"A purported health care cost-sharing company . . . has lost a class-action lawsuit resulting in a nearly $4.7 million judgment" in U.S. District Court at Lexington, reports Jeremy Chisenhall of the Lexington Herald-Leader.
After representatives of The Aliera Companies "failed to appear in court multiple times, according to records, Senior Judge Joseph M. Hood "declared that the company should have been subjected to Kentucky insurance laws because their claims of selling health care sharing ministry plans were inadequate," Chisenhall reports. "Members in health care sharing ministries share medical expenses among themselves. Health-care sharing ministry plans aren’t subject to the same regulations as insurance, but they have to meet strict requirements. Aliera didn’t meet those requirements, Hood ruled."
Jay Prather, one of the plaintiffs' attorneys, said “Aliera and its partners have taken advantage of hundreds of Kentuckians, many of whom trusted the company because it professed Christian beliefs. “Aliera’s customers sought affordable healthcare coverage to protect their families in times of need. But when those times of need came, Aliera was more likely to shut the door in the face of its own customers. This ruling by Judge Hood is the first step in helping those families recover what they have lost.”
"Aliera created, marketed, sold and administered health care plans for Unity HealthShare and Trinity HealthShare, companies that were purported to be health-care sharing ministries, according to the lawsuit. Unity HealthShare later rebranded itself as OneShare Health, according to court records," Chisenhall reports. "Hood sided with the victims that purchased a plan while Aleria was partnered with Trinity. Assuming each policyholder would elect to receive the higher payout of those two options, Hood reached an aggregate judgment of $4.7 million, according to court records. Trinity has since filed for bankruptcy, according to court records."
The lawsuit continues because Hood's ruling applies only to policies sold through Trinity. Attorneys for the plaintiffs said Aleria sold plans to "hundreds, if not thousands, of Kentucky residents" and kept 84 percent of their payments. Conversely, insurance companies are required to pay out 80% of the premiums they received, but the law doesn't apply to health care cost-sharing companies.
Aleria denies that it was a health care cost-sharing company. It said in a court filing, “It is a for-profit entity that contracted with Unity and then Trinity (through its subsidiaries) to market memberships in their sharing programs and to create processes to facilitate member-to-member sharing of medical expenses. Aliera has created a system that is designed to afford members the ability to consent to their contributions being shared on a real-time, case-by-case basis with other members as their needs arise. But, as previously noted, all members are informed that their requests for sharing payments may not be met — there are no payment guarantees or indemnification.”
from KENTUCKY HEALTH NEWS https://ift.tt/3rAXG7d
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