Oregon regulators ordered a health sharing company to stop selling coverage to residents, saying the company’s membership plans were functioning as unlicensed insurance.
ClearShare Health was ordered to stop selling coverage by the Oregon Division of Financial Regulation, which began reviewing ClearShare in January. The DFR reportedly found that the company’s membership plans function as insurance contracts because ClearShare pays specific and ascertainable medical expenses once members meet their annual maximum. These annual maximums operate as insurance deductibles, according to DFR.
ClearShare Health’s affiliates include Clearwater Benefits LLC, Clearwater Benefits Administrators LLC and Clearwater Benefits Holdings LLC. The division also determined that Clearwater Benefits Administrators provided third-party administrator without holding a third-party administrator license.
The DFR order prohibits ClearShare and its affiliates from marketing, offering, selling or renewing memberships in Oregon. It also bars the entities from soliciting or collecting contributions or fees for new memberships or renewals and from representing that ClearShare memberships are not insurance or are not subject to regulatory oversight.
The order includes a limited exception that allows the entities to continue processing medical expense submissions for memberships that were active on April 14. This exception is intended to ensure that existing members can continue to have their claims considered under the terms of their current agreements.
The division found that ClearShare had enrolled at least 370 Oregonians, including 180 primary members, into its plans. Respondents have 20 days from the date the order was served to request a contested case hearing.
Topics
Oregon
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