The Aliera Companies and a health care sharing ministry whose plans it promoted, Trinity HealthShare, have agreed to stop marketing in Connecticut, the state Insurance Department announced Tuesday.
The agreement comes 16 months after the department issued a cease and desist order against Trinity and Aliera, saying they illegally advertised their plans as health insurance in the state. Insurance Commissioner Andrew Mais accused the organizations of “misleading consumers and trying to avoid insurance regulation.”
The deal does not affect current ministry members, but it bars the groups from marketing their plans to new customers.
“We are seeing entities in the marketplace misleading consumers and trying to avoid insurance regulation,” Mais said Tuesday. “Consumers need protection from these practices, and the department will provide that. It is important for consumers to be cautious when they purchase health coverage or have questions or concerns. The department is always willing to verify licensing and answer questions from consumers.”
In addition to halting their marketing practices in Connecticut, Aliera and Trinity will pay the state $50,000 in penalties. In the agreement, the organizations did not admit fault but acknowledged that continuing to fight the cease and desist order “would result in protracted litigation and considerable time and expense.” The groups had appealed the order but dropped that appeal as part of the deal with the insurance department.
“Aliera and Trinity have denied in their answer the findings of fact and the conclusions of law contained in the order, but are willing to resolve the matter amicably and settle all issues raised,” the agreement states. “Aliera and Trinity agree that they will cease offering Trinity’s health care sharing programs or enrolling new members in Connecticut, provided that any current Connecticut members, who remain in good standing, who desire to retain their memberships may remain enrolled in their respective programs.”
Aliera said in a statement Tuesday that it was glad the matter has concluded.
“We’re pleased all issues raised by the department have been resolved amicably, and we look forward to providing continued service to our client, Trinity HealthShare, and the Connecticut members they serve,” the company said. “Health care sharing ministries provide a vital, more affordable alternative to expensive, traditional health insurance, and on behalf of our clients, we plan to work with the department to make more affordable health care options available to Connecticut citizens in the future.”
As the health ministries have gained popularity in recent years, drawing new members by marketing themselves as a lower-cost alternative to traditional health insurance, complaints have also multiplied against the groups.
But residents who are members of the organizations have complained about denial of coverage and non-payment of medical bills. Some say they were duped into buying the plans, believing they were purchasing health insurance. Others said they were aware the ministries did not offer traditional coverage but still expected all of their medical bills to be paid – only to find out they weren’t.
In Connecticut, the insurance department fielded 10 complaints against the organizations from March to December 2020, nearly the same number it received over a two-year stretch before the pandemic. At least four complaints have also been filed with the state Attorney General’s office since the pandemic began, and one has been filed with the health care advocate’s office. The offices have recorded a growing number of grievances in recent years.
The insurance department has received at least four complaints against Aliera since the start of the pandemic, records show, while the attorney general’s office has received at least four in that time period. Three complaints have been filed with the insurance department against Trinity HealthShare in that timeframe.
A bill now under consideration in the General Assembly would prohibit anyone licensed by the state’s insurance department from conducting business with a health care sharing ministry. It would also bar everyone – regardless of their position – from accepting money for selling or marketing a ministry plan to Connecticut residents, for negotiating such a plan on behalf of a resident, or for administering such a plan that includes any state resident.
The measure has drawn significant opposition from dozens of residents who say they rely on the plans, unable to afford traditional insurance. The proposal was voted out of the Insurance and Real Estate Committee in March.
The co-chairs of the Insurance Committee on Tuesday praised the deal reached by the insurance department.
“We work hard to make sure consumers are protected with the best oversight possible,” Rep. Kerry Wood, D-Rocky Hill, said in a statement. “Consumers often don’t realize that there are health insurance-type products available that fall outside the oversight and protections of our Department of Insurance. It’s reassuring to see the department take proactive measures to rein in these businesses.”
Her co-chair, Sen. Matthew Lesser, has been vocally opposed to the ministries.
“As consumer complaints rise against junk ‘health sharing’ schemes, I am pleased to see Commissioner Mais and the Connecticut Insurance Department taking steps to protect consumers in shutting down two of the worst offenders,” Lesser said. “This settlement moves the ball forward in a big way. We need to stay vigilant to protect consumers from shady companies and sham insurance products as bad actors proliferate in the marketplace.”