FTC Obtains $195 Million Judgment, Permanent Ban on Telemarketing and Selling Healthcare Products Against Simple Health Plans LLC Over Charges It Sold Sham Health Insurance
FTC charged that Simple Health claimed to offer health care insurance with comprehensive coverage and instead effectively left most consumers uninsured
WASHINGTON, DC (STL.News) The Federal Trade Commission has obtained a $195 million judgment against Simple Health Plans LLC and its CEO, Steven J. Dorfman, over charges they duped consumers into signing up for sham health care plans that did not deliver the coverage or benefits they promised and effectively left consumers uninsured and exposed to limitless medical expenses.
In granting the FTC’s motion for summary judgment, the Federal District Court in the Southern District of Florida also banned Simple Health Plans, five related entities and Dorfman from telemarketing and from marketing, promoting, selling or offering any healthcare products.
“Simple Health preyed on consumers by selling them bogus health care insurance that cost them thousands of dollars for ‘benefits’ that, in fact, left consumers unprotected,” said Samuel Levine, Director of the FTC’s Bureau of Consumer Protection. “We are pleased the court recognized this blatant bait and switch and ordered the company and its CEO to turn over the money they bilked from consumers.”
In a complaint filed in 2018, the FTC said that Florida-based Simple Health Plans misled people into thinking they were buying comprehensive health insurance that would cover preexisting medical conditions, prescription drugs, primary and specialty care treatment, inpatient and emergency hospital care, surgical procedures, and medical and laboratory testing. In reality, most consumers who enrolled reported paying as much as $500 per month for what was actually a medical discount program or extremely limited benefit program that did not deliver the promised benefits and often left consumers with thousands of dollars in uncovered medical bills, or worse yet, unable to get necessary healthcare.
The court found that Dorfman and Simple Health, along with Health Benefits One LLC, Health Center Management LLC, Innovative Customer Care LLC, Simple Insurance Leads LLC, and Senior Benefits One LLC, violated the FTC Act and the agency’s Telemarketing Sales Rule.
The court ordered that all of their assets, which have been frozen since November 2018, be liquidated and all the proceeds be turned over to the FTC, which is expected to use the money to provide refunds to consumers. In addition to the banned conduct, the order also prohibits any misrepresentations in the sale of any good or service. The defendants are also prohibited from collecting any money for any healthcare product they previously sold and are required to destroy any personal information they collected about their customers.
Simple Health’s Chief Compliance Officer Candida Girouard agreed in February 2021 to settle the FTC’s charges. As part of that settlement, Girouard is banned from marketing, promoting, or selling any healthcare-related products, from making misrepresentations in connection with the sale of any good or service, and from violating the FTC’s Telemarketing Sales Rule.
The litigation was handled by Elizabeth Scott, Joannie Wei, Purba Mukerjee, and Jim Davis from the FTC’s Midwest Regional office.
SOURCE: FTC (02-09-2024)
