Connecticut insurance regulators have pumped the brakes on an unlicensed insurance company for misleading consumers and potentially placing them at risk.
Connecticut Insurance Department (CID) Commissioner Andrew N. Mais on Monday issued a cease and desist order against Aliera Cos. Inc. and Trinity Healthshare Inc. for operating an illegal insurance business in the state.
According to the cease and desist order, Aliera, acting as an insurer and insurance producer in Connecticut, since summer 2018 has been administering and marketing health coverage on behalf of Trinity, which represents itself as a healthcare sharing ministry whose members share common religious and ethical beliefs. Both entities were organized under Delaware law.
However, Aliera did not limit the marketing of their products to individuals with any particular religious ideology, and enrolled consumers who agreed to a series of general statements on their faith and helping others.
In particular, Aliera’s marketing materials promoted individual and family coverage that includes primary care physician visits, pharmaceuticals, urgent care needs, and basic eye and hearing exams, among other offerings at “lower rates” and “no penalty.”
Aliera marketed their plans to consumers through licensed insurers and collected fixed monthly payments from their members. State law prohibits unlicensed individuals or insurers from administering any insurance business or healthcare business in the state.
In one case, a consumer filed a complaint with the department’s Consumer Affairs Division alleging nearly $300,000 in unpaid claims and concerns over how the policies were marketed and sold to them, according to CID. The consumer met the $10,000 plan deductible paying out of pocket for diagnostic tests and Aliera refused to pay the $280,000 surgical and physician bills citing a pre-existing condition.
“Some consumers believed they were buying traditional health insurance and did not know the plans were offered by a health care sharing ministry, which would be exempt from state insurance regulations, until their claims were denied,” CID said in a statement announcing the alleged misconduct.
Aliera and Trinity Healthshare will continue to process and pay healthcare claims for existing policies, but they are prohibited from soliciting and selling any new business in the state, CID said.
Consumers in Connecticut will need to find new health insurance options during the open enrollment period for the 2020 plan year, the agency said.
Health plan enrollment generally closes Dec. 15, CID said.
