Benefytt to refund $100M to customers who paid for sham health plans

Benefytt Technologies, along with two subsidiaries, former Chief Executive Gavin Southwell, and former Vice President of Sales Amy Brady, lied to consumers “about their sham health insurance plans” and used “deceptive lead generation websites to lure them in,” the FTC alleged in a press release Monday. Benefytt also made it difficult to cancel plans and services, including those they did not order.

Benefytt and Southwell were repeatedly warned by the company’s compliance professionals that sales representatives from Benefytt and a major subsidiary misled customers about the health plans offered, according to a complaint filed by the FTC in U.S. District Court for the Middle District of Florida. Those warnings were ignored, the complaint stated. The practices began when Southwell, a former chief risk officer for a large independent global wholesale and reinsurance brokerage, joined the company, the FTC said.

From 2016-21, Benefytt allegedly used deceptive websites to fool customers into thinking they were buying federal government-backed health insurance plans through the Obamacare platform. Instead, they were sold sham healthcare plans that were not connected to or supported by Obamacare. Later, the company also misrepresented its healthcare plan offerings as being connected to “Trumpcare,” a healthcare platform which the FTC noted in its complaint does not exist.

The company’s compliance department’s requests to improve practices by examining sales scripts or conducting onsite inspections were regularly ignored, the FTC said. In 2016, a Benefytt compliance executive told Southwell in an email Brady’s assurances about third-party vendor Simple Health were “becoming a daily joke” due to the vendor’s alleged deceptive and unfair sales practices, the complaint said.

Brady continued to prevent Benefytt compliance personnel from assessing the compliance of the sales scripts used by Simple Health, according to the FTC. “Not until the FTC sued Simple Health in 2018 and obtained a temporary restraining order putting the company out of business did defendants finally terminate their relationship with the distributor,” the agency said.

Benefytt also allegedly “refused to implement processes that … would enable them to root out their agents’ misconduct,” such as collecting the full recordings of sales calls.

Internal complaint data and reviews of individual sales personnel confirmed the breadth of problems regarding the firm’s misleading and deceptive practices, but it did not take steps to correct the issues, the complaint said.

In June, Health Insurance Innovations, which later became Benefytt, and Southwell agreed to pay $12 million to settle charges laid by the Securities and Exchange Commission they had misrepresented the robustness of the company’s compliance program while simultaneously misleading investors about numerous customer complaints lodged against it.

Benefytt did not respond to a request for comment.