Important Update: The claim filing deadline has been extended to February 23, 2022.
What is the Settlement About?
“Limited benefit indemnity plans” and ancillary products such as “medical discount plans” (collectively “LBIPs”) are not considered comprehensive medical insurance, and they do not comply with the Affordable Care Act (“ACA” or “Obamacare”). Plaintiffs brought the Action alleging that a group of Florida companies and individuals led Plaintiffs and other consumers nationwide to believe that LBIPs were major medical insurance. Plaintiffs allege, among other things, that Simple Health and Nationwide Health lured Plaintiffs and other consumers with websites and standardized sales scripts that misled Plaintiffs and other consumers to believe they were buying major medical insurance, when in reality they were only buying LBIPs. Plaintiffs allege that Defendants knew what Simple Health and Nationwide Health were doing, and assisted the acts by, among other things, reviewing the sales scripts and loaning Simple Health and Nationwide Health money in the form of advance commissions. Defendants, Health Insurance Innovations, Inc. (“HII”), Health Plan Intermediaries Holdings, LLC (“HPIH”) (collectively, the “HII Defendants”), and Michael Kosloske (“Kosloske”), vigorously deny that they did anything illegal or wrong.
This Settlement is a compromise of these and other claims described in the Settlement Agreement. For a more detailed description of the lawsuit, see FAQ 3.
Who is Included?
The Settlement Class includes all individuals who purchased the HII Defendants’ limited benefit indemnity plans and/or ancillary products such as medical discount plans through Simple Health or Nationwide Health within the applicable statute(s) of limitation, and paid fee(s) and/or a premium(s) that were not completely recovered through a refund or chargeback.”
The Court has already decided that members of the Settlement Class may also make a claim to be included in the “Medical Expense Subclass” and/or the “Tax Penalty Subclass”. The Medical Expense Subclass includes all members of the Settlement Class who incurred uncovered medical expense(s). The Tax Penalty Subclass includes all members of the Settlement Class who incurred a penalty under the ACA's individual mandate provisions.
For a more detailed description of the Settlement Class, see FAQ 7.
What Does the Settlement Provide?
The HII Defendants, which are now known as Benefytt Technologies, Inc., have agreed to create a $27.5 million Settlement Fund. If the Settlement receives final approval, the Settlement Fund will first be used to pay (1) Court-awarded attorneys’ fees, reimbursement of costs, and Service Awards; (2) Notice and Administration Expenses; (3) Taxes, if any; and (4) any other costs, fees, or expenses approved by the Court. The term “Notice and Administration Expenses” means all costs, fees, and expenses incurred in connection with providing Notice and distributing the Settlement proceeds to the Settlement Class. The money remaining after these fees and costs are deducted is the Net Consideration.
HII Defendants have also agreed to various business practice changes, such as requiring all sales agents to record and maintain all sales calls.
Each Settlement Class Member who timely submits a valid Claim Form and does not opt out of the Settlement shall receive his or her pro rata share of the Settlement Fund. The actual amount that each Settlement Class Member will receive will ultimately depend on a variety of factors, including the fees and expenses awarded by the Court and expended by the Settlement Administrator, the number of Settlement Class Members who choose to opt out of the Settlement, the number of Subclass Members and the number of Settlement Class Members who timely return a Claim Form.
For more information about the benefits provided by settlement, see FAQ 12.