January 13, 2022 - OAKLAND – California Attorney General Rob Bonta on Wednesday announced a lawsuit against The Aliera Companies (Aliera) and the Moses family – the family that founded Sharity Ministries, Inc. (formerly called Trinity Healthshare, Inc.), a nonprofit corporation that purported to be a health care sharing ministry (HCSM). Aliera, a for-profit corporation, created, operated, and sold unauthorized health plans and insurance through Sharity/Trinity, collecting hundreds of millions of dollars in monthly premiums from thousands of Californians and others throughout the country. However, rather than paying its members’ healthcare costs, the company declined claims and retained nearly 84% of its members’ contributions – leaving many crushed by the burden of impossible medical debt.
“Aliera preyed on consumers who, in many cases, thought their monthly payments were being used to help others who shared their faith and religious beliefs. Instead, Aliera and the Moses family funneled its members’ payments into their own pockets,” said Attorney Rob General Bonta. “When members suffered medical emergencies, their problems were compounded by Aliera claiming it had no obligation to pay medical costs. Aliera’s sham business is unlawful and our lawsuit seeks to ensure they are held to account to pay the price for the Californians they lured in and cheated.”
“These allegations provide a chilling reminder of the dark days of health insurance, when some companies took advantage of people by offering Swiss-cheese coverage that was full of holes, when benefits were routinely rejected and people were left with enormous medical bills,” said Peter V. Lee, executive director of Covered California. “The good news is that Californians do not need to put themselves and their families at risk because Covered California’s open enrollment period is underway right now, and thanks to the American Rescue Plan, comprehensive coverage has never been more affordable.”
Last year, after receiving multiple complaints from consumers alleging that their HCSM plans refused to cover treatments and pay their medical bills, Attorney General Bonta issued a consumer alert warning Californians about illegitimate HCSMs.
Prior to the passage of the Affordable Care Act (ACA), HCSMs allowed people to pool their money with others who shared their religious beliefs in order to assist one another during times of medical crisis. After the ACA was passed, the Covered California health insurance marketplace was established, giving uninsured Californians access to quality, affordable, and ACA-compliant health insurance.
Some companies also began to capitalize on the exemption of HCSMs from many of the coverage mandates in the ACA by marketing their plans as a less-expensive alternative to ACA-compliant health insurance. However, unlike plans through the Covered California marketplace, HCSMs do not guarantee payment for covered services or coverage for essential health benefits, like birth control, prescriptions, preexisting conditions, and mental health care.
Aliera, however, has never fit the legal definition of an HCSM, which among other requirements, mandates that HCSMs be an IRS 501(c)(3) nonprofit in existence since December 31, 1999. Instead, today’s complaint alleges that Aliera falsely represented Sharity/Trinity as a legitimate HCSM that satisfied the ACA’s standards for exemption.
Members of Sharity were led to believe their monthly payments were going toward the healthcare costs of fellow members when in reality Aliera retained nearly 84% – leaving about 16 cents of every dollar for member expenses. Aliera also routinely rejected member requests for payment of their healthcare costs, leaving many consumers with thousands of dollars in medical debt. In contrast, ACA plans are required to spend 80% or 85% of premiums on medical care.
In today’s complaint, Attorney General Bonta alleges that Aliera violated California law by making false or misleading statements about Sharity that led consumers to believe its HCSM plans were being used to pay members’ healthcare costs and provide coverage similar to that of a traditional ACA health insurance plan.
In addition to today’s lawsuit against Aliera, 14 states and the District of Columbia have initiated actions against the company. In 2020, the California Department of Insurance also issued a cease-and-desist order to stop Aliera from selling new plans in the state. However, Aliera continued operating plans for existing members in California until Sharity entered bankruptcy in 2021.
A copy of the complaint is available here.
Source: CA. DOJ