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The good, the bad, and the ugly - discover what customers are saying about Cinergy Health

Welcome to our customer reviews and complaints page for Cinergy Health. We understand that making informed decisions about where to invest your time and money can be challenging, which is why we've created this platform for our community to share their honest feedback about their experiences with Cinergy Health.

On this page, you'll find a comprehensive collection of reviews and complaints from real customers who have used Cinergy Health's products or services. Our reviews are authentic and unbiased, providing you with a complete picture of the company, its products or services, and their customer service.

Whether you're considering doing business with Cinergy Health, or you've already had an experience with them, our community's reviews and complaints will give you a valuable perspective on what to expect. Our goal is to help you make informed decisions about where to invest your time and money, and we hope that our platform will be a valuable resource for you.

Please feel free to browse our reviews and complaints and share your own experience with Cinergy Health. Your feedback is an important part of our community and will help others make informed decisions.

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10:22 pm EST
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Cinergy Health More Injustice

Now it comes out in new articles:
http://miamiherald.typepad.com/nakedpolitics/2010/10/scott-turns-to-newspapers-for-latest-attack-on-sink.html
that felons were allowed to work at this company. Yes they have been fined in NY, again, and FL, but this is just a slap on the hand. Where does this leave us, those who are in debt because of them! Large debt.

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Cinergy Health Unpaid Claims

I obtained Cinergy Health for my child and myself...They are nothing but liars! I was told that pregnancy would be covered 80-20 and they didn't even pay 20%! They are pushy, rude and inconsiderate...and they take forever to answer claims just to deny them. My doctors office got pre-approval on several charges as to how much they would cover and then the actual claim would be submitted and they would pay NOTHING AT ALL! Thanks to them we have paid out over $4600 in premiums just for a discount card! Now we are in debt about $15, 000 for all of the delivery, hospital and other required procedures or products directly connected to pregnancy! Thanks for nothing Cinergy Health!

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Cinergy Health Insurance
Sunrise, US
Jun 25, 2010 2:01 pm EDT
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Mr. T,
I'm sorry to hear there has been an issue. Please call our online complaints number at [protected] so that we may look into your issue.

Thank you.

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Mr. T in Louisiana
New Orleans, US
Jun 23, 2010 11:02 am EDT

I have unpaid claims dating back to October 2009. I have been asked 3 times to re-fax them. They admit they were received, but nothing was entered into system. I called again today, person said he has last fax and will send claims to "clearing house" and to check back in 10 days. They are friendly and helpful on phone, after you hang up things get forgotten.

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Cinergy Health Insurance
Sunrise, US
Jun 17, 2010 7:13 pm EDT
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I'm sorry that you've had a hard time. We're trying to make an engaged effort to tackle all of these tough problems and we are working with our insurance company partners to improve their procedures.

Please call our special online complains number so that we can help you get back on your feet: [protected]. Thank you for the chance to help you.

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11:22 am EDT

Cinergy Health Rip off alert

Dont use Cynergy! I got Ripped offed over $1000! The sales rep promised this and that. I got monthly fee before I got the terminal and started processing. I brought that up and was told that I would get a refund. That never happened. Then Istarted ramdon fees. I brought that up and was never resolved! When I finally decided take the loss on the cancelation fees, it took 6 months to have the account closed. During the 6 months I got a Monthly Charge! Their excuse was that they did not get my paperwork. I guess calling weekly, faxing paperwork weekly and my new company trying to contact them was not enough. When they finally got the paper work, they said the dam signature did not "match". They did try to contact me to tell me the problem. They just let it account open. I still got charged the monthly fee! My store is just mom and pop shop. Using common sense, why the heck would I leave the account open and process 1 transaction for more then 6 months? You do not have to be a business person to know that. When I finally got the stupid cancelation bill. I thought that I had to send out a check. They took Money out of the account and I got Insufficients Fund FEES! You do not want to deal with companies who send ot sales reps to trick their customers. I guess they rather get the cancelation fees then long term realationship and possible futures customers! My family and I work very hard. I do not want anyone else to be taken advantage of like I was.

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patti wood
powell, US
Mar 30, 2010 9:33 am EDT

drafting payments out of my account after i asked them to stop due to my workers comp check comming at different times this caused my bank to charge me a over draft fee twice and cinergy says sorry cannot help you do not buy anything from this co. the tell you one thing and do another

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checkthisout
, US
Oct 21, 2011 10:43 pm EDT

I totally agree Cinergy is a huge rip off. If you are think about using them you may as well take that money and through it in the river and watch it float away getting nothinig in return accept the Privilege of watch it float away with no retun or benfits to you, Because that is exactly what Cinergy offers a big fat NOTHING!

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Cinergy Health Scam

Once again, Cinergy does not pay (except for very trivial things) so watch out and avoid them. I consider their product to be a huge scam affecting who knows how many of us. And worse, it is difficult to see them getting away with it year after year!

Actually I live in CA. I did not realize that when submitting a complaint here that state selected means where we live. As posted in previous posts, I was sold insurance by Cinergy Health Inc., which is based in FL. I am wondering how many other people have been affected in CA. Please feel free to contact me with such information.

I was encouraged to find out that the state of Arkansas had issued a cease and desist order against this company. However, as they had not sold any insurance in Arkansas (or CA or almost anywhere) of the "limited" variety, the order has been revoked. Investigators and attorneys in AR determined (and I am not sure how) that all people having the insurance knew it was limited. In my opinion this means that they are still not aware of how limited it is.

Folks, they DO NOT pay your hospital bills or anything that is significantly expensive as is indicated that they DO in the rather deceptive adds. There are many exclusions but if you do not read the fine print carefully you will be in for a rude shock.

If they have scammed you, do not feel stupid. These people are good at what they do, have been doing it for years and getting away with it. Sad but true. Their management team has lawyers and when one reads the CVs of these guys or who their PR firm is (see the article by Craig Malisow in the Houston Press on this Company, which describes all of the players, and don't miss Craig's blog on the head of the PR firm. These are scary people.

And will the health care reform help us? I don't know. I also feel that Arkansas withdrawing from the whole thing is sad, as they have made sure no new people are hurt, but what about those of us who have lost thousands and thousands of dollars because of Cinergy?

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Update by bfowler
Feb 08, 2010 9:42 pm EST

This company operates on deceptive advertising. They are an advertising company, not a Health Insurance company. They are backed by entities such at American Medical and Life Insurance (AMLI) or Guarantee Trust Life
(GTL). It is a limited insurance plan. They do not pay for anything significant, like the hospital or er. They prey on the desperate amongst us, those who have no insurance or have been turned down for something as small as a prescription medication. I did not find out what was up until a year and a half later, they did not pay my hospital bill. I called and was told 1)computers were down 2) the hospital did not submit the bill correctly and then finally, that 3) I was stupid as I did not realize what they were. They have tried to buy me off with $500 which I consider a bribe. My bill is over $12, 000 and I lost over $5K in premiums, all removed from my account by Cinergy as American Med. is not licenced in CA where I live.

Update by bfowler
Apr 29, 2010 3:47 am EDT

Yes about Arkansas. They decided it was not needed as Cinergy was not selling anywhere, their horrible limited plan.

Update by bfowler
Mar 31, 2010 1:47 am EDT

Check this out on their website

http://www.cinergyhealth.com/management.asp

The credentials of the people who did all this to us are intimidating to say the least. Lest someone think this is slander, it IS on their website. You all might also find googling videos of commercials they have aired to be...er... amusing in a black humor kind of way. I did not ever see the TV commercials, just what is/was on the Internet. I found it amusing to see a Google advertisement for them on the same page as a complaint! Now THAT is ironic isn't it?

All I can say to anyone is please be more careful than I was. If only I knew then what I know now! Then none of this would have happened to me. I had no clue what trouble I was getting into.

So BEWARE this company and any that have the same song and dance over the phone. You will learn to recognize it if you shop for insurance very long. I am shopping again since realizing I have NO insurance after discontinuing my alliance with Cinergy, and wow, there are a lot of other companies out there to get us if they can. Always check with your state Commissioner of Insurance first. It is nice that these websites exist where the burned can warn others.

Update by bfowler
Mar 30, 2010 8:33 pm EDT

Interesting News. The state of Arkansas has issued a cease and desist order against Cinergy Health Inc. and American Medical and Life (AMLI) their underwriter. They have a new underwriter which I hear is Guarantee Trust and Life (GTL) which will not in my opinion make anything better. Somehow another Entity called American Trade is in trouble also. See:

http://www.insurance.arkansas.gov/Administration/newsreleases/index.htm

click on "news releases, " the most recent additon called

Consumer Alert: Suspension Order Filed Against Company Marketing Fraudulent Insurance Products [protected])

Not only are the government entities involved in catching these guys but they are warning the citizens of their state to avoid them if they already have fake insurance with them.

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debbie gagon
Las Vegas, US
Sep 09, 2009 6:11 pm EDT

this company is not valid in Nevada the second time i pulled it up.
Also my doctor will not take me with this insurance and the salesnan
outright said she is on the list of providors. when i tried to cancel i had to pay over $9.00 to select a button on the phone. i have disputed the change and now i have to cancel in writing or by fax and i have no information on contacting them other than phone. is there anyone who can help me please?
Thank you,
Deb

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Tobi
San Jacinto, US
May 12, 2010 1:32 pm EDT

I am a CA resident and went with Cinergy last August(2009). I went with them cause I was pregnant and they took people with pre existing conditions. In January I called Cinergy to verify my RX info and found out that they got a new underwritter in Nov 09 and i was never notified. They then continued to notify me that my maternity coverage was cancled and i was not covered for any pregnancy related visits since nov 15 09. Well, long story short... I filed a complaint with the insurance commisioner of CA and nothing has happened to this date. Oh ... byt the way .. they continued to take my monthly premium during this time. Now, I have medical bills building up and no way to pay them. I have been looking for an attorney to help and cant seem anyone who wants to touch this issue.
Please contact me if you have similar issue and know of anyone who can help us. tt33182@yahoo.com

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Cinergy Health Insurance
Sunrise, US
May 07, 2010 8:36 am EDT
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At Cinergy Health, we work with insurance companies to deliver the type of coverage people need for their personal circumstances and to avoid being uninsured. With either a limited benefit health insurance plan or a short term medical plan, customers can be more prepared for common medical expenses as a result of illness or injury.

We've setup a special phone line to handle all of our online complaints, questions and concerns. Please contact someone from our online support team at [protected].

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:29 pm EDT
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Hi Bill, Thank you for your feedback. I'm sorry that you've had a hard time. We're trying to make an engaged effort to tackle all of these tough problems and we are working with our insurance company partners to improve their procedures. So we've setup a special number you can call to reach somebody on our team. Call [protected] so we can get you back on your feet. Thank you for the chance to help you.

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:15 pm EDT
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We wanted to inform you that the Arkansas order was rescinded by the Arkansas Insurance Commissioner. We at Cinergy Health aim to provide customer support for all online questions, complaints and general concerns. For more information, please don’t hesitate to visit us at www.cinergyhealth.com or call us at [protected] anytime. Thank you.

Here's the link:
http://insurance.arkansas.gov/LEGAL%20DATASERVICES/orders.htm

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Bill McPike
Auberry, US
Feb 01, 2010 10:25 am EST

I saw this on Bloomberg Financial News. I bought into this in June 2008 for about $270. per month. I had one Dr. visit and one ER hospital visit. I got a check for about $60. for
the Dr. visit which I believed was covered. When the Hospital checked for billing Cinergy,
it had changed it claims phone number, so it couldn't be contacted by the hospital. Finally
a few months later, I received a check for $100.00 for that visit and that was it. My bill
of over $2, 000. went to collections. I cancelled in June 2009, after paying about $3, 000.00 to Cinergy and getting $160.00 coverage. I was and am, very upset.

As anyone can see, if I had not obtained this coverage, I would have had a net savings and my bills would have been paid by myself, instead of paying Cinergy.

Bill in CA [protected]

Cinergy Health, Inc.
Cinergy Health, Inc.
Aventura, US
Sep 11, 2009 11:41 am EDT
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Dear Deb,

We sincerely apologize for any inconvenience you experienced. The Cinergy Health agency license number for the State of Nevada is 563114. The underwriter, American Medical and Life Insurance, is a Nevada-licensed insurance company. This information can be verified by calling the Nevada Division of Insurance at [protected].

Your complaint states that your doctor would not accept the insurance although you had been told the doctor is on the list of providers. According to our investigation, however, you did not identify any providers at the time of sale and you were not told about any specific doctor being on a list of providers. You were told at the time of sale that this plan allows you to go to any provider of choice. As stated in your member handbook, “To receive care you may go to any doctor, urgent care center, hospital, lab or diagnostic facility of your choice and qualify for coverage. You are not required to visit network providers in order to receive coverage.

If you have any questions about your plan coverage, membership status, how to access care or if you need to file a claim for covered services, please call Member Care Services toll-free at [protected].”

Regardless of whether the member or the provider submits the claim, the plan will pay up to the benefit limit toward that covered visit. The list of providers does not guarantee that the provider will agree to file the claim on the member’s behalf. Unfortunately, many providers are very limited as to which companies they will work with. In that situation, the member can still receive claims payments by filing the claim themselves with the help of Member Care Services.

Your complaint mentions that you were charged over $9 to “select a button on the phone.” That aspect of your complaint is unclear; we do not charge a cancellation fee and we do not charge members for speaking on the phone with Member Care Services. We have no technical ability to charge anyone a fee for selecting a button on the phone. The $9.00 fee mentioned appears to be an issue between you and your telephone company.

All cancellations must occur in writing for the protection of our members. Cancellations by fax can be sent to: [protected]. Cancellations by mail can be sent to:

Cinergy Health, Inc.
10251 W. Oakland Park Blvd.
Sunrise, FL 33351

We again apologize for any inconvenience. If you have any questions, please contact Member Care Services at [protected].

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Cinergy Health More Comments

Regarding my earlier post, I must say it's about time something happened. Hooray for Arkansas!

As to we who live in other stated than FL, NY and now AR, we will just have to wait and see what happens. You really must go see the latest incarnation of their website at cinergyhealth.com. They still claim alliance with AMLI and it is also interesting to check out the link to the page on management. Scroll to the bottom and click on About Us and then on Management. What an array of intimidating credentials we see here!

I do hope those of you who live in CA do voice your complaints to the Commissioner's office. Our current commissioner is Steve Poizner who is also running for Governor of CA. I imagine the more they hear from us the better, as I heard that was how the ball got rolling in Arkansas. Or if you live somewhere else find your state's commissioner. File that report and get a case going. I hope to see results in my state as appropriate as we see in Arkansas, NY and FL.

And remember, this is NOT the only company out there selling these pretty useless, expensive (in most of our experiences) products.

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Just new information here: As a result of this and their deceptive advertising practice they lost their BBB membership in the state of Florida. (www.seflorida.bbb.org) "BBB Comments & Analysis: Bureau's Comments and Analysis of Company's Business: On February 17, 2010, this companies [sic] membership in the BBB was revoked by the BBB’s Board of Director...

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Cinergy Health non-payment

DO NOT PURCHASE CINERGY HEALTH INSURANCE!
Consider yourself warned! They dont pay your healthcare providers, PEROID!. My wife needed surgical proceedures which were approved before hand by Cinergy. They didn't pay the surgeon hospital or the anesthesiologist. The total bills we now owe are over
$70, 000. Thats right seventy thousand dollars!
The suregon no longer accepts Cinergy because of our case.
Luckily he doesn't deny her care, now we pay him out of pocket.
CINERGY PROVIDES NOTHING BUT EXCUSES! THEY CLAIMED THEY NEVER RECIEVED BILLS FROM OUR PROVIDERS! THEY WON'T ACCEPT CERTIFIED MAIL CONTAINING THESE INVOICES.
STAY AWAY FROM CINERGY!1

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:21 pm EDT
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Hi Mike, Thank you for your feedback. I'm sorry that you've had a hard time. We're trying to make an engaged effort to tackle all of these tough problems and we are working with our insurance company partners to improve their procedures. So we've setup a special number you can call to reach somebody on our team. Call [protected] so we can get you back on your feet. Thank you for the chance to help you.

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Cinergy Health misrepresentation

I had cinergy health insurance. their underwriter got canceled I received a letter stating one of their reps will call me as soon as they had another underwriter. One did he explained the new insurance, and that it would be going up 52 more dollars. He asked me how I wanted to pay for checking, credit card. I use automatic debit . I asked him when they would start to take the money. He said right away or a few days depending on my bank. I said I couldn't afford that amt. right now and I still had coverage with them for two weeks more. I asked if they could take it out on the 20th of each month like I had before. He said no it had to be paid for now, and they he couldn't set up the time of month, but he said to hang up after our call and call their customer service. he said he would not put my checking acct. info in. thus leading me to believe I could call customer service and work it out with them.. I called and their customer service told me He should not have signed me up if I said I couldn't afford it. But they would have to investigate the my recorded conversation. and they would take 3 to 5 days for them to get back to me. well 2 days later they took the money out of my account.. I AM SO ANGRY. I am going to call back tomorow since it will be 5 days.. If I get no where I am going to try the ca. state insurance commissioner.. Maybe nothing will happen But I am going to cancel this insurance if I get no response tomorrow.. So BEWARE of this insurance company, , ,

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:26 pm EDT
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Hi k white, Thank you for your feedback. I'm sorry that you've had a hard time. We're trying to make an engaged effort to tackle all of these tough problems and we are working with our insurance company partners to improve their procedures. So we've setup a special number you can call to reach somebody on our team. Call [protected] so we can get you back on your feet. Thank you for the chance to help you.

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A Mad Consumer
Long Beach, US
Feb 13, 2010 3:34 pm EST

I know, they did the exact same thing to me, except 4 days after they took my money out of my bank account I received an email telling me that they are canceling the policy completely. They have my money and I have nothing. I have stated a blog at http://membersreview.blogspot.com

Go with an Insurance company. This company is nothing more than a coupon book vendor and they pretty much admit it. They do not contact with anyone for anything.

Run away as fast as you can !

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1. The salesperson misrepresented the information about coverage and about the facts about my current health insurance: a. The salesperson said that Chiropractic Care was covered in the plan. When I went to use my insurance for Chiropractic care, I was told on the phone that Chiropractic Care was not covered and only covered one office visit not including...

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Cinergy Health Rude Salesperson

I called Cinergy Health for health insurance as they were advertising insurance for $6.00 a day. They took my number and a rep. called me back today. His name was Larry Sullivan. He was rude and very pushy. I also wanted info to look over and he said to use the website. I told him I would and call him back. He insinuated I would not know how to use the website. Also the price was well over $6.oo a day. He also said pre-existing things were covered. The website says not for 6 months. I think any insurance that wants a fee up front, knows you will cancel and just takes your money.

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:46 pm EDT
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Hi Lillian,
Thank you for your feedback. I'm sorry that you've had a hard time. We're trying to make an engaged effort to tackle all of these tough problems and we are working with our insurance company partners to improve their procedures. So we've setup a special number you can call to reach somebody on our team. Call [protected] so we can get you back on your feet. Thank you for the chance to help you.

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tom white
, US
Aug 31, 2009 5:51 pm EDT

New York State
Insurance
Department
New York State seal
NEWS
RELEASE
Contact:
Public Affairs
[protected]
www.ins.state.ny.us

Kermitt J. Brooks Acting Superintendent of Insurance 25 Beaver Street New York, N.Y. 10004
ISSUED: AUGUST 13, 2009 FOR IMMEDIATE RELEASE
GOVERNOR PATERSON TAKES ACTION AGAINST MISLEADING SALES OF LIMITED BENEFIT HEALTH INSURANCE PLANS
Health Insurer Fined $700, 000 for Misleading Sales Practices; Insurance Department Blocks Sale of Limited Benefit Health Plan

* Limited benefit health plans often pay far less than those who buy them expect
* National TV ad squashed
* Broad crackdown on misleading sales practices announced
* Another company suspends sales
* Hearings planned on usefulness

Governor David A. Paterson announced today that New York is cracking down on companies that sell limited benefit health insurance plans in ways that mislead people into believing they have full heath insurance coverage. As a result, the New York State Insurance Department has moved to protect New Yorkers by stopping one company from selling the product in New York and from advertising nationally and is examining the marketing practices of all companies selling this product.

"Many New Yorkers are desperate for affordable health insurance. More than 2.5 million have no coverage, and with tens of thousands losing their jobs, that number is growing. Unfortunately, some businesses are taking advantage of that need to sell limited health insurance in ways that mislead consumers into believing they are getting full coverage. If they get seriously ill, consumers who buy this product can find themselves with huge bills they are unable to pay. New York will not allow disreputable businesses to take advantage of consumers, " Governor Paterson said.

"At Governor Paterson's direction, the Insurance Department has taken a number of steps to protect consumers, " Acting New York State Insurance Superintendent Kermitt J. Brooks said. "Especially in this economic climate, we will not allow consumers to be twice victimized - first by paying for insurance that covers much less than they were told it would, then by having to pay thousands more for the health care that insurance did not cover."

Governor Paterson announced the Department fined one company, American Medical and Life Insurance Company (AMLI), $700, 000 for numerous violations, and imposed new restrictions on the company. The company can no longer sell its limited benefit products in New York, and has been forced to pull its nationwide television commercial. The commercial was the company's main marketing tool.
"We are working to help AMLI customers and we urge anyone who has had a problem to call the Insurance Department so that we can help, " Brooks said, noting that the company is now cooperating with the Department.

Brooks said AMLI agreed to:

* Discontinue all of its limited medical benefit group policies in New York;
* Offer to convert terminated group policies to individual policies upon request;
* Fully cooperate with the Department in resolving customer complaints;
* Retain an independent outside counsel to review its operations and make specific recommendations for changes; and
* Prepare a compliance monitoring plan to ensure compliance with applicable laws and regulations.

Limited benefit health insurance plans normally provide less than comprehensive hospital/medical coverage, but with healthcare bills being the leading cause of personal bankruptcy filings nationally, many consumers searching for affordable coverage buy limited benefit health plans as one way to insure against potential liability. Limited benefit health plans may leave consumers with large medical bills. If injury or illness occurs and an insured files a claim, they may find that they have less coverage than they thought (see Appendix A for comparisons).

A sampling of complaints received by the Insurance Department about AMLI's coverage illustrates this gap:

* A Rochester-area woman purchased health insurance from a telemarketer and agreed to have the $419 a month premiums paid by automatic charges to her credit card. She was provided no written documents spelling out details of the coverage. Soon afterward, she needed hospitalization, which cost nearly $28, 000. It turned out the policy, sold by an agent unlicensed in New York, paid only $1, 164 of the expenses. AMLI paid in full only after the Department intervened.
* A young man suffered a stroke at the age of 36. AMLI paid only $250 toward his medical bills. The insured had to pay a total of $29, 917.04.
* A woman went to the emergency room with stomach pains and a day later received an appendectomy. AMLI paid $1, 416.10, leaving the insured a balance of $19, 437.59.
* After being given misleading coverage information by an agent, a man purchased a limited medical benefit plan from AMLI. He understood, and the information sent to him indicated, that the plan required a $10 co-pay for doctors/specialists (10 covered visits per family member per calendar year) and would pay $25, 000 for hospital inpatient services (100 days maximum per calendar year). Therefore, he was surprised to find that AMLI only paid $39.65 toward an ENT bill for $237.42 and $250.00 toward an inpatient hospital bill for $3092.73. His total medical bills were $4197.79 and AMLI paid $807.29. With regard to the hospital stay, AMLI contended that the insured should have known that a $250 per day limit applied to the $25, 000 limit for hospital inpatient services, since the maximum days were limited to 100. AMLI agreed to pay only after the Department intervened.
* A man bought a limited medical benefit plan issued by AMLI. When he bought the policy, he was told that there would be a $20 co-payment for doctor's visits and a $100 co-payment for emergency room services. He was not made aware of any other limitations on his benefits and never received a Summary Plan description from the carrier. AMLI paid less than he expected for two hospital emergency room visits. The first time, the bill was $1, 720.61 and AMLI paid $150. AMLI denied the second claim for $731 saying the emergency room benefit maximum had been met because it was his third visit to the emergency room that year. Only when he complained to the company was he told that emergency room benefits were limited to a maximum of two visits per policy year and a maximum of $150.00 per visit. After the Insurance Department intervened, the company agreed to pay the remainder of his claim.

The actions against AMLI were triggered by an Insurance Department investigation begun after consumers complained to the Department, Brooks said:

* The Department investigated American Medical and Life Insurance Company after receiving consumer complaints about a limited medical benefit plan sold by the company. The company is licensed to sell this product and other life and health products in 38 states and the District of Columbia.
* The company describes itself as a "virtual" insurance carrier, outsourced all underwriting, sales and marketing and claims handling functions to third parties, and exercised little or no oversight of such functions.
* The investigation revealed that AMLI violated numerous New York insurance law provisions in its sales and marketing of the limited medical benefit plan from the fall of 2006 through the fall of 2008:

o Sold thousands of limited benefit plans to New York residents using unlicensed agents employed by telemarketing firms located in New York and Florida.
o Received approval in New York to use a written policy application form that contained important disclosures about limitations in the coverage, but then conducted its New York sales via Internet and phone without using the approved application form.
o Sold many of its policies as group coverage through an association known as the National Congress of Employers, which the Department determined violated New York law because the association was not formed and maintained for a primary purpose other than selling insurance.
o Conducted a nationwide marketing campaign through an intermediary called Cinergy Health, Inc. that, in violation of New York Insurance Law, created the misleading impression that the limited benefit plan offered major medical or comprehensive coverage.
o The company continued to use the misleading advertising as part of its national marketing campaign, even after the Department had the company stop such marketing in New York.

Governor Paterson announced further Insurance Department action:

* Another insurer has agreed to suspend sales of a similar product nationally while the Insurance Department investigates its marketing practices.
* The Department will consider whether to propose new regulations to guarantee consumers are properly informed about just how restricted limited benefit health insurance plans may be.
* The Department directed insurance companies to provide information to the Department about any limited benefit health plans they sell in New York.
* The State will hold public hearings to determine if the proper course is tighter regulation or banning the product completely.

In addition to the limitations inherent in these policies, marketing and sales practices surrounding them may add to the confusion, Brooks said. Many limited benefit plans are solicited via the Internet and through television commercials. Some of these advertisements imply the policies provide comprehensive or major medical coverage. Exclusions and policy limits are not completely revealed. The sales are completed via the Internet or telephone without the benefit of a written application, circumventing specific disclosures that are required by New York Law. The mandatory disclosures are either not provided, are not prominently displayed or are lost during the sales pitch and thus are ineffective. Investigations have also revealed that some policies are sold through telemarketing firms using unlicensed agents, which is in violation of New York Insurance Law.

"We will hold hearings to look at the larger issues surrounding limited benefit health plans, " Brooks said. "Are they being sold properly? Should they be sold at all? What else can we do to protect New Yorkers? We want to hear what the public thinks about these plans."

Hearings are scheduled for September 21 in New York City, September 24 in Newburgh and September 30 in Rochester. More information on the hearings, including how to testify, is available at the Insurance Department's website at www.ins.state.ny.us.

Consumers with insurance questions or concerns can call the Insurance Department's consumer hotline at [protected]. The hotline is open from 9 a.m. to 4:30 p.m. Monday through Friday. Consumers may also ask questions or file complaints at the Insurance Department's website, www.ins.state.ny.us.
###
APPENDIX A
AVERAGE SERVICE COST/AMLI COVERAGE COMPARISON
Services New York State Average Cost American Medical and Life Insurance: National Congress of Employers Group Plan Coverage

Hospital Room & Board

$5, 516- average daily charge
(*Includes insured & self insured data & excludes Medicare and Medicaid)

$1, 000 / day
(max. 30 days)

Diagnostic Tests-High tech (MRI, PET, CT, etc.)

$1150-$2500 (MRI)
$500-$1250 (CT Scan)
$850-$4200 (PET Scan)
(*www.comparemricost.com and www.americanwellnessandimaging.com)

$100 per day
(max. 3 test days/yr)

Diagnostic Tests-Low tech (x-ray, lab, etc.)

$83-$1, 100 per test

Included in above

Doctor’s Office Visit

$45-$150 (minor problems)
$84-$185 (low to moderate severity)
$130-$250 (moderate to high severity)
$200-$355 (moderate to high severity, more complex)
$373-$550 (moderate to high severity, highly complex)
(* Taken from The Attorney General’s Report “The Consumer Reimbursement System is Code Blue” (2009))

$100 per visit (max. 5 visits/yr)

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Return to 2009 News Index

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Cinergy Health Scammers

I am SO glad I checked here before telling my desperate friends about this option - I think I saw this on the Internet. I've learned to check it out. If I may offer some assistance - I am a life and health insurance agent (very new to the business, but...) and I totally recommend working with an experienced life/health agent with at least 10 years in the business. I also want to bring to people's attention the low cost option of Aflac insurance. Go to the web site - www.aflac.com. Full disclosure - I am working with this company. My story - I was in a car accident 10 years ago - did not break a bone, and it took me until LAST YEAR to figure out that my symptoms were caused by traumatic brain injury. I could not get any help from doctors for many years for my strange symptoms. I REALLY wish I had known about Aflac - the key is, you gotta have the policies BEFORE you get sick or injured, but it's never too late... So here's the deal - Aflac pays you cash for accidents or illness - depending on the policy you buy. I am not gonna make any money from telling you this - i don't WANT to make money from you - I am just wanting everyone to know that there is a low cost financial cushion available. For some policies, you need to have health insurance, but the Accident, Dental and Vision (dental and vision have some waiting times, Accident is immediate) you can at least have a bit of breathing room financially. Go check it out! I hope this helps.

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Kventin
, US
May 07, 2009 12:58 pm EDT

The TV add and the person who finally calls you back would have you believe you are getting a real good deal on health insurance covering doctor.hosp. dental, and prescriptions. What you really get for the advertised $6 a day or in my case $8 or $240 a month is just a discount card you still have to pay for all treatment and services exc. In my opinion this plan is a giant ripoff and was grossly misrepresented in the TV ad and by the sales person on the phone.

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:38 pm EDT
Verified customer This comment was posted by a verified customer. Learn more

Cinergy Health provides affordable health insurance options so that people around the country don't have to be uninsured. We understand that health insurance and healthcare reform can be complicated and confusing. At Cinergy Health we partner with insurance companies to deliver unique insurance solutions to help cover the cost of medical care. Our website can help you understand some of the plans available - visit www.cinergyhealth.com right now, or call us at [protected] so we can better understand your needs and explain who we are and how we can help you. Thank you for your time.

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Cinergy Health Insurance
Sunrise, US
Apr 08, 2010 2:34 pm EDT
Verified customer This comment was posted by a verified customer. Learn more

Cinergy Health provides affordable health insurance options so that people around the country don't have to be uninsured. We understand that health insurance and healthcare reform can be complicated and confusing. At Cinergy Health we partner with insurance companies to deliver unique insurance solutions to help cover the cost of medical care. Our website can help you understand some of the plans available - visit www.cinergyhealth.com right now, or call us at [protected] so we can better understand your needs and explain who we are and how we can help you. Thank you for your time.

T
T
tom white
, US
Aug 31, 2009 5:50 pm EDT

New York State
Insurance
Department
New York State seal
NEWS
RELEASE
Contact:
Public Affairs
[protected]
www.ins.state.ny.us

Kermitt J. Brooks Acting Superintendent of Insurance 25 Beaver Street New York, N.Y. 10004
ISSUED: AUGUST 13, 2009 FOR IMMEDIATE RELEASE
GOVERNOR PATERSON TAKES ACTION AGAINST MISLEADING SALES OF LIMITED BENEFIT HEALTH INSURANCE PLANS
Health Insurer Fined $700, 000 for Misleading Sales Practices; Insurance Department Blocks Sale of Limited Benefit Health Plan

* Limited benefit health plans often pay far less than those who buy them expect
* National TV ad squashed
* Broad crackdown on misleading sales practices announced
* Another company suspends sales
* Hearings planned on usefulness

Governor David A. Paterson announced today that New York is cracking down on companies that sell limited benefit health insurance plans in ways that mislead people into believing they have full heath insurance coverage. As a result, the New York State Insurance Department has moved to protect New Yorkers by stopping one company from selling the product in New York and from advertising nationally and is examining the marketing practices of all companies selling this product.

"Many New Yorkers are desperate for affordable health insurance. More than 2.5 million have no coverage, and with tens of thousands losing their jobs, that number is growing. Unfortunately, some businesses are taking advantage of that need to sell limited health insurance in ways that mislead consumers into believing they are getting full coverage. If they get seriously ill, consumers who buy this product can find themselves with huge bills they are unable to pay. New York will not allow disreputable businesses to take advantage of consumers, " Governor Paterson said.

"At Governor Paterson's direction, the Insurance Department has taken a number of steps to protect consumers, " Acting New York State Insurance Superintendent Kermitt J. Brooks said. "Especially in this economic climate, we will not allow consumers to be twice victimized - first by paying for insurance that covers much less than they were told it would, then by having to pay thousands more for the health care that insurance did not cover."

Governor Paterson announced the Department fined one company, American Medical and Life Insurance Company (AMLI), $700, 000 for numerous violations, and imposed new restrictions on the company. The company can no longer sell its limited benefit products in New York, and has been forced to pull its nationwide television commercial. The commercial was the company's main marketing tool.
"We are working to help AMLI customers and we urge anyone who has had a problem to call the Insurance Department so that we can help, " Brooks said, noting that the company is now cooperating with the Department.

Brooks said AMLI agreed to:

* Discontinue all of its limited medical benefit group policies in New York;
* Offer to convert terminated group policies to individual policies upon request;
* Fully cooperate with the Department in resolving customer complaints;
* Retain an independent outside counsel to review its operations and make specific recommendations for changes; and
* Prepare a compliance monitoring plan to ensure compliance with applicable laws and regulations.

Limited benefit health insurance plans normally provide less than comprehensive hospital/medical coverage, but with healthcare bills being the leading cause of personal bankruptcy filings nationally, many consumers searching for affordable coverage buy limited benefit health plans as one way to insure against potential liability. Limited benefit health plans may leave consumers with large medical bills. If injury or illness occurs and an insured files a claim, they may find that they have less coverage than they thought (see Appendix A for comparisons).

A sampling of complaints received by the Insurance Department about AMLI's coverage illustrates this gap:

* A Rochester-area woman purchased health insurance from a telemarketer and agreed to have the $419 a month premiums paid by automatic charges to her credit card. She was provided no written documents spelling out details of the coverage. Soon afterward, she needed hospitalization, which cost nearly $28, 000. It turned out the policy, sold by an agent unlicensed in New York, paid only $1, 164 of the expenses. AMLI paid in full only after the Department intervened.
* A young man suffered a stroke at the age of 36. AMLI paid only $250 toward his medical bills. The insured had to pay a total of $29, 917.04.
* A woman went to the emergency room with stomach pains and a day later received an appendectomy. AMLI paid $1, 416.10, leaving the insured a balance of $19, 437.59.
* After being given misleading coverage information by an agent, a man purchased a limited medical benefit plan from AMLI. He understood, and the information sent to him indicated, that the plan required a $10 co-pay for doctors/specialists (10 covered visits per family member per calendar year) and would pay $25, 000 for hospital inpatient services (100 days maximum per calendar year). Therefore, he was surprised to find that AMLI only paid $39.65 toward an ENT bill for $237.42 and $250.00 toward an inpatient hospital bill for $3092.73. His total medical bills were $4197.79 and AMLI paid $807.29. With regard to the hospital stay, AMLI contended that the insured should have known that a $250 per day limit applied to the $25, 000 limit for hospital inpatient services, since the maximum days were limited to 100. AMLI agreed to pay only after the Department intervened.
* A man bought a limited medical benefit plan issued by AMLI. When he bought the policy, he was told that there would be a $20 co-payment for doctor's visits and a $100 co-payment for emergency room services. He was not made aware of any other limitations on his benefits and never received a Summary Plan description from the carrier. AMLI paid less than he expected for two hospital emergency room visits. The first time, the bill was $1, 720.61 and AMLI paid $150. AMLI denied the second claim for $731 saying the emergency room benefit maximum had been met because it was his third visit to the emergency room that year. Only when he complained to the company was he told that emergency room benefits were limited to a maximum of two visits per policy year and a maximum of $150.00 per visit. After the Insurance Department intervened, the company agreed to pay the remainder of his claim.

The actions against AMLI were triggered by an Insurance Department investigation begun after consumers complained to the Department, Brooks said:

* The Department investigated American Medical and Life Insurance Company after receiving consumer complaints about a limited medical benefit plan sold by the company. The company is licensed to sell this product and other life and health products in 38 states and the District of Columbia.
* The company describes itself as a "virtual" insurance carrier, outsourced all underwriting, sales and marketing and claims handling functions to third parties, and exercised little or no oversight of such functions.
* The investigation revealed that AMLI violated numerous New York insurance law provisions in its sales and marketing of the limited medical benefit plan from the fall of 2006 through the fall of 2008:

o Sold thousands of limited benefit plans to New York residents using unlicensed agents employed by telemarketing firms located in New York and Florida.
o Received approval in New York to use a written policy application form that contained important disclosures about limitations in the coverage, but then conducted its New York sales via Internet and phone without using the approved application form.
o Sold many of its policies as group coverage through an association known as the National Congress of Employers, which the Department determined violated New York law because the association was not formed and maintained for a primary purpose other than selling insurance.
o Conducted a nationwide marketing campaign through an intermediary called Cinergy Health, Inc. that, in violation of New York Insurance Law, created the misleading impression that the limited benefit plan offered major medical or comprehensive coverage.
o The company continued to use the misleading advertising as part of its national marketing campaign, even after the Department had the company stop such marketing in New York.

Governor Paterson announced further Insurance Department action:

* Another insurer has agreed to suspend sales of a similar product nationally while the Insurance Department investigates its marketing practices.
* The Department will consider whether to propose new regulations to guarantee consumers are properly informed about just how restricted limited benefit health insurance plans may be.
* The Department directed insurance companies to provide information to the Department about any limited benefit health plans they sell in New York.
* The State will hold public hearings to determine if the proper course is tighter regulation or banning the product completely.

In addition to the limitations inherent in these policies, marketing and sales practices surrounding them may add to the confusion, Brooks said. Many limited benefit plans are solicited via the Internet and through television commercials. Some of these advertisements imply the policies provide comprehensive or major medical coverage. Exclusions and policy limits are not completely revealed. The sales are completed via the Internet or telephone without the benefit of a written application, circumventing specific disclosures that are required by New York Law. The mandatory disclosures are either not provided, are not prominently displayed or are lost during the sales pitch and thus are ineffective. Investigations have also revealed that some policies are sold through telemarketing firms using unlicensed agents, which is in violation of New York Insurance Law.

"We will hold hearings to look at the larger issues surrounding limited benefit health plans, " Brooks said. "Are they being sold properly? Should they be sold at all? What else can we do to protect New Yorkers? We want to hear what the public thinks about these plans."

Hearings are scheduled for September 21 in New York City, September 24 in Newburgh and September 30 in Rochester. More information on the hearings, including how to testify, is available at the Insurance Department's website at www.ins.state.ny.us.

Consumers with insurance questions or concerns can call the Insurance Department's consumer hotline at [protected]. The hotline is open from 9 a.m. to 4:30 p.m. Monday through Friday. Consumers may also ask questions or file complaints at the Insurance Department's website, www.ins.state.ny.us.
###
APPENDIX A
AVERAGE SERVICE COST/AMLI COVERAGE COMPARISON
Services New York State Average Cost American Medical and Life Insurance: National Congress of Employers Group Plan Coverage

Hospital Room & Board

$5, 516- average daily charge
(*Includes insured & self insured data & excludes Medicare and Medicaid)

$1, 000 / day
(max. 30 days)

Diagnostic Tests-High tech (MRI, PET, CT, etc.)

$1150-$2500 (MRI)
$500-$1250 (CT Scan)
$850-$4200 (PET Scan)
(*www.comparemricost.com and www.americanwellnessandimaging.com)

$100 per day
(max. 3 test days/yr)

Diagnostic Tests-Low tech (x-ray, lab, etc.)

$83-$1, 100 per test

Included in above

Doctor’s Office Visit

$45-$150 (minor problems)
$84-$185 (low to moderate severity)
$130-$250 (moderate to high severity)
$200-$355 (moderate to high severity, more complex)
$373-$550 (moderate to high severity, highly complex)
(* Taken from The Attorney General’s Report “The Consumer Reimbursement System is Code Blue” (2009))

$100 per visit (max. 5 visits/yr)

Link to homepage
Return to 2009 News Index

R
R
RogerDodger2009
Las Vegas, US
Jul 25, 2009 2:07 pm EDT

Major medical is EXACTLY what most of us uninsured people need and as the comment from Cinergy says, Cinergy DOES NOT offer ANY such coverage. From my personal experiences with current Health Plans today in the USA, all the ones i paid have problems. Health Plan of Nevada failed to pay one doctor for visits they approved and when i needed an eye exam, they sent me to a Gynecologist (true story)! Another plan turned out to be a discount card for $40 a month. I later found out that some doctors and hospitals will negotiate reduced rates for their services if you simply ask them BEFOREHAND. Bottom Line: I hope congress & Obama make major changes to our current health system.

Cinergy Health, Inc.
Cinergy Health, Inc.
Aventura, US
Jul 22, 2009 6:06 pm EDT
Verified customer This comment was posted by a verified customer. Learn more

Truthi….we apologize that we don't allow independant agents to represent and sell Cinergy Health insurance plans. I hope you current career goes well for you. For your personal knowledge and gain, we also have an accidental benefit that is included in our Cinergy Health insurance plans. Please visit www.CinergyHealth.com to learn more. If you have any further questions, then please call us at [protected], or email us at info@cinergyhealth.com.

Cinergy Health, Inc.
Cinergy Health, Inc.
Aventura, US
Jul 22, 2009 5:56 pm EDT
Verified customer This comment was posted by a verified customer. Learn more

Kventin, in regards to your claims that Cinergy Health is a ripoff, please review the membership materials we sent you or review our website at www.CinergyHealth.com, and understand that Cinergy Health is not a discount plan, but rather we are a licensed health and life insurance agency in all 50 states and D.C. While we do not offer major medical insurance, we do provide a limited medical benefit insurance plan that is designed with the intention of delivering meaningful and defined health insurance coverage at rates that are more affordable than those associated with major medical insurance. While the plan you have choosen may cost $240 a month, we do offer plans as low as $186 a month, which is approximately $6 a day.

We understand that our health plans may not be suitable for everyone. Therefore, we ask that every healthcare consumer make a thorough personal assessment to determine if a limited medical plan is sufficient to meet their own healthcare needs. As with most things it is often a trade-off between cost and the extent of coverage you get. Unfortunately for many, the choice is difficult because of the rapidly increasing cost of major medical health insurance.

If you have any further questions or would like to discuss this, then please call us at [protected] and ask to speak with the Chief Compliance Officer (x105), or email us at info@cinergyhealth.com.

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I HAVE TRIED TO LOOK UO THE LEGITAMACY OF THEIR COMPANY VIA THE DEPTS. OIF INSURANCE IN FLORIDA AND LOUISIANA . THEY DO APPEAR AS A COMPANY REGISTERED / LICENSED TO DO BUSINESS. I HAVE ASKED THEIR ( CINERGY HEALTH ) PHONE REPS TO PROVE THEIR VALIDITY AND ALL I AM TOLD IS THAT JUST LOOK UP THEIR WEBSITE: CINERGYHEALTH.COM. I SEE NOTHING THAT PROVES THEY...

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