Tina Passione wanted medical insurance in a rush in December. The newly retired 63-year-old was relocating to suburban Atlanta along with her husband to be nearer to grandchildren. Their home in Pittsburgh flew off the market, they usually had six weeks to maneuver out 40 years of recollections.
Passione mentioned she went on-line to seek for the federal medical insurance market, clicked on a hyperlink and entered her info. She promptly bought a number of calls from insurance coverage brokers and acquired a plan for $384 a month. Later, although, when she went to a pharmacy and docs’ workplaces in Georgia, she was instructed she didn’t have insurance coverage.
In reality, it mentioned it proper on her card: “THIS IS NOT INSURANCE.”
Passione is one in every of 10 customers who instructed KHN that they thought they have been shopping for insurance coverage however realized later that they’d been bought a membership to a Houston-based well being care sharing ministry referred to as Jericho Share. The ministry shaped in 2021 when Home of Prayer and Life Inc., a half-century-old Christian congregation, assumed the title Jericho Share, in keeping with Texas enterprise filings.
Well being care sharing ministries are faith-based organizations whose members conform to share medical bills. The ministries grew in reputation earlier than the Reasonably priced Care Act’s mandate for having insurance coverage protection was repealed, as a result of they supplied a less expensive different to insurance coverage, and the legislation exempted individuals in ministries from having to pay a tax penalty for not having insurance coverage. However they don’t seem to be insurance coverage, are largely not regulated as such and do not essentially cowl members’ medical payments. Massachusetts is the lone state that requires ministries to often report knowledge, and solely about half of claims submitted to ministries there have been deemed eligible for fee. This spring, the Colorado legislature handed comparable necessities that await the governor’s signature.
The Higher Enterprise Bureau offers Jericho Share an F score, its lowest, and its web site reveals greater than 100 complaints filed in lower than a 12 months. Texas Division of Insurance coverage paperwork present two complaints, from February and March, about Jericho Share. The division responded to each by saying it regulates insurance coverage, which ministries should not, and forwarding them to the state lawyer common’s workplace. The lawyer common’s workplace didn’t reply to KHN’s questions in regards to the standing of the complaints.
John Oxendine, a lawyer who was elected 4 instances as Georgia’s insurance coverage commissioner, responded to KHN’s inquiries made to Jericho Share. He’s dealing with federal expenses of conspiracy to commit well being care fraud that he mentioned are unrelated to Jericho Share. He denied any wrongdoing. If Jericho Share memberships are being bought to customers in deceptive methods, “that is a great way for a dealer to get fired,” he mentioned.
“Jericho Share doesn’t tolerate any kind of misrepresentation or unethical conduct on the a part of its packages,” in keeping with an announcement despatched by Oxendine. “Each time we develop into conscious of inappropriate conduct, we take applicable motion to treatment the state of affairs.”
Customers can at all times cancel their Jericho Share plans, Oxendine mentioned. Many customers who spoke to KHN did cancel their plans and obtain refunds, however a number of mentioned the method to take action was irritating. Some have been left to kind out fee for payments they incurred whereas they thought they have been insured. A minimum of seven of the individuals KHN spoke with mentioned they ended up with Jericho Share after starting their medical insurance searches on Google.
Encountering such points whereas searching for medical insurance just isn’t unusual, mentioned JoAnn Volk, co-director of Georgetown College’s Heart on Well being Insurance coverage Reforms. She co-authored a 2021 report that discovered “deceptive advertising practices” have been directing customers to different well being plans, like ministries, that may value greater than market plans and supply fewer protections.
“It is particularly unlucky as a result of individuals have got down to purchase complete protection,” Volk mentioned.
Susan Fauman, 47, a metalsmith from Germantown, N.Y., relied on her partner’s insurance coverage protection however wished her personal insurance coverage coverage earlier than submitting her divorce paperwork final fall. Fauman mentioned her Google search landed her on a collection of what the promoting trade calls “lead-generating” web sites: nongovernmental webpages that join insurance coverage brokers to customers.
Not one of the customers KHN spoke with might say with certainty which website in the end related them to the brokers who bought them Jericho Share memberships. ObamacarePlans.com and AffordableHealthPlans.org are among the many lead-generating web sites that present up on Google when somebody searches with phrases similar to “Obamacare insurance coverage” or “healthcare market.” These website listings are literally ads that resemble unusual Google search outcomes however are labeled with the phrase “Advert” and are positioned above probably the most related search end result: the federal authorities’s official medical insurance market, healthcare.gov.
Google spokesperson Christa Muldoon mentioned corporations that publicize on searches associated to the Reasonably priced Care Act should show they’re licensed to promote insurance coverage through the federal or state marketplaces.
These marketplaces let customers store for complete medical insurance, inform them whether or not they qualify for monetary help and join customers with enrollment help, if wanted. In contrast, lead-generating web sites usually simply promote the non-public info supplied by customers to insurance coverage brokers and brokers who can promote different sorts of plans.
Fauman mentioned she unwittingly put her info into what turned out to be a number of lead-generating web sites. She was quickly inundated with cellphone calls from insurance coverage brokers, she recalled.
Desperate to get insurance coverage, Fauman mentioned, she purchased a plan for about $330 a month, plus a $99 sign-up charge. She mentioned the dealer — who, she later realized, by no means named the plan — mentioned she’d have principally no copays and no restrictions on the place to get care. However he didn’t inform her that it was a well being care sharing ministry, she mentioned, or that it wasn’t insurance coverage — one thing she did not know to ask about. When she obtained her Jericho Share card with its disclaimer, she thought, “What the hell did I join?”
Ministries and aggressive insurance coverage advertising practices have raised eyebrows earlier than, and the Washington state lawyer common issued a client alert final 12 months about “adverts and web sites posing because the official medical insurance market.” However Georgetown College’s Volk mentioned large-scale crackdowns would probably require cooperation by a number of state regulators as a result of states are the default enforcers of insurance coverage guidelines. The Federal Commerce Fee did deliver a case towards a Florida-based operation in 2018, alleging it collected over $195 million by enrolling customers in “nugatory plans.” The case is ongoing.
And it is not at all times clear who can and must be defending customers on this sophisticated area that covers private and non-private insurance coverage, interstate commerce, web sites and well being care sharing ministries.
The Facilities for Medicare & Medicaid Providers manages the healthcare.gov web site. “When CMS sees an advert we expect is misrepresenting HealthCare.gov, we share it instantly with the various search engines,” Deputy Administrator Ellen Montz mentioned in an announcement.
Louise Rasho, a spokesperson for MediaAlpha, which operates ObamacarePlans.com, mentioned in an e-mail that the corporate’s code of conduct doesn’t enable brokers who purchase buyer results in mislead customers. It periodically displays calls to make sure compliance. She additionally famous that the positioning has disclaimers saying that it isn’t a authorities web site.
Craig Sturgill of Excel Influence, which owns AffordableHealthPlans.org, mentioned that if the corporate learns a dealer has damaged the legislation or used questionable ways, it terminates contracts and takes “additional motion” as vital. “As a digital advertising firm, we aren’t essentially within the enterprise of deeply educating customers from beginning-to-end about all of their out there choices,” Sturgill mentioned in an e-mail. “Our function is to attach customers to advisors who can and will successfully educate customers.”
The dealer callback quantity that client Hemani Hughes mentioned she used to right the spelling of her title on her Jericho Share plan — earlier than she realized it was a ministry — is listed on the web sites of the Higher Enterprise Bureau and the Utah Insurance coverage Division as belonging to Florida-based Prosperity Well being. In an e-mail, Prosperity Well being’s registered enterprise agent, Ahmed Shokry, mentioned it had “by no means bought Well being Shares.”
Hughes, a 49-year-old communications strategist in Kansas, mentioned she was bought a Jericho Share plan in February after particularly telling a dealer she didn’t need a well being care sharing ministry plan. Hughes mentioned she realized after her name that the dealer by no means talked about the plan by title, saying solely that she was signing up for a “nationwide PPO” and strolling her by the copays.
When Hughes realized it was a well being care sharing ministry, she mentioned, she referred to as to cancel her plan. She was met with what she described as “a fairly manipulating and really belligerent gantlet of customer support reps and maintain instances” over a number of calls.
At one level, Hughes mentioned, the individuals she was talking with instructed her it was irresponsible to go with out insurance coverage — although Jericho Share itself just isn’t insurance coverage.
Hughes outlined her story in a criticism she filed with the Higher Enterprise Bureau. Jericho Share responded to the buyer watchdog that it was contacting Hughes straight to guard her personal well being info and mentioned, “We’re working very diligently to analyze this criticism totally.” Hughes in the end obtained a refund.
Passione, in Georgia, mentioned she filed her criticism with the Higher Enterprise Bureau after she could not get a straight reply about fee for her physician appointments and prescriptions. In March, Passione canceled her Jericho Share plan and signed up for COBRA protection by her former employer for $782 a month.
“A bit costly, however at the very least I do know what I get,” Passione mentioned.
She mentioned she was reimbursed by Jericho Share for one month’s fee and is ready to listen to whether or not her bank card firm can recoup funds she made in January and February.
Fauman, who additionally filed a criticism, obtained a refund too, however spent two months uninsured and averted calling her physician whereas she sorted out the state of affairs.
“I used to be afraid of what it was going to value me,” Fauman mentioned.
She ultimately bought market insurance coverage with the assistance of a “navigator,” somebody educated to assist customers enroll in protection with out incomes a fee. After subsidies, Fauman’s premium is round $95 a month, costing her about $2,800 much less a 12 months than what she mentioned her Jericho Share plan would have — and her new plan is definitely insurance coverage.
KHN (Kaiser Well being Information) is a nationwide newsroom that produces in-depth journalism about well being points. It’s an editorially unbiased working program of KFF (Kaiser Household Basis).