We operate under the Indian Self-Determination and Education Assistance Act (P.L. 93-638) and Section 813 tribal authority. This is the legal mechanism that allows a tribal sponsor to enroll non-Indian members and extend health-sharing benefits to communities outside the tribe. Kindwell One is not insurance and is not regulated as such under state insurance codes.
Neither Kindwell One nor its members guarantee or promise that medical requests will be shared or paid by the membership. The trust exists to facilitate cost-sharing among members, but ultimate financial responsibility for care remains with the individual member. This is the foundational principle of health sharing.
Health sharing trusts are explicitly exempt from the Affordable Care Act's individual mandate. Members in states with an individual mandate (CA, NJ, RI, MA, DC) may qualify for exemptions. We provide documentation support to members in these states to file for exemptions where available.
Pre-notification is required for planned hospitalization, surgery, and high-cost procedures. Emergency care does not require pre-notification. The trust reviews all sharing requests for eligibility under the tier's sharing rules. Members receive written notification of sharing decisions within 30 days of a complete request submission.
The federal individual mandate penalty was reduced to zero in 2019. Five jurisdictions — California, New Jersey, Rhode Island, Massachusetts, and the District of Columbia — maintain their own state-level individual mandates with associated tax penalties.
Because Kindwell One operates as a tribally-sponsored health benefit under Section 813 of the Indian Health Care Improvement Act, P.L. 93-638 self-determination authority, and tribal sovereignty, the application of state individual mandates to Kindwell One members is structurally distinct from the application of those mandates to commercial health share ministries or unenrolled individuals. The specific treatment varies by jurisdiction and by member circumstance and has not been uniformly addressed in published state guidance.
Members in CA, NJ, RI, MA, or DC should consult with tribal counsel and a qualified tax professional regarding their specific circumstances. We are working with Indian health law counsel to publish jurisdiction-specific guidance; until that guidance is finalized, we encourage members to bring questions directly to the Kindwell One member services team and we will connect you with the appropriate resources.