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According to the court, Zanfei and Crouse, with the help of South Dakota
accounting firm Wohlenberg, Ritzman & Co. LLC, sold illegal or improper health
care expense reimbursement plans - - the HI Plan and the HealthIER Plan - - to
hundreds of employer-customers. The court concluded that the defendants
knowingly misrepresented the tax benefits to employees and employers in selling
these plans. According to the government’s complaint, the IRS estimated that the
defendants’ schemes cost the U.S. Treasury losses of between $12 million and $63
million and would cause ongoing losses of between $6 million to $24 million per
year if the defendants were not stopped.
The court also found that the defendants told employers that they could avoid
employment tax by contributing to such plans. Employees purportedly would also
avoid employment tax and would receive the amounts back by seeking
reimbursement of health care expenditures. The court found that defendants made
numerous false statements in promoting the plans and improperly administered
them. For example, materials supplied to employees as part of defendants’ plans
listed “athletic shoes,” “electrolysis,” “health club fees,” “soaps,” and “day care” as
reimbursable expenses. The court noted that expenses such as these are reimbursable
as health care expenses only in rare circumstances. Moreover, the court found that
the defendants often reimbursed medical expenses without substantiating them. The
court also found that defendants’ HI Plan was illegal because it allowed
reimbursement for health insurance premiums as opposed to out-of-pocket health
care expenses.
The court also noted that the Department of Labor filed a suit in an Indiana federal
court against Zanfei and Crouse for violating their fiduciary duties under the
Employee Retirement Income Security Act (ERISA) by using employees’ monthly
health insurance premiums to pay for personal expenses. The federal court enjoined
them from acting as ERISA fiduciaries. Since 2001, the Justice Department’s Tax
Division has obtained more than 210 injunctions to stop the promotion of tax fraud
schemes and the preparation of fraudulent returns. Information about these cases is
available at http://www.usdoj.gov/tax/taxpress2006.htm. Information about the
Justice Department’s Tax Division is available at
http://www.usdoj.gov/tax/index.html.
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06-842