Cinergy Health reviews and complaints

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.

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.

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.

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

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!

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

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

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].

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.

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

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]

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].

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.

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.

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 !

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.

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

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.

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.

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.

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

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.

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.

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.