A proposed class action alleges the Aliera Companies, Inc. has sold illegal health insurance “masquerading” as legitimate Health Care Sharing Ministry (HCSM) plans providing traditional health insurance.
A bona fide HCSM plan allows those of a similar religious faith to join together to share responsibility for participants’ medical expenses, the suit says, noting that true HCSMs are generally exempt from federal and Georgia insurance laws and regulations.
According to the 67-page lawsuit, the defendant, formerly known as Aliera Healthcare, has falsely portrayed its health insurance plans as HCSMs despite that the plans do not meet federal and state requirements. The plaintiffs, consumers from New York, New Jersey and Georgia, claim the defendant’s conduct amounts to “an illegal scheme” devised to sidestep federal and state laws pertaining to, among other restrictions, limitations on the percentage of premiums that can be diverted to purposes other than the payment of benefits.
All told, the defendant has charged the plaintiffs and proposed class members hundreds more for insurance each month, with most of that money diverted to the Aliera Companies and its principals, the complaint alleges, noting that the patriarch of the family who owns and operates the defendant, Timothy Moses, has in the past been charged with felony securities fraud and perjury while heading International BioChemical Industries.
Moses was sentenced to six years in prison and ordered to pay $1.65 million in restitution, the case says. Once released, Moses’s probation was revoked after it was discovered he lied to a supervising probation officer about certain financial dealings and failed to disclose secret bank accounts, the lawsuit states, claiming the conduct alleged by the plaintiffs commenced once Moses’s supervised release was terminated in April 2015.
The case adds that Aliera fails to meet the legal requirements to be an HCSM because, among other reasons, it is incorporated as a for-profit company and has not been in existence since 1999, while genuine HCSM entities must have existed at all times since December 31, 1999.
The defendant’s marketing and sales of the apparently illegal insurance plans have succeeded to the extent that Aliera has kept roughly 84 cents of every dollar paid by proposed class members, the case claims. Per the suit, the amounts pocketed by the defendant flagrantly violate the federal limit on costs and profits of 15 percent of premiums paid. Adding insult to injury, the defendant also “delayed and failed” to pay for covered medical expenses incurred by proposed class members, the suit alleges.
Neither the plaintiffs nor proposed class members were apprised of the fact that several state regulators found the plans offered by the Aliera Companies to be not qualified as HCSM plans and sold illegally, the lawsuit continues. Consumers were similarly unaware the same regulators entered cease and desist orders against the defendant to prevent the company from continuing its scheme in a number of states, the case claims.
The lawsuit looks to cover all current and former Aliera plan participants since 2017 onward who have made periodic payments to the company to participate in plans positioned as HCSM-compliant plans.
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