One of the Defendants Behind Alleged Sham Health Insurance Scheme Agrees to Settle FTC Charges

One of the defendants behind an alleged sham health insurance scheme has been permanently banned from the health care business as part of a settlement with the Federal Trade Commission.

The FTC’s proposed settlement with Candida Girouard stems from an ongoing lawsuit against the Florida-based Simple Health enterprise.  The FTC alleges that the Simple Health defendants collected more than $195 million by enrolling American consumers in worthless association and discount memberships with limited benefits, leaving tens of thousands of consumers uninsured, some stuck with thousands of dollars in unpaid medical bills.

In its complaint against Simple Health, the FTC alleged that Chief Compliance Officer Girouard was an integral part of the scheme, which lured consumers through a network of deceptive websites and misled them to think they were buying comprehensive health insurance that would cover preexisting medical conditions, prescription drugs, and a host of standard care, treatments, and tests. In fact, the FTC alleges, people who enrolled in the plans later learned that the Simple Health plans were not comprehensive health insurance and did not provide the promised coverage and benefits. Consumers instead were enrolled in membership plans that provided extremely limited benefits and left them responsible for the vast majority of their medical expenses. Under the proposed settlement, Girouard is banned from advertising, marketing, promoting, offering for sale, or selling any healthcare-related products. She also is banned from making misrepresentations in connection with the sale of any good or service, and is prohibited from violating the FTC’s Telemarketing Sales Rule. The settlement includes a monetary judgment of $195.5 million, which is suspended due to her inability to pay. Girouard also must fully cooperate with the FTC and with investigations related to the case.

The FTC continues to litigate against the other defendants in the case, including Simple Health Plans LLC, five related companies, and the companies’ owner and CEO, Steven J. Dorfman. 

The Commission vote approving the proposed settlement was 4-0. The FTC filed the proposed order in the U.S. District Court for the Southern District of Florida. 

NOTE: Stipulated final orders or injunctions, etc. have the force of law when approved and signed by the District Court judge.