H.R. 3103: Health Share Transparency Act of 2025

This bill, known as the Health Share Transparency Act of 2025, aims to enhance the transparency and accountability of health care sharing ministries (HCSMs). HCSMs are organizations that allow members to share health care expenses, often as an alternative to traditional health insurance. Here’s what the bill proposes in simpler terms:

Annual Disclosure Requirements

The bill requires all health care sharing ministries to:

• Submit annual reports to the Secretary of Health and Human Services, the Commissioner of Internal Revenue, and the Director of the Bureau of Consumer Financial Protection. These reports must include detailed financial and operational information about the ministry.
• Provide prospective and current enrollees with specific information regarding claims, costs, and reimbursement processes.

Information to Be Disclosed

Specifically, the annual reports must include:

• The amount of financial reserves the ministry holds.
• The ratio of money collected for member claims versus what is actually spent on those claims.
• The total number of individuals enrolled in the ministry.
• The total amount paid by members for coverage.
• The total amount of claims paid by the ministry for the year.
• The average out-of-pocket expenses incurred by members.
• Information about which states and counties allow enrollment in the ministry.
• The percentage of claims that were denied during the previous year.
• Contact information for the ministry's representatives.
• A list of health care providers that have contracts with the ministry.
• The average reimbursement time for claims during the past year.

Disclosure for Enrollees

When individuals seek to enroll in a health care sharing ministry, they must be provided with:

• How to file complaints or appeals regarding coverage decisions.
• Information on whether appeals require arbitration.
• A disclaimer that there is no guarantee of reimbursement for claims.
• The average enrollment cost per individual.
• Details about the total amount paid for claims and how costs are shared.
• A list of non-reimbursable items and conditions for reimbursement.

Entity Requirements

Entities that help enroll individuals in health care sharing ministries must provide the following information:

• An explanation of any available tax credits for purchasing health plans through established exchanges.
• Information on eligibility for state plans or Medicare benefits.
• Comparative information on benefits and cost-sharing requirements of group health plans versus those offered by HCSMs.
• A clear statement that HCSMs do not provide guaranteed benefits like traditional health insurance.

Enforcement and Penalties

The bill grants the Secretary the authority to impose civil monetary penalties on health care sharing ministries that fail to comply with the disclosure requirements. The maximum penalty can be $100 for each day of non-compliance for each individual involved.

Consumer Complaint Disclosure

The Federal Trade Commission (FTC) is required to publicly disclose information about consumer complaints related to health care sharing ministries twice a year. This will include:

• The number of complaints received.
• A breakdown of the types of complaints.
• Details of each complaint, including the name of the ministry in question.

Implementation Timeline

The FTC disclosures must begin within 90 days from the bill's enactment. Annual reporting by the HCSMs will follow a similar schedule.

Relevant Companies

None found.