What are Unlicensed Entities?
Entities acting as insurance companies must be licensed by the state insurance department in the state in which they are domiciled, must have a statutorily-prescribed amount of capital and surplus, and must comply with other financial standards.
Some entities act as insurance companies even though they are not licensed by the state, do not have the statutorily required minimum capital and surplus, and do not comply with other state requirements. Some of these entities purport not to be insurance companies but rather religious organizations called health care sharing ministries. These organizations do not comply with state law, do not provide the minimum benefits insurance companies are required to provide under the federal Affordable Care Act, and in many cases do not pay claims that they purport to cover. We are currently representing policyholders of one such company and investigating others.
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