Insurance Department Commissioner Andrew N. Mais and Insurance & Real Estate Committee Co-Chair Senator Matt Lesser join the National Association of Insurance Commissioners (NAIC) in issuing a warning to anyone considering purchasing a Health Care Sharing Ministries (HCSMs) product, discount, or risk-sharing plan. Consumers are strongly encouraged to take the time to fully understand what they are and how they work before purchasing.
These offerings are either not health insurance plans, or they are unauthorized insurance products. They are not Affordable Care Act (ACA) compliant and, unless they constitute an unauthorized insurance product, do not fall under the jurisdiction of state or federal regulators. The NAIC has a full description of these products.
In a true HCSM, members typically pay a monthly fee that allows them to submit qualifying medical expenses for sharing with others in the group. The group may pay part of a health care bill by sharing funds from other members. However, they are not legally required to do so.
“Consumers should research, prior to purchasing a product, if it comes with protections required by Connecticut and/or federal law and is marketed by a licensed insurance carrier or licensed broker in Connecticut,” Commissioner Mais said.
In 2019, Commissioner Mais issued a cease and desist order against a HCSM for conducting an insurance business illegally in Connecticut, and potentially placing consumers at risk.
“I’ve personally heard from constituents who have paid for products they believed were health insurance. These reports are alarming – and consumers should be on the lookout,” said Senator Matt Lesser. “Many of these products claim to be “Health Care Sharing Ministries” which are not insurance and may not cover needed medical care.”
Consumers are inundated with increased advertising and marketing for products that may not be health insurance, are not approved or licensed in the state and may not have the required consumer protections under state and federal law. These products are being marketed on TV, the Internet and through social media and telemarketers.
Licensed producers, brokers and agents are also cautioned that under Connecticut law, any person who sells, or aids or assists anyone in the sale of, an unauthorized insurance product will be liable to pay any unpaid claims. In addition, any Insurance Department licensee assisting in any such sale will be subject to administrative action by the Department.
Anyone with questions can contact the Connecticut Insurance Department by email at firstname.lastname@example.org or by calling 860-297-3900.
· Access Health CT – the state health insurance exchange
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