The Texas Department of Insurance (“TDI”) has filed an action seeking to stop Georgia-based Aliera Healthcare from selling health insurance in Texas without a state license.
A public hearing in front of a state administrative law judge is scheduled to begin at 9 a.m. May 28 at the State Office of Administrative Hearings (“SOAH”) in Austin.
Aliera claims to be running a health-sharing ministry and therefore exempt from TDI regulation and reporting requirements. Texas law requires health-sharing ministries to be non-profit organizations. TDI alleges that Aliera is a for-profit corporation and is using only 20 percent or less of the money it collects from consumers to pay health claims.
The insurance commissioner of Washington also ordered Aliera to stop selling health insurance in that state. Additionally, the New Hampshire Department of Insurance issued a consumer warning that the company may be operating illegally.
The TDI has estimated that Aliera has about 17,000 customers in Texas and 100,000 nationwide.
Aliera health plans sold in Texas remain in effect until after the hearing and a ruling by the Texas Insurance Commissioner.
Under Chapter 1681 of the Texas Insurance Code, the requirements for a health-sharing ministry include:
- The organization must be faith-based and nonprofit. Participants must be of a similar faith.
- The organization matches participants who have medical bills with other participants able to help pay those bills.
- There is no assumption of risk or promise to pay among the participants or the health care sharing ministry.
- The organization must provide a monthly statement that includes administrative fees and costs to participants.
- All applications, guidelines, and plan cards must clearly indicate that the participant is part of a health care sharing ministry that is not engaging in the business of insurance.
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Steven A. Meyerowitz
Steven A. Meyerowitz, a Harvard Law School graduate, is the founder and president of Meyerowitz Communications Inc., a law firm marketing communications consulting company. He may be contacted at [email protected].