attach is the request regarding the Molina Brooks case. Respondent attached to the email screenshot copies of the applications for Brooks and her son and a letter addressed to Brooks from the marketplace dated December 21, 2022j. The letter stated in the first line, “You're automatically enrolled in the Marketplace plan(s) below for coverage beginning, January 1, 2023.
24. On November 6, 2024, Investigator Cox sent an email to Respondent
explaining that she was the newly assigned Department investigator to the case and requested that Respondent send records of telephone calls and contact that she had with Ms. Brooks.
25. Investigator Cox requested that Respondent provide the information by
November 15, 2024. Respondent failed to provide the information requested on December 4, 2024.
26. The Department issued a subpoena deuces tecum, requiring that
Respondent provide all records, including records of telephone communications related to the Lomen and Brooks enrollments, no later date than December 26, 2024. Respondent did not respond to the subpoena.
27. In response to the Department's request for information regarding the Lomen complaint, United Healthcare sent a letter date June 14, 2024 summarizing the
complaint and attaching a copy of their investigative findings report. The report addressed the complaints of both Lomen and Brooks. The letter stated, “This matter was referred to our disciplinary action Committee for review. The investigator assigned the case assigned to the case, attempted to reach the agent [Respondent] by email four times and twice by phone. The response to the investigative inquiry was received from the agent after the due date, as a chain of emails between herself and the investigator that offered no documentation or explanation.” The report stated that Respondent never provided documentation of the enrollment of either Lomen or Brooks. The report also stated that the investigation found the allegations of enrollment without permission to be substantiated.
CONCLUSIONS OF LAW
This matter lies within the Department’s jurisdiction.
The Notice of Hearing that the Department mailed to Respondent at her address of record was reasonable, and Respondent is deemed to have received notice of the hearing.
This matter is a disciplinary proceeding wherein the Department must prove by a preponderance of the evidence that Respondent violated the State’s Insurance Laws.
The Department has established by a preponderance of the evidence that Respondent used dishonest practices in the conduct of business in the state of Arizona, which is a violation of Ariz. Rev. Stat. § 20-295(A)(2) and (A)(8).
The Department has established by a preponderance of the evidence that Respondent’s conduct demonstrated untrustworthiness and financial irresponsibility in the conduct of business in the state of Arizona, which is a violation of Ariz. Rev. Stat. § 20-295(A) (2) and (A) (8).
Grounds exist for the Director of the Department to suspend, revoke, or refuse to renew the License pursuant to Ariz. Rev. Stat. § 20-295(A).
ORDER
Based upon the above, Respondent’s License shall be revoked on the effective date of the Order entered in this matter.
Pursuant to A.R.S. § 41-1092.08(I), the licensee may accept the Administrative Law Judge Decision by advising the Office of Administrative Hearings in writing not more than ten (10) days after receiving the decision. If the licensee accepts the Administrative Law Judge Decision, the decision shall be certified as the final decision by the Office of Administrative Hearings.
In the event of certification of the Administrative Law Judge Decision by the Director of the Office of Administrative Hearings, the effective date of the Order will be forty (40) days from the date of that certification.
Done this day, October 15, 2025.
/s/ Velva Moses-Thompson
Administrative Law Judge
Transmitted by either mail, e-mail, or facsimile to:
Maria Ailor, Interim Director
Department of Insurance and Financial Institutions - Insurance
Adriana Garcia
[email redacted]
Raya Gardner
Assistant Attorney General
Office of the Attorney General
[email redacted]
By: OAH Staff