THE "FIRST ENROLL" SCAM

in #scamlast year

scammers.jpg

My wife fell for the First Enroll scam AGAIN.

When we got scammed last time (Feb 28, 2023 for $296.50), I put a complaint on BBB (which I do not see) and now she got scammed by the same company again (Sep 11, 2023 for $752.09). Two times in the same year. She was scammed by a guy named Clement Noll ([email protected])(561-613-9187) at the "Health Service Center". He claimed he was selling her an "Aetna Insurance plan with Dental and Vision". He actually sold us an "Accidental Death and Dismemberment" policy and a discount plan called "America First Choice 100" (https://accessonedmpo.com/), which is NOT INSURANCE.

She did the same thing last time. Clement Noll used First Enroll to bill us AGAIN. Clement Noll works for Synergy Insurance Affiliates LLC (SIABENEFITS.COM)(844-475-0169)
Company Agent: Vcorp Services, Llc https://www.floridareg.com/company/L22000430056/synergy-insurance-affiliates-llc https://www.bbb.org/us/fl/boca-raton/profile/insurance/synergy-insurance-affiliates-llc-0633-92031557
https://www.floridareg.com/company/P05000028483/access-one-consumer-health-inc

"Access One Consumer Health, Inc. is a Discount Medical Plan Organization - this is not insurance and payment is due at time of service."

First Enroll claims ignorance: "First Enroll does not advertise insurance nor do we sell insurance. You are regrettably confusing First Enroll (your premium billing company) with your insurance agent and agency. We do not sell insurance. We have nothing to do with the sales process what-so-ever and we do not represent any of the products provided by your carrier." The scam is perpetrated by various companies and scam artists, but the single unifying element is that they all use First Enroll to perform the instant billing.

Yet the plan they are billing us for is not insurance. On page Six of the agreement, it says: "The plan is not insurance; The plan provides discounts at certain healthcare providers for medical services; The name and address of the licensed discount medical plan organization: Access One Consumer Health, 84 Villa Road, Greenville, SC 29615; 800-896-1962; www.AccessOnedmpo.com. THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance. This plan does not meet the minimum creditable coverage requirements under M.G.L. c.111M and 956 CMR 5.00. This plan is not a Qualified Health Plan under the Affordable Care Act."

The way to avoid getting scammed is: 1) Get their State Insurance License number 2) Read all documents from top to bottom 3) Do not pay over the phone. Say goodbye, read over the documents at your leisure, and then get back to him. The First Enroll Scam relies on the instant billing of First Enroll. Actual insurance does not require instant billing. An actual insurance company will send you a bill.

BBB REPORT ON Synergy Insurance Affiliates LLC, 350 Camino Gardens Blvd. Ste 201, Boca Raton, FL 33432 888-634-0185:

1a. COMPLAINT ONE 08/02/2023: Yesterday, August 1st 2023 at about 3:26PM, I was coerced over the phone into purchasing insurance when I said multiple times I only wanted an estimate. I was asked for a credit card "to have on file" and was told there would be no charge, and a charge appeared immediately. In addition, I signed a contract that presents itself as an agreement for health insurance, but upon closer inspection: stipulates that I may not refute any charges made to my card, that I must submit in writing cancellation requests to two different companies in order to cancel the policy, and that I must mail back an ID card that I have not received in order to cancel the policy. Furthermore, the contract directly states that the service provided is not health insurance when I was lead to believe that it was over the phone. In addition, an add-on package was added without my knowledge or consent, and the contract stipulates I must go through an entirely separate process to cancel that as well. I called the customer service line within 20 minutes of being charged in order to cancel the policy. The first time I called I was put on hold for over 16 minutes and was not returned to. I called again and was immediately hung up on. I called a third time and was told that the policy was "in underwriting" and to call back today, the 2nd of August in order to cancel. Now when I call, my carrier tells me "call failed" as though I have been blocked. I emailed them promptly after this, and received a prompt reply that "The cancellation process has been initiated and to wait several business days". After the behavior I have seen so far, I am doubtful that they will return to me. All I want is to cancel the policy and it appears that Synergy Insurance Affiliates intends to make it impossible for me to do so.

1b. RESPONSE ONE: we apologize your experience with us did not meet your expectations. Before enrollment and purchasing a plan, it is a requirement all licensed agents send out a document that pertains terms and conditions of the policy. By signing the terms and conditions, this grants the licensed agent authorization to charge the payment method given. Listed at the top of the terms and conditions, there is a paragraph that pertains disclosures for the specified Health Insurance Coverage given. The Insurance policy given was bundled with a discount card for Telemedicine. Listed in the "Billing Authorization" section of the terms and conditions it states; "You certify that you are an authorized user of this credit card or bank account and that you will not dispute the scheduled payments with your ******************* or bank provided the transactions correspond to the terms indicated in this authorization". For cancellation requests, it is a requirement for the Plan Administrator to contact the insurance carrier in writing based on the consumers request and the phone number listed is for the consumer to call to conduct the request. All consumers are entitled to a free trial period of 30 days. According to our call records, it shows the cancellation request was submitted and the initial payment was returned. Please let us know if there is anything else we can do to make this right. Thank you.

2a. COMPLAINT TWO 06/13/2023: I cancelled this policy on 4/18 because it is a scam. No providers take this and it is not insurance. They have taken money out of my account since May. I spoke to shaya. She would not give me her last name nor the address nor the owners name. The attachment shows that they refunded my payment in *****. The only reason they would have refunded me In ***** was because I cancelled this insurance. They will not refund my ***** ** May. Thank you.

2b. RESPONSE TWO: We apologize that your experience with us did not go as expected. As an Insurance Agency, we are contracted with different insurance carriers that utilize different networks. Depending on the time of enrollment, the sales agent conducts a search and finds a plan that best fits the consumer based on their health history. The network search shows over 60 providers around your area. According to your account, two refunds were issued back to the payment method you provided us initially. Please reach out to us if you need further assistance.

Synergy Insurance Affiliates LLC phone numbers 888-634-0185, 844-475-0169 are telnyx.com numbers. Pay as you go: "Make outbound calls: $0.002 per minute + the SIP Trunking fee for outbound calls."

Jouxel L Urquia finally sent my wife an email that states "This email is to notify you that the following request for your cancellation had been submitted over to the carrier. Please keep in mind all cancellation requests are subject to the order that it is received. During the process of the cancellation, the carrier will determine in regards to any refunds. PLEASE understand we do not have any jurisdiction or authorization in regards to any refunds as for we are only able to submit requests for cancellations. Once the cancellation request has been reviewed, an email confirmation will be sent to the email address on file confirming the status of your request."

It took two hours of waiting and battling Customer Service Representatives. She spoke to Jouxel L Urquia, who refused to cancel their fake insurance until she provided all the details for her new coverage. He claimed that "Hippa Rules" required that "the carrier" (AccessOnedmpo.com: "THIS PLAN IS NOT INSURANCE and is not intended to replace health insurance") be informed of coverage gaps. He offered the fake insurance as an add-on (which is all it is) and even offered to lower the monthly premium.

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