- An Atlanta-based company claiming to be a healthcare sharing ministry is now facing a lawsuit from California's attorney general for allegedly committing fraud. California is now the 14th state to bring action against Aliera Companies, AG Rob Bonta said Wednesday in a statement that slammed the business as a "sham."
- Aliera allegedly scammed thousands of consumers in California by collecting hundreds of millions of dollars in monthly payments but denying coverage of medical costs. Instead, the owners "funneled the majority of members' monthly payments into their own pockets," according to the the complaint.
- The owners — Shelley Steele, who served as CEO of the company, her husband, Tim Moses, and son Chase Moses — are also named defendants in the case.
Healthcare sharing ministries are an alternative and risky type of health coverage that is largely unregulated. HCSMs collect monthly payments from members to cover healthcare costs incurred by other members, but are not held to the same coverage requirements under the Affordable Care Act that so many consumers are used to, such as coverage of pre-existing conditions.
HCSMs are exempt from those coverage requirements, and when the ACA initially required people to obtain health insurance, HCSM members were exempt from this requirement. The plans were appealing to consumers looking for lower cost options, yet many regulators and patient advocates have raised concerns members were unaware of the fine print.
The lawsuit alleges thousands of Californians were duped when purchasing these plans.
"When members suffered medical emergencies and incurred substantial debts, Aliera claimed it had no obligation to pay for any member's medical costs," the lawsuit states. "Aliera retained as much as 84% of every member payment, leaving around 16 cents of every dollar for member expenses."
For large-group plans regulated by the ACA, for example, the law requires that at least 85% of premiums be paid on care for the actual member.
Even though Aliera claimed to be an HCSM, it was not. California alleges Aliera was not a legitimate HCSM under the law as it was for-profit entity, not a nonprofit established before 2000 like the law mandates, among other requirements.