ATLANTA — Now more than ever people are relying on the health care coverage we pay for to protect us.
But for months now, in a series of Channel 2 Action News investigations we’ve reported on problems with an Atlanta based health care sharing ministry.
While Aliera says it’s done nothing wrong, along with a new lawsuit, sources at the FBI confirm to Channel 2 investigative reporter Justin Gray that there is an active investigation into the company.
After repeated complaints, it's no longer a shock or a surprise.
We reported in January after the Segar family received a $324,000 hospital bill and Aliera would not pay a dime for 10-year-old Lola Grae Segar’s emergency brain surgery.
“We had a life-threatening emergency. They failed us and her,” father Wesley Segars said.
It was the same situation for Julie Boulanger, who was left with a $55,000 bill, and a $37,000 heart emergency for Ricky Smallwood.
In all these cases, the company providing their health coverage, Atlanta-based Aliera, didn't pay for their medical bills.
“At a time like this, that’s particularly cruel when people think that they’re buying something that covers them, and it doesn’t,” said attorney Jay Angoff.
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Angoff just filed a class action lawsuit against Aliera and Trinity Healthshare.
“We’re alleging that what Aliera sells is inherently unfair and deceptive,” Angoff said.
Tom Kelly is one of the name plaintiffs in the new lawsuit.
“We made sure before we signed up that, of course, our doctors and hospitals would all be in network,” Kelly said.
But when it came time to pay, Aliera told Kelly that's not the case.
Just like the other families we’ve introduced you to in our series of Channel 2 Action News investigations over the past six months, Kelly has an expensive Aliera story to tell.
“It seemed like no matter what our circumstances were, the surgery was denied for the same reason -- we were out of network.
“It stated to see there was nothing that was in network?” Gray asked Kelly.
“Right. Exactly,” Kelly said.
What Aliera claims to be is not traditional health insurance. It administers the payouts for a faith-based nonprofit, Trinity Healthshare.
Members pay in monthly and are supposed to share each other’s medical expenses.
“They think a faith-based organization, they must have my interests at heart here?" Gray asked Kelly.
"And that’s particularly offensive no matter what religion you belong to,” Kelly said.
Multiple states have ordered Aliera to stop doing business.
Kelly went with Aliera specifically because he wanted to be part of a faith-based health share.
“They’re not a faith-based group. I believe they are con artists. I believe that they’re just doing this to steal money. I don’t believe they have really helped anyone or plan on doing just that,” Kelly said.
Shelley Steele-Moses is registered as the CEO of Aliera. Court papers show for most of Aliera's history Steele shared control with her husband Timothy Moses.
In 2006, Moses was sentenced to more than six years in prison for securities fraud and perjury.
Channel 2 investigative reporter Jim Strickland tracked Steele down in the fall.
“Do you have any apologies to the members who feel their claims ought to be paid and they're not paid?” Strickland asked Steele.
“We're not a health care sharing ministry Mr. Strickland. We only administer on behalf of the ministries. I can't help you any further. I need to get out of town,” Steele said.
If it sounds confusing, Angoff told Gray that it’s by design.
“It’s just inherently confusing and unfair and deceptive,” Angoff said.
Since it's not technically insurance, Aliera can avoid regulation and enforcement from state insurance commissioners.
“Aliera effectively markets itself to the general public as insurance and it's a fraud and it's using religion as a cover which I find extremely offensive,” Angoff said.
Channel 2 Action News did contact Aliera for comment about this story. They told Gray in a statement:
"Marketing materials make a point of stating very clearly that these programs are absolutely not insurance. Any assertions to the contrary are simply incorrect. We will continue to vigorously defend against false claims about the services our company provides its clients.”
Along with the new lawsuit, Gray confirmed that an FBI investigation into Aliera is still active and underway.
Kelly and his wife said they have canceled their Aliera coverage and found a different health care sharing ministry they trust.
“It can be catastrophic. It can tear up families. It can ruin them financially. It’s time to take some action and get away from them,” Kelly said.
Aliera officials still maintain they are doing nothing wrong.
The company told Gray that in health care sharing, members pay for one another’s health care through voluntary gifts not because of a legal obligation.
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