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Simple Health

United States of America vs. Steven Dorfman, Candida L. Girouard, and John A. Sand

United States District Court for the Southern District Of Illinois

Criminal No. 22-CR-30024-SMY

UPCOMING EVENTS: Following an 11-day jury trial, defendants Dorfman and Sand were convicted of one count of conspiracy to commit mail and wire fraud, four counts of mail fraud and eight counts of wire fraud. Girouard pleaded guilty to conspiracy to commit mail and wire fraud on Nov. 30, 2023.

Dorfman’s sentencing hearing is scheduled for 10:30 a.m. on May 21, 2024, Sand will be sentenced at 10:30 a.m. on May 22, 2024, and Girouard’s sentencing is scheduled for 10:30 a.m. on May 15, 2024. All three sentencings will take place at the federal courthouse in East St. Louis.

Sentencing hearings are open to the public. Victims wishing to address the Court or present the Court with information prior to sentencings are encouraged to contact the U.S. Attorney's Office by emailing USAILS.VW_ILS@usdoj.gov.

PREVIOUS EVENTS:  This case is set for trial and scheduled to begin on Jan. 29, 2024, with Judge Stephen P. McGlynn presiding at the U.S. District Courthouse, 750 Missouri Ave., in East St. Louis, Illinois. This is a public proceeding and open to the public. As of this update, the trial is expected to last three weeks.

On Feb. 23, 2022, Dorfman, Girouard, and Sand were charged with various federal fraud offenses.  The thirteen count indictment charges Dorfman, Girouard, and Sand with conspiracy to commit mail and wire fraud, in violation of Title 18, United States Code, Section 1349, mail fraud, in violation of Title 18, United States Code, Section 1341, and wire fraud, in violation of Title 18, United States Code, Section 1343.  Steven D. Weinhoeft, United States Attorney for the Southern District of Illinois, announced the charges.  If convicted, Dorfman, Girouard, and Sand are subject to maximum penalties of up to 30 years in prison on the conspiracy count, and up to 20 years in prison on the mail and wire fraud counts.

The charges arose from the defendants’ participation in a south Florida business known as Simple Health (also known as Health Benefits One).  Simple Health was a telemarketing business that sold health insurance policies over the phone.  The vast majority of the policies sold by Simple Health were limited indemnity plans.  Limited indemnity plans have a relatively low cap on the amount of medical expenses they will cover.  After those caps are reached, the patients are responsible for paying 100% of their medical expenses out of their own pockets.

The indictment alleges that Simple Health employed a deceptive sales script to trick people into purchasing the limited indemnity plans.  Among other things, the script required the Simple Health salespersons to tell the customers that:  “The whole idea of this plan is to make your out of pocket expenses as low as possible . . . .” and “When all is said and done, you end up with pennies on the dollar!!”  Relying on these and other false and misleading representations, thousands of people across the country purchased limited indemnity plans from Simple Health.  According to the indictment, after customers purchased these policies, they frequently called Simple Health’s Customer Service Department and complained that (1) that they had incurred significant medical expenses that they had been led to believe would be covered, but were not; (2) that their doctors and hospitals did not accept the limited indemnity plans; and (3) that their prescription drug costs were not covered, contrary to what they were told when the purchased the policies.

The indictment alleges that from May 4, 2012, through November 1, 2018, Simple Health sold policies to over 400,000 people nationwide, generating revenues to Simple Health of more than $190,000,000.  Simple Health sold 1,175 policies to individuals residing in all 38 counties that comprise the Southern District of Illinois.

According to the indictment, Dorfman was an owner of Simple Health.  Girouard worked as the Chief Compliance Officer for the business.  Sand held the position of Vice President of Sales.  The charges against Dorfman, Girouard, and Sand are further described in the indictment, which is attached below.

An indictment is a formal charge against a defendant.  Under the law, a defendant is presumed to be innocent of a charge until proven guilty beyond a reasonable doubt to the satisfaction of a jury.

 

Updated March 6, 2024