Health care plan. Photo: Adobe Stock
California has completed blocking efforts by Aliera Companies and Sharity Ministries to sell health care cost-sharing ministry memberships in their state.
The current managers of Aliera and Sharity, which was formerly known as Trinity Healthshare, have agreed to pay $34 million in penalties and stop marketing or selling health care sharing ministry memberships in California, California Attorney General Rob Bonta announced last week.
Health care cost-sharing ministries: Health care cost-sharing ministries are religious organizations that give members a way to pay each other's medical bills. The Affordable Care Act exempts the ministries from the rules that apply to major medical insurance.
Aliera and Trinity: Aliera helped Trinity market its memberships to people who were interested in using an alternative approach to paying for health care.
Trinity was once one of the most visible health care cost-sharing ministries in the United States, with prominent sponsorships at health benefits group meetings.
Trinity attracted at least 98,000 members, including some members who came in through employer-sponsored plans.
Legal proceedings: The U.S. Department of Labor announced in August 2023 that it had obtained a consent judgment barring Aliera from serving as a benefit plan fiduciary or service provider.
Aliera and Sharity are still involved in other active legal proceedings, including bankruptcy proceedings in Delaware. A liquidating trust is now in charge of the companies.
The people who previously controlled Aliera — Tim Moses; Moses' wife, Shelley Steele; and Moses' son, Chase Moses — are also involved in the litigation.
Bankruptcy filings show that Trinity owes more than $300 million and that the list of creditors includes 60,000 former cost-sharing ministry members, according to a complaint filed by the liquidating trustee of Aliera in the Delaware bankruptcy court in January 2025.
Trinity had 14,000 members in California, according to Bonta.
Non-ACA arrangements: Supporters of the current ACA major medical insurance framework have attacked a wide variety of "non-ACA" arrangements that could serve as alternatives to ACA-compliant major medical coverage.
Issuers of ACA-compliant policies must offer standard benefits, including unlimited coverage for services classified as "essential health benefits," and they cannot reject applicants with health problems or charge people with cancer or other expensive conditions higher rates.
Non-ACA can put tight limits on benefits and use medical underwriting.
ACA-framework supporters say many different types of non-ACA arrangements, ranging from short-term health insurance to specified-disease plans, could hurt ACA policy issuers by using low prices to lure young, healthy people out of the major medical insurance risk pool.
Health care cost-sharing ministry defenders have suggested that the ministries may also face opposition due to regulator prejudice against religious organizations and that problems at one ministry should not tarnish the reputation of the others.
Bonta and other critics have argued that they believe Aliera and Trinity were of special concern because, according to the critics' accounting, Trinity used only 16% of contributions to pay members' medical bills.
Reactions: Dane Steffenson, an attorney who has served as counsel to the Moses family, said in an email that Aliera was simply a third-party administrator for health care cost-sharing ministry memberships offered by Trinity.
Aliera was "acting pursuant to Trinity's guidelines and at Trinity's direction," Steffenson said.
Trinity failed because it failed to respond appropriately to its claims data, Steffenson said.
The California attorney general's offices and representatives for the trust liquidating Aliera could not immediately be reached for comment.
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