Company won’t add Texans to insurance
A Georgia company accused of selling deceptive faith-based health plans has agreed to temporarily limit its access to assets until a Texas District Court case against it concludes. It also said it will not enroll new Texas members at this time.
The agreement by Aliera Companies, a multimillion-dollar Atlanta-based business, came late Thursday afternoon in an ongoing lawsuit filed by Texas Attorney General Ken Paxton in June, new court documents show.
On July 12, a judge in Travis County issued a temporary restraining order against Aliera prohibiting new Texas enrollment, but it was not immediately clear whether the company would challenge the ruling.
“This agreement demonstrates our commitment to transparency and to negotiating in good faith while the parties endeavor to resolve this matter,” Aliera said in a statement Friday. “In the meantime, we will continue working with thousands of Texans to help them meet their health care needs.”
Aliera has been accused by authorities in multiple states of deceiving customers who spent thousands of dollars on what they thought were comprehensive health plans through two affiliated Christian health share minis
tries, first Unity Healthshare and now Trinity Healthshare. More than 70 complaints have been filed with regulatory agencies in four states, including Texas, for nonpayment of claims. Last month, 10 complaints were sent to the FBI by the Georgia attorney general’s office.
Aliera has 100,000 members nationwide, with 17,000 in Texas, and it earned $215 million in revenue last year, according to the company.
Aliera offers health plans through a partnered health share ministry, an obscure but growing subset of health coverage based on the biblical principle that the like-minded should help each other in times of need. Members contribute monthly into a fund to help pay their future medical bills.
Aliera has said it makes clear to customers that it is not selling traditional insurance and explains the risks involved. It said it offers affordable “alternatives” that are outside government rules and regulations — including the legal obligation to pay claims. The company also contends that it is separate from its affiliated Christian health share ministry, acting only as the administrator of money collected.
Texas authorities, though, have accused Aliera of using the low cost and religious appeal of the health share ministry concept to amass hundreds of millions of dollars. And then, because the plans fall outside most government oversight, the company pays out little or nothing in claims and keeps the rest. “Merely stating that a business is not insurance will not suffice to take the business out of the realm of insurance regulation,” the state has argued in its lawsuit.
Health policy experts across the country are watching the case unfold, seeing it as cautionary tale in a time of loosening insurance regulation.
“It’s certainly fallout from the problem we’re having with health care in this country,” said George Nation III, professor of law and business at Lehigh University in Pennsylvania.“People are so frustrated, they are ripe to be taken advantage of.”
The Thursday agreement signed by Aliera lawyers said the company will “refrain from transferring, expending or disbursing any funds out the ordinary course of business without the approval from the court until such time that this case is resolved.” The agreement does not apply to money needed for day-to-day operations, the company said.
Aliera also agreed that it “will not accept or write any new business in the state of Texas until such time as this case is resolved.”
A settlement conference between the state and Aliera is scheduled for July 26 to potentially determine financial compensation to harmed Texans, authorities said Friday. The company has agreed to turn over an accounting of money collected from Texas members and paid out on their behalf before that conference.
Jill Baine, a former Aliera member in The Woodlands, said Friday that she is pleased that authorities are being aggressive. The 58year-old breast cancer patient said Aliera refused to pay a $195,000 claim for a course of radiation treatment, calling it a pre-existing condition even though the company had previously paid for the two surgeries to remove the cancer. She filed complaints in both Texas and Georgia attorneys general offices.
Georgia authorities said hers was among the complaints turned over to the FBI in Atlanta. She was told by Texas authorities to expect to be interviewed by an investigator next week.
“I do feel like I’m being heard now,” she said.
The history of Aliera, formed in 2015, and the troubled past of one of its founders was detailed in a July 7 Houston Chronicle investigation.