NEOSHO — A Christian health care sharing ministry sold "inherently unfair and deceptive health plans" to Missouri residents and failed to provide them with coverage, a class action lawsuit alleges.
The federal lawsuit against Aliera Companies and Trinity Healthshare comes as millions of people who are unable to afford private insurance are attracted to the low prices offered by health care sharing ministries, KCUR-FM reports.
A health care sharing ministry is a group of people with common ethical or religious beliefs who share health care costs. Many of the plans offer none of the protections of the Affordable Care Act.
Aliera said in a statement that its marketing materials make clear that their programs "are absolutely not health insurance."
"Any assertions to the contrary are simply incorrect. We will continue to vigorously defend against false claims about the services our company provides its clients," it said.
Last month, California insurance regulators barred Aliera and Trinity from doing business in the state, saying the two companies used deceptive marketing tactics to mislead consumers. At least half a dozen other states have launched probes.
George Tom Kelly III told KCUR he was looking for health insurance options back in 2018, so when his insurance agent recommended a health care sharing ministry, he signed up with Aliera.
Kelly, who has a lawn care business, first suspected he'd been duped when Aliera refused to cover his claims for some routine medical expenses. Then it denied him coverage for hernia surgery he needed.
Kelly filed a federal lawsuit in Missouri on Wednesday against Aliera and Trinity, the health sharing ministry for whom Aliera marketed its products.
Health sharing ministries are exempt from the requirements of the Affordable Care Act as long as they meet certain requirements. They must be tax exempt, have existed since Dec. 31, 1999, and must have continuously shared medical expenses among members who share common ethical or religious beliefs.
But Kelly's lawsuit alleges Trinity didn't exist until 2018, didn't limit its membership to those of similar faith and siphoned off members' payments for "exorbitant fees and commissions."
"On the one hand, these guys state, in small letters sometimes, that they're not insurance, but they convey the impression that they are insurance," said former Missouri Insurance Commissioner Jay Angoff, now an attorney in Washington, D.C., who represents Kelly.
"They do that so they can sell what is de facto insurance, but it's crummy insurance that violates the Affordable Care Act. It doesn't cover preexisting conditions and it has very low annual and lifetime limits."
Because they're not technically insurance providers, health care sharing ministries are not subject to the same regulations as insurance companies.
It's not known how many Missourians are enrolled in Trinity's plans.
Carrie Couch, director of the consumer affairs division of the Missouri Department of Commerce and Insurance, said the division had received several complaints against Aliera and Trinity.
Before founding Aliera, Timothy Moses headed International BioChemical Industries Inc., which filed for bankruptcy in 2004 after Moses was charged with securities fraud and perjury. A jury convicted Moses and he was sentenced to more than six years in prison and ordered to pay restitution of $1.65 million.