Alliance of Health Care Sharing Ministries

What it reported doing in 2024

Constitutional challenges and litigation: on may 16, 2024, after years of working in good faith with Colorado, the alliance was forced to bring legal action to defend the rights of its member ministries and their members to exercise their religious liberty in the health care system. Health care sharing ministries (hcsms) help facilitate the sharing of medical expenses among a community of religious believers. The complaint marshals significant evidence that Colorado is selectively targeting health care sharing ministries because of their religious beliefs while leaving similar secular activities untouched. The complaint also marshals significant evidence that the Colorado regime will harm health care sharing ministries and their members, without sufficient justificaton. No other state has the same regime as Colorado. Consequently, the complaint alleges that Colorado is violating the first amendment in five different ways. First, it violates the free exercise rights of ministries to be free from laws that allow state officials to exempt their favored organizations. Second, it violates the free exercise rights of ministries to be free from laws that target religious exercise and that do not treat comparable secular activites similarly to religious activites. Third, it violates the establishment clause rights of ministries to be free from excessive entanglement and continuous monitoring by the government. Fourth, it violates the freedom of association rights of ministries not to disclose with whom they affiliate and associate. Finally, it violates the free speech rights of ministries with respect to their religious speech to their members and prospectve members. The case is now before the tenth circuit court of appeals.

Financial Efficiency

• Mission deployment rate: Limited
• Program expense ratio: Limited
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 63rd percentile among comparable filings
• Pay-setting controls: 2 of 6 controls in place; rating input score 33
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Pass
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Limited
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 63rd percentile among comparable filings
• Governance controls: 7 of 8 controls in place; rating input score 88
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: NotApplicable
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Fail

Sustainability

• Operating margin: 1.9%; rating input score 42; 42nd percentile among comparable filings
• Total-asset coverage ratio: 0.39; rating input score 18; 18th percentile among comparable filings
• Liabilities to assets ratio: 0.38; rating input score 20; 20th percentile among comparable filings
• Officer compensation ratio: 24.8%; rating input score 10; 10th percentile among comparable filings

Growth

• Program expense growth: Limited
• Revenue growth: 5.9% per year; rating input score 100; 49th percentile among comparable filings
• Asset growth: 16.5% per year; rating input score 100; 75th percentile among comparable filings