Drawing on court documents, congressional hearings and actual cases, the book provides examples of the three most prevalent forms of fraud: scams involving multiple employer welfare arrangements, employee leasing schemes, and fictitious labor unions. In addition, it examines innovations such as “24-hour plans” and coverage offered by dubious religious organizations. Two structural changes have created an environment wherein white-collar criminals are able to thrive by creating what is essentially a black market in health insurance. First, most large insurance companies have left the market as many large corporations have set up their own insurance plans, and health maintenance organizations and other managed care networks have made significant inroads into the health care market. Small business owners have seen their health insurance costs rise dramatically and many are unable to find insurance for their employees at any cost. Second, the Federal Employee Retirement Income Security Act, which was intended to make it easier for employers, labor unions and other organizations to provide health benefits to employees, contains legal loopholes that facilitate massive fraud. Abbreviations, notes, figure, index