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Gov. Action

On August 8, 2022, the Federal Trade Commission is taking action against healthcare company Benefytt Technologies Inc, formerly known as Health Insurance Innovations, Inc., its subsidiaries, and former CEO Gavin Southwell, and former vice president of sales Amy Brady, for the following alleged violations: 

Count I: Misrepresentations Regarding the Features of Benefytt Products
Count II: Misrepresentations Regarding Charges for Benefytt Products
Count III: Unauthorized Charges
Count IV: Deceptive Telemarketing Acts and Practices in Violation of the TSR: Product Features
Count V: Deceptive Telemarketing Acts and Practices in Violation of the TSR: Product Charges
Count VI: Assisting and Facilitating Violations of the TSR: Deception
Count VII: Abusive Telemarketing Acts and Practices in Violation of the TSR: Failure to Obtain Express, Informed Consent
Count VIII: Abusive Telemarketing Acts and Practices in Violation of the TSR: Initiation of Calls to Numbers on the National Do Not Call Registry
Count IX: Abusive Telemarketing Acts and Practices in Violation of the TSR: Initiation of Unlawful Prerecorded Messages
Count X: Assisting and Facilitating Violations of the TSR: National Do Not Call Registry and Prerecorded Messages
Count XI: Failure to Disclose All Material Terms in Violation of ROSCA
Count XII: Failure to Obtain Consumers' Express Informed Consent in Violation of ROSCA
Count XIII: Failure to Provide a Simple Cancellation Mechanism in Violation of ROSCA

Plaintiff requests that the Court:
A. Enter judgment against Defendants and in favor of Plaintiff for each violation alleged in this complaint;
B. Enter a permanent injunction to prevent future violations of the FTC Act, the TSR, and ROSCA by Defendants;
C. Award monetary and other relief within the Court's power to grant; and
D. Award any additional relief as the Court determines to be just and proper.

On March 14, 2024, Benefytt agreed to a settlement that required the company to pay $100 million to provide refunds and prohibited the company from lying about its products or charging illegal junk fees. Separate orders permanently banned Benefytt’s former CEO and a former vice president of sales from selling or marketing any healthcare-related product, and the former vice president was also banned from telemarketing.

The FTC is sending checks to 463,629 consumers. Recipients should cash their checks within 90 days, as indicated on the check. Consumers who have questions about their payment should contact the refund administrator, Epiq Systems, at 888-574-3126 or visit the FTC website to view frequently asked questions about the refund process. The Commission never requires people to pay money or provide account information to get a refund.

For more information about this case please contact The Federal Trade Commission (312) 960-5634 or www.ftc.gov
(Case 8:22-cv-01794, U.S. District Court for the Middle District of Florida)


Benefytt and its agents have misrepresented the features of their products during their sales pitch, falsely indicating to consumers that their products are actually ACA-qualified plans, or provide coverage equivalent to comprehensive, ACA-qualified plans at a lower cost. Defendants have also often added fees for items that consumers do not want or agree to purchase, and continued to bill consumers for products after they request cancellation. Many consumers learn the truth about Benefytt's products only when they need the benefits Defendants promised. In some instances, for example, consumers try to schedule an appointment with a doctor or fill a prescription, only to find that the products Defendants sold them provide little or no coverage whatsoever. In other instances, consumers may incur hundreds or thousands of dollars in medical costs with the assumption they will be covered, only to later learn that the products they purchased from Defendants do not cover most or all of those costs.

In addition to the "core" products, Defendants also have sold and supported several products and services they have described as "supplemental" or "ancillary," including life and accident insurance, vision and dental discount plans, telemedicine, and fitness programs that feature exercise routines and daily health tips. The various products and services Defendants have sold and supported are
referred to collectively hereafter as "Benefytt Products." Defendants have sold and billed for many of their core and ancillary Benefytt Products with a negative option in which the consumer continues to pay a monthly fee to continue to receive the Benefytt Product unless they cancel. Third parties underwrite the insurance products that Benefytt sells and supports. Corporate Defendants are not insurers or insurance carriers, and they do not provide insurance coverage or assume any underwriting, insurance, or reimbursement risk in connection with any Benefytt Product. Benefytt also does not process, adjudicate, or pay insurance claims.

Benefytt Technologies, Inc. wholly owns Defendant Health Plan Intermediaries Holdings, LLC, as well as the various indirect subsidiary operating companies owned by Defendant Health Plan
Intermediaries Holdings, LLC, including HealthPocket, Inc., which also does business as AgileHealthlnsurance. Benefytt Technologies, Inc. has done business as Health Plan Intermediaries Holdings, LLC, Health Insurance Innovations, Inc., HealthPocket, Inc., and AgileHealthlnsurance, among other names. The Corporate Defendants have operated as a common enterprise while engaging in the deceptive and unfair acts and practices and other violations of law alleged below. The Corporate Defendants have conducted the business practices described below through interrelated companies, which have common ownership, officers, managers, and business functions. Benefytt Technologies and HPIH primarily operate out of the same location, hold themselves out as Benefytt, and have held themselves out as Health Insurance Innovations. Because these companies have operated as a common enterprise, each of them is liable for the acts and practices alleged.

Defendant Gavin D. Southwell joined Benefytt as a consultant in early 2016, and the company's then-CEO tasked him with coordinating the company's "compliance challenges" and "broader strategy" shortly thereafter. Prior to joining Benefytt, Southwell held multiple leadership positions in compliance and risk management. He served as Chief Risk Officer and then Chief Operations Officer
for a large independent global wholesale and reinsurance brokerage. Before that, he worked as a risk manager and served as Chief Risk Officer at another insurancerelated company. Southwell was named Benefytt' s President in July 2016, at which point he assumed responsibility for overseeing Benefytt' s sales and compliance departments. He added the title of CEO in November 2016. Southwell thereafter served as an officer or director of all three Corporate Defendants until he separated from the companies in approximately August 2021.

Defendant Amy E. Brady served as a Benefytt vice president and manager until approximately July 2021. Acting alone or in concert with others, she formulated, directed, controlled, had the authority to control, or participated in the acts and practices set forth in this Complaint.

In October 2018, the FTC sued one of Benefytt's largest third-party distributors, Simple Health Plans LLC ("Simple Health") and related companies, as well as Simple Health's President and Chief Executive Officer Steven Dorfman ("Dorfman"). See FTC v. Simple Health Plans LLC et al., 18-cv-62593-DPG (S.D. Fla.). The FTC alleged that Simple Health claimed to offer consumers comprehensive health insurance or its equivalent, but instead typically enrolled consumers in an assortment of lesser programs, including Defendants' limited benefit plans and medical discount memberships. In addition to the significant monthly fees they paid for Defendants' products, many Simple Health customers incurred substantial medical expenses under the mistaken belief that these expenses would be covered by the comprehensive health insurance they thought they had obtained from Simple Health.

On May 14, 2019, the court granted the FTC's motion for a preliminary injunction, finding it likely that the FTC would prevail on its claims against Simple Health and Dorfman. Specifically, the Court found that the record supported a finding that Simple Health "made a series of material misrepresentations that were likely to influence consumers' decisions to purchase" various health-related products, several of which Simple Health sold on Benefytt's behalf.