The Department warns consumers that these misleading lookalike health plans marketed as “health care sharing ministries” do not comply with California laws to protect consumers. These plans were marketed as cheaper alternatives to traditional coverage when, in reality, they do not provide comprehensive coverage for pre-existing conditions and other coverage as required by state and federal laws. Up to 11,000 Californians may belong to unapproved plans offered by these two entities.
CALIFORNIA DEPARTMENT OF INSURANCE NEWS RELEASE
Department Issues Cease and Desist Order to Protect California Consumers from Misleading Health Plans Known as ‘Health Care Sharing Ministries’
Deceptive marketing tactics by Aliera and Trinity could impact up to 11,000 Californians
OAKLAND, Calif. — The California Department of Insurance issued a Cease and Desist order effective immediately against Aliera Healthcare, Inc., and Trinity Healthshares, Inc., for violating California law by misleading California consumers regarding their products and transacting insurance business without a certificate of authority from the Insurance Commissioner.
The Department warns consumers that these misleading lookalike health plans marketed as “health care sharing ministries” do not comply with California laws to protect consumers. These plans were marketed as cheaper alternatives to traditional coverage when, in reality, they do not provide comprehensive coverage for pre-existing conditions and other coverage as required by state and federal laws. Up to 11,000 Californians may belong to unapproved plans offered by these two entities.
“Consumers who bought these plans thinking they purchased comprehensive health insurance deserve the full protection of our laws,” said Insurance Commissioner Ricardo Lara. “Consumers should know they may be able to get comprehensive coverage through Covered California that will protect their health care rights.”
Consumers who purchased coverage through Aliera Healthcare, Inc. or Trinity Healthshares, Inc. should contact Covered California at 855-295-2023, to determine if they have experienced a qualifying life event that entitles them to a special enrollment opportunity. Consumers are encouraged to contact the Department of Insurance’s Hotline at 800-927-4357 to learn about their options or to file a complaint if they were faced with unexpected costs or other problems with Aliera Healthcare, Trinity Healthshares, or any other health care sharing ministry plan.
The Department’s Cease and Desist Order alleges that Aliera and Trinity provided misleading training to sales agents, promoted misleading advertisements to California consumers, and sold products that do not cover preexisting conditions, abortion and/or contraception, or comply with the federal Mental Health Parity and Addiction Equity Act, which is in violation of Insurance Code section 10112.27, Insurance Code section 10198.7, and the federal Patient Protection and Affordable Care Act. Deceptive marketing practices may have pressured some consumers to purchase a health sharing ministry plan, thinking they had missed the deadline for purchasing coverage through Covered California.
The Cease and Desist Order prohibits Aliera and Trinity from immediately transacting insurance in California, including advertising or receiving any money, commission, fee, rebate, payment, remuneration, or any other valuable consideration whatsoever, in connection with any insurance transactions.
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Insurance Code section 740(a) provides that “[n]otwithstanding any other provision of law, and except as provided herein, any person or other entity that provides coverage in this state for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether the coverage is by direct payment, reimbursement, or otherwise, shall be presumed to be subject to the jurisdiction of the department unless the person or other entity shows that while providing the services it is subject to the jurisdiction of another agency of this or another state or the federal government.”
Aliera Healthcare and Trinity Healthshares are incorporated in Delaware and do not hold a certificate of authority or other license authorizing them to transact insurance in the state of California. On or about August 13, 2018, Respondent Aliera and Respondent Trinity entered into an Agreement wherein Respondent Aliera is named the administrator, exclusive marketer and program manager for Respondent Trinity. Effective July 22, 2019, the name of Aliera Healthcare, Inc. changed to the Aliera Companies, Inc. and become a holding company for multiple wholly owned subsidiaries.