You don't have to be elderly, uneducated or naive to get taken advantage of. It happened to me yesterday. Although I am not uneducated in general, I am uneducated when it comes to details about health insurance. Fortunately I was able to get educated before any serious damage was done but I am absolutely stunned at how easily I was duped. This is really long but I hope it's helpful for someone out there.
If you find yourself unexpectedly unemployed and needing to secure new health insurance within a matter of days, I have some tips to offer.
First and foremost, do NOT use this website for your search:
If you do, your phone will ring approximately every 5 minutes from sun up until sun down for at least 2 solid days. Every incoming call will display a different number so there is no effective way to block the calls. Don't do it. Trust me.
I didn't know that when I used this website yesterday to help with my health insurance search. It seemed harmless enough, the design was simple and pleasant. All I had to provide was my zip code, name, email address and phone number. Normally I never put my phone number in an inquiry form but I was certainly not opposed to receiving phone calls since we needed to get new insurance pronto.
I clicked on the button that said "Get Quote" and was immediately taken to another page where all kinds of different insurance policies were listed for comparison. I was staring glassy-eyed at all the options when I heard Jayson say those all too familiar words "let me let you talk to my wife". I was barely even aware his phone had rung.
I took the phone and the person on the other end said they were calling in response to the insurance inquiry I made online. I asked them if they were talking about the one I had just done literally 2 seconds ago...the one where the page still hadn't finished loading. They said yes. I said that's really freaky and borderline scary. They agreed.
I guess I should explain the reason I put Jayson's phone number on the form instead of mine. First of all, we have no land line, just cell phones and we like it that way. Second, I have no experience with shopping for insurance. We've always had it provided through Jayson's job where he is the insured and me & Taylor are the dependents. That is my mindset when it comes to insurance so not only did I put his phone number in the form but I put his name as well!
After a few preliminary questions I was transferred to Craig Schneider who introduced himself as a licensed agent with Health Benefits Center. I explained my situation and told him I wanted to see what my options were. The first thing he asked me is how much we're able to spend. The response on the tip of my tongue, the one I was barely able to bite back, was, "OMG Seriously??! Do you really think I'm stupid enough to tell a salesman how much I'm willing to spend?!"
Apparently I'm a lot stupider than that. Okay, maybe not stupid but most definitely uninformed. I told Crooked Craig that since we have no income we aren't able to spend anything at all but we still need insurance and I would like to know what's available. He explained that he has 16 different companies to choose from so he was confident we'd be able to find a good fit.
He began with a package that he said costs $332.83 per month. I don't know much about insurance and I know even less about Obamacare but I knew that sounded unreasonably low. However, I was willing to forgo some benefits in order to save money since that's something we're short on right now.
Crooked Craig started describing what sounded like the top of the line package. It was what he called a MultiPlan PPO with a huge network from which we could choose our doctors. We've always had a PPO so I liked the sound of that. When I mentioned the low price he explained that a MultiPlan is like a big group which helps to keep the costs down.
That sort of made sense to my unemployment traumatized brain so I let him continue.
He explained that it's through Companion Life which is well established and reputable. I've never heard of them but then I've never had to shop for health insurance so I have no idea what's out there. He also said our coverage is good nationwide, not just in Texas. That sounded great.
Then he said it includes dental and vision coverage, which sounded perfect but I began to expect the other shoe to drop at any moment.
He started rattling off all the benefits, copays, etc., which all sounded fantastic, but I had to cut him short since I really had only one major concern: prescription coverage.
Crooked Craig explained that it's a 3-tier system that will cover up to 80% of the cost of the prescriptions. He kept wandering off that topic and I had to bring him back a couple of times. I told him I was familiar with tiered plans and asked if there was a set copay amount for each tier. He said no, it's a percentage of the cost up to 80%. I wanted to ask if there was a different percentage for each tier but he kept wandering away from the topic and assured me that all the details would be forthcoming once we got signed up.
Again, I was about to let him know that I needed those details BEFORE we signed up but then he started telling me about the 30-day "free look" where we could take our time to read all the documentation and if we decide it's not going to work we will get a refund.
Getting a refund for something like that is generally a pain in the backside but we didn't have time to waste and overall it sounded too good to be true. So I told Craig that. I said, "It sounds too good to be true, what's the catch?"
He assured me there's no catch. He said one of the reasons they're able to keep costs so low is because it doesn't offer maternity coverage. I later found out that should have raised a big honkin' red flag but it didn't because I am uninformed when it comes to insurance and I pretty much ignored all the talk about Obamacare because we've always been insured through Jayson's job therefore it didn't apply us.
I know, I know. That was very foolish and I realize that now.
I told Crooked Craig I was ready to sign up and wanted more details on what it would cost. He said he would spell everything out but basically all it would take to get it started is the first month's premium plus the enrollment fee of $155 so the total would be $487.83.
Again, if I had a clue I would have known that there is never an enrollment fee when you apply for insurance but I didn't have a clue so I said okay. He did make sure to specifically ask me if any of us would be needing any kind of surgery within the next 12 months. He explained that there is a 12 month waiting period before we can receive full benefits on surgical procedures but that didn't include emergencies. If an appendix burst or one of us broke a leg, we would get our full benefits. I assured him we had no surgical needs that we were aware of. I reminded him that my one and only concern at this point was prescription coverage and he assure me I would be happy with it.
I completely failed to see anything wrong with what I was told, other than the fact that I was missing some detailed information. That didn't bother me too much since I knew I could cancel and get a refund if the details didn't please me.
I was transferred to Mario in the verification department of Health Benefits Center to complete my application. He said he was required by law to read several pages of "fine print" and to record the process. If I stopped him at any time to ask a question he would have to restart from the beginning and it would take at least 20 minutes to get through it all.
At that point I had been on the phone for over an hour already so I wasn't looking forward to another half hour of crap I wasn't even interested in hearing. Then Mario asked if I happen to be calling from a smart phone. I told him I was then he said we could save tons of time if he sent me a link to the documents and let me sign them electronically by phone.
I told him I'm a big fan of saving time so he sent me links to the documents and gave me very good instructions on how to sign by phone. He did warn me that there were a lot of pages and I would have to sign 8 or 9 times. I was good with that if it meant I got to avoid 20 minutes of listening to insignificant legalese.
I fully intended to browse though the documents because I never sign something that I haven't read and don't fully understand. That didn't really work. I was overwhelmed by the number of pages and the "fine print" is bad enough when it's full size but on a cell phone it's practically just squiggly lines. I gave up trying to read and just crossed my fingers that I wasn't signing something I would regret. Like an Amway membership.
At the end of it all Crooked Craig assured me I would be receiving email copies of everything as well has hard copies of all the detailed benefits. He said that he is my agent and he is available at any time if I have any questions whatsoever. He gave me his phone number and stressed that it was his direct line. It was an 800 number which is rarely a direct line so I asked him for his extension. He stumbled over it a little but did give me a 4-digit extension.
That whole process took over 2 exhausting hours so I relaxed while I looked over the documents that were emailed to me.
There was some confusing strangeness in the documents but really the only thing I was interested in was getting the details for the prescription coverage. I finally found the link, went to the website and began entering in each one of my prescriptions to see what my savings would be. The prescription that gives me the most trouble is the one I take for narcolepsy. Without insurance a one month supply would cost me around $600. It's like swallowing a $20 bill every day. I can get it cheaper at Walmart, it's only $594 there.
Right now I pay around $250 per month out of pocket but I was pretty sure the new insurance would be higher. I was correct. With my new insurance I would be paying $1106 per month for my prescriptions. Not ideal but still better than trying to pay for them without insurance right? That would cost me $1200 per month.
Clearly this wasn't going to work so I began to try to get in touch with Crooked Craig to cancel my policies. This proved difficult since the only options I was given when I called the 800 number were for customer service or for the operator. There was no way to enter his extension. I tried the operator, several times, and each time she connected me to his extension there was a weird artificial sounding busy signal.
I intended to try customer service but Jayson's phone was still ringing off the hook so he asked me to please answer some of the calls and make them go away. Since I decided that the policies I had just signed up for weren't going to work, we still needed insurance so I didn't mind talking to some people anyway.
I answered the next call and spoke with Sheridan from Fortegra. She was really nice and ended up being extremely helpful. I explained our situation to her then told her that I signed up for insurance that morning but found out I'm going to have to cancel it because the prescription coverage, the one thing I need most, is pretty much non-existent.
Sheridan groaned then asked, "Did you by chance sign up for a MultiPlan?"
I said, "Yes. Is that bad?"
She said, "It's not necessarily bad but it's not insurance."
Then she asked if we were asked to pay a huge enrollment fee. I told her I didn't really consider it to be huge but we were asked to pay $155. She said there is never an enrollment fee for insurance.
I did not realize this.
She then went on to explain that she talks to at least one person a day who has done exactly what I did but they usually don't realize it until they go to use their benefits and find out that they don't have any. She said it's nothing more than a discount program. She said it's really not bad to use for supplemental insurance with your major medical but if it's the only coverage we have we'll get penalized at tax time.
I told her I was shocked that I was so easily deceived. I consider myself a pretty savvy shopper and I'm not stupid so I never thought I would have been capable of falling for something like this. Sheridan said she doesn't know how these people sleep at night. She assured me that it happens daily and can happen to anyone since insurance is so confusing and most people aren't aware of the details they need to know.
She was surprised they actually sent me the documents they promised then advised me to read all that fine print. Somewhere in there it would clearly state that it is not insurance.
She was right.
I was stunned.
I told her I hadn't cancelled yet but intended to and she told me to make sure I demand a full refund or else I would report them to the Texas Department of Insurance and to the BBB. I told her I would say that then go ahead and report them anyway ;)
She did get us signed up for some actual insurance with United Health Care (the first company name I've recognized through this whole ordeal) which will work just fine. She specifically checked for how much coverage I would get on my narcolepsy medication and it was acceptable. Our premiums are about 3 times what Crooked Craig the Criminal quoted me but that's what I was expecting to pay in the beginning.
Once I got everything squared away with Sheridan I went back and started reading through Crooked Craig's documents and doing some Google investigating. Everything Sheridan told me was spot on and then some. I discovered, much to my surprise, that not only had I signed up for what I thought was major medical, dental and vision insurance, but apparently I also signed up for life insurance and an accidental death & dismemberment policy through something that looked a lot like Amway.
I knew it.
It took some digging but I was finally able to figure out what they did and the cost for it all. Crooked Craig told me I was getting medical INSURANCE along with dental and vision for $332.83 a month. Here's what I actually got:
Principle Advantage Limited Benefit Health Insurance from Companion Life Insurance Company for $181.43 per month.
Group Accident Insurance from Unites States Fire Insurance Company where Med-Sense Guaranteed Association is the policy holder and I am the certificate holder. I didn't understand what that meant but there was a glossary of terms in the paperwork. It said, "”Policyholder” means the entity shown as the Policyholder in the Schedule of Benefits." I am totally NOT making that up! Anyway, that costs $36.95 per month.
Med-Sense Guaranteed Freedom Spirit Plus Membership. Apparently I'm at the coveted Topaz Level. At first glance it looks like another insurance policy but it's actually a membership program where you can get discounted services on stuff like cell phones and car rentals and magazines and vitamins. The price for that membership that I didn't know about and don't want is $48.40 per month plus $16 per month for administration fees for a total of $64.45 per month.
Discount Medical Plan from Careington International Corporation but only the dental portion. There is a one-time enrollment fee of $30 then it's $50 per month.
That all adds up to $332.83 per month plus $155 in enrollment fees. From what I can tell I have something that calls itself health insurance from Companion Life Insurance company but is not health insurance because it clearly states that preexisting conditions are not covered for the first 30 days and hospitalization, surgery and anesthesia benefits resulting from a preexisting condition are not available for the first 12 months.
Then I have the coveted Topaz Level membership in the Med-Sense Guaranteed discount club Amway-thing. My membership includes a free $100K life insurance policy, eyecare discounts from Outlook Vision and prescription discounts from Agile Rx. For an additional charge I also have an AD&D policy from United States Fire Insurance Company. That's why Med-Sense shows to be the policy holder...they bought it from the insurance company and sort of subcontracted the benefits to me.
The AD&D policy is "signed" by Andres Canal, Agent #890000 in the state of TX. Insurance licenses are available to the public and easy to find so I did a quick search. Not surprisingly there is no agent #890000 in the state of Texas. However I did find this Texas agent:
ANDRES HUMBERTO CANAL
5300 BROKEN SOUND BLVD NW SUITE 200
BOCA RATON, FL 33487
The dental plan from Careington calls itself a discount plan and makes it clear in the fine print that it is not insurance. However it is also signed by our friend Andres Canal. The Florida license number on the document was false, of course, but I did find that his actual license number is W156369 and he's in Boca Raton, FL.
Pieces of the puzzle were starting to fall into place. I did a Google search for Health Benefits Center, where Crooked Craig said he was calling from, and found that it is located in Hollywood, FL but earlier this year they expanded their operation to Boca Raton. I learned that Steve Dorfman is the CEO and the BBB gives them an F rating.
I Googled the name of the company where all of my emails came from: Health Insurance Innovations. I found nothing interesting on the website other than the same vague insurance service offerings I've been seeing everywhere else but in their "about" section they do list their association with Med-Sense Guaranteed. A quick BBB search showed that the company has issues.
I Googled Steve Dorfman and discovered that he is also the CEO of a company called Simple Insurance Leads. More vagueness on the website but there is a BBB Accredited Business link on their website. I clicked it and it went nowhere. I searched for them on the BBB website and came up with nothing. Clearly the BBB isn't aware they have accredited this company.
From what I can tell this looks like a very large scam operation that uses licensed agents to deceive people and maybe even some legitimate insurance companies. Andres Canal has insurance licenses dating back to 2013 so I'm willing to bet that when he gets his license revoked they'll just replace him with someone else.
I called Health Benefits Center back to try to get in touch with Crooked Craig and was once again connected to a busy signal. I called back and chose the option for customer service and got a recording that gave me another phone number to call. I called that number and found myself speaking to someone at Health Insurance Innovations, where my policy emails originated.
I informed the representative that I wanted to cancel all of my policies that I just got the day before. She asked why I wanted to cancel and I told her because I was told they are insurance but they're not Obamacare compliant. She said the enrollment period doesn't start until November 1 so I can't buy Obamacare insurance right now. I told her I most certainly can buy it right now because my husband just lost his job. She stumbled over that then confirmed my cancellation and told me it could take 3-5 business days for my refund to appear in my bank account. I thanked her and hung up but couldn't understand why it would take several days for a deposit to show up when the withdrawal came out of my account the minute I gave Crooked Craig my account information.
Just to make sure all my bases were covered and I have a paper trail, I found the email address for cancelling policies and sent the following to Health Insurance Innovations:
Today is Friday but it's not quite midnight so guess what? I lied. That's okay, I'll use my extra special Topaz Level Med-Sense Guaranteed Association Amwayesque membership to send them a discounted bouquet from 1-800-Flowers.Effective IMMEDIATELY, please cancel the following policies and any other associated policies that I am not aware of. I revoke my electronic signature and any use of it to authorize further payments will be considered fraud and prosecuted as such.
Principle Advantage Member ID xxx (this includes Dental and Vision)
Freedom Spirit Plus Member ID xxx
Accident Insurance Member ID xxx
I signed up for the Principle Advantage plan which was presented to me by Craig Schneider as a major medical health insurance policy for my family. I later discovered that it is not health insurance therefore my signature was obtained fraudulently so it is now considered null and void on that policy as well as any others that I wasn’t aware I was signing up for.
I expect a FULL and immediate refund of the charges totaling $487.83 that were deducted from my bank account August 20, 2015. If this FULL refund is not back in my bank account by Friday, August 21, 2015 at midnight CDT, I will proceed with my complaints to the Texas and Florida Departments of Insurance and to the Better Business Bureau against Health Insurance Innovations, Health Benefits Center, MultiPlan, Companion Life, Med Sense Guaranteed Association, and Craig Schneider. Just to be thorough I will also include Steve Dorfman as well as Simple Insurance Leads.
I will then use my social media reach to publicly reveal the details of how I was defrauded into signing up for a non-Obamacare compliant discount program because I was told by a company representative who claimed to be a licensed insurance agent that it was major medical health insurance for my family.
I would appreciate your immediate action in this matter.