Medi-Share insists it doesn't provide insurance, but the state disagrees.

A Christian organization that pools member money to pay medical bills, but says it isn't an insurance company, is still going to be treated like one, a state regulator said Wednesday.

"If it looks like a rose and smells like a rose, then it's a rose," said Oklahoma Insurance Commissioner Kim Holland. "We are going to treat Medi-Share like an insurance company."

That means Medi-Share, a Christian Care ministry of the mission-driven American Evangelical Association, will have to prove to the state it can cover claims that members file, Holland said.

Impossible, the group's president said.

Robert Baldwin said the organization has no money on reserve other than members' shared dollars being processed before going to pay a medical bill.

Baldwin said he would not comment directly until he is contacted by the Oklahoma Insurance Commission. He said that hasn't happened.

Oklahoma Insurance Code has not historically applied to Medi-Share because it was considered a religious group that helped members with health-care costs but -- and this is a key point -- does not promise to pay or assume risk for those costs.

District Judge Joe Vassar decided recently that wasn't the case.

The Creek County judge ruled earlier this month that Medi-Share was "involved in the offering of contracts for insurance" and wasn't exempt from state Insurance Department regulation.

Judges in four other states have made similar rulings, but Baldwin said Medi-Share still operates in those states: South Dakota, Illinois, Wisconsin and Montana.

In Kentucky, a court has ruled that Medi-Share wasn't in the insurance business.

In a telephone interview from Medi-Share headquarters in Melbourne, Fla., Baldwin said the group would likely appeal the court's decision.

"We do believe the ability for Christians to share medical bills on a nonprofit, noninsurance basis should be preserved."

Medi-Share is the largest of several organizations that pool members' money to pay others' medical costs.

These kinds of programs are growing in popularity and demand as the rising cost of private health insurance becomes too expensive for even middle-class Americans.

Andy Bowman, 53, pastors a church in Park Hill and is a Medi-Share member.

He brought the suit in Vassar's court after he amassed $27,000 in unpaid medical claims.

Bowman, a heart patient, said the debt has loomed over his family for years.

Vassar's decision sets the stage for a September trial in Bowman's claim.

Medi-Share has paid more than $250 million in medical bills for its members. But in its literature and on its Web site, it says it is not insurance. Why?

Because it does not guarantee payment of members' medical bills. That would be assuming risk.

Rather, Medi-Share says it "brings Christians together to share the cost of their medical bills and save money."

At the same time, the organization advertises that "100 percent of every eligible medical need has been met since 1993."

The organization's material "encourages families to drop their traditional coverage and states 'Most families save between $2,000-$4,000 a year,' " according to court documents.

Baldwin said his organization does tout payment of every eligible claim since Medi-Share formed, but that no guarantees are made for the future.

Holland says she sees an implied promise in that marketing.

"People are not joining the organization that maybe they will get their coverage. They are joining on the assertion that their health care will be covered. If not by a guarantee, by the statement that 'Hey, we've always done it.' "

Leigh Woosley 581-8465
leigh.woosley@tulsaworld.com

What is Medi-Share?

The monthly dues are based on member age, family size and which of two plans are chosen. One plan requires a member to pay $250 from his or her own pocket for each medical incident. The other requires $911.

Medi-Share only accepts people who "have a verifiable Christian testimony indicating a personal relationship with the Lord Jesus Christ" and turns away anyone who has sex outside of Christian marriage and uses tobacco in any form or abuses drugs and alcohol.