Clearwater Benefits is not an insurance company and does not own or underwrite any insurance products. Clearwater is a Third Party Administrator (TPA) that administers a wide range of health benefit products on behalf of the carriers, organizations, and employers that offer them.
What Is a Third Party Administrator (TPA)?
A Third Party Administrator, or TPA, is a company hired by an insurance carrier, employer, or benefits organization to handle the day-to-day operations of a health benefit plan. The TPA does not own the plan, does not underwrite it, and does not take on the financial risk of paying claims. Instead, the TPA is a service provider—responsible for tasks like processing claims, managing enrollment, coordinating care, answering member questions, and making sure everything runs smoothly behind the scenes.
Think of it this way: if a health benefit plan is a restaurant, the TPA is the management company hired to run the kitchen, serve the food, and handle reservations. The TPA doesn't own the restaurant or decide the menu—it makes sure the operation works for everyone involved.
That's exactly what Clearwater Benefits does. Clearwater is the administrative partner hired to manage benefits on behalf of the organizations and employers that sponsor them. The products themselves—including their terms, coverage rules, and funding—belong to the carriers and plan sponsors, not to Clearwater.
Clearwater Benefits: Far More Than Health Share Administration
While ClearShare is one of the products Clearwater administers—and often the one that generates the most questions—it represents just one piece of what Clearwater does. Clearwater Benefits is a full-service TPA that administers a broad portfolio of health benefit solutions, including:
- Major medical plans – Traditional health insurance products offered through licensed carriers, administered by Clearwater on behalf of those carriers.
- Self-funded group health plans – Employer-sponsored plans where the employer assumes the financial risk of providing health benefits to employees, and Clearwater handles claims processing, network access, compliance, and plan management.
- Dental plans – Standalone dental benefit products administered on behalf of carriers and employers.
- Vision plans – Vision care benefits managed as part of employer benefit packages.
- Minimum Essential Coverage (MEC) plans – Plans designed to meet Affordable Care Act requirements, commonly offered by employers to satisfy compliance obligations.
- Health sharing programs – Including ClearShare, a community-based health sharing membership that Clearwater administers but does not own or sponsor.
In every case, Clearwater's role is the same: it is the administrator hired to run the plan, not the entity that owns, funds, or underwrites it. The financial obligations and product terms belong to the respective carriers, employers, or organizations—not to Clearwater.
Understanding the Relationship Between Clearwater and ClearShare
Because the names sound similar, it's common for people to assume Clearwater Benefits and ClearShare are the same entity. They are not. ClearShare is a 501(c)(3) nonprofit healthcare sharing organization. Clearwater Benefits is the TPA that ClearShare has hired to administer its program. Clearwater does not own ClearShare, does not control its membership guidelines, and is not financially responsible for sharing member needs. Clearwater's job is to process needs, coordinate care, manage enrollment, and provide member support on ClearShare's behalf.
This is an important distinction: if a member has a medical need that is processed through ClearShare, the sharing of that need comes from ClearShare's Benevolent Fund—not from Clearwater. Clearwater facilitates the process; ClearShare and its member community fund it.
Insurance vs. ClearShare: What Is Actually Different?
ClearShare doesn't try to be insurance. It was built as an intentional alternative—a philosophy grounded in community, transparency, and mutual aid. For the more than 1.7 million Americans who participate in health sharing nationally, that distinction represents not just a product choice but a values alignment.
The differences between traditional insurance and a health sharing membership like ClearShare are structural, philosophical, and practical.
It's a Community, Not a Contract
ClearShare is a 501(c)(3) nonprofit organization. Members make voluntary monthly contributions to a shared Benevolent Fund, and when a member has a qualifying medical need, the community shares in those costs. The word "voluntary" is critical. No individual member—and not the organization itself—is legally compelled to pay another member's bills. The model runs on community trust and shared commitment, not legal obligation.
Traditional insurance, by contrast, is a legally binding contract between a policyholder and an insurance company. If a covered claim is not paid, the policyholder has legal recourse through state insurance regulators and the courts. ClearShare operates entirely outside that framework—and it's by design.
Members Are Always Personally Responsible
This is the most important difference a prospective member must understand. ClearShare is not insurance or an insurance policy, nor is it offered through an insurance company. Members are always personally responsible for the payment of their own medical bills.
ClearShare's own Member Guidelines state it plainly and repeatedly. Regardless of whether ClearShare shares a member's costs or whether the organization continues to operate, each member remains personally responsible for their own medical bills. This isn't a hedge or a caveat. It's the foundational structure of the model.
No State Insurance Oversight
Traditional insurers must comply with state insurance codes, file rates, maintain reserve funds, and submit to regulatory audits. ClearShare is exempt from those requirements. There is no state insurance department a member can contact if a need is not shared. Prospective members in states with individual coverage mandates—including California, Massachusetts, New Jersey, and Rhode Island—should know that ClearShare membership doesn't satisfy those mandates.
ClearShare Addresses "Needs," Not "Claims"
The language ClearShare uses is intentional and meaningful. Medical expenses are called "needs," not claims. The member's personal cost-sharing threshold is called the "Annual Maximum," not a deductible. Monthly payments are "contributions," not premiums. When costs are eligible for community support, they're "shareable," not covered. When a member receives an explanation of how their need was processed, it's an Explanation of Sharing (EOS), not an Explanation of Benefits. This isn't merely semantic. It reflects the mutual-aid philosophy at the core of what ClearShare is.
Rooted in a 300-Year-Old Tradition
The concept of health sharing isn't new. It traces back to the early 1700s, when small religious communities pooled money to help each other through medical hardships. Modern health sharing has grown from that tradition. ClearShare, incorporated in 2022, was built to modernize that model—removing religious requirements and making it open to everyone regardless of background, nationality, ethnicity, or sexual orientation. In a market where most healthshares have historically been tied to faith communities, ClearShare positions itself as a new kind of option: transparent, inclusive, and willing to say yes when other healthshares say no.
How ClearShare Actually Works: A Member's Journey
Setting aside the legal distinctions, what does the actual experience of being a ClearShare member look like? Here's how the process unfolds in practice. Remember: throughout this process, Clearwater Benefits is the TPA working behind the scenes to administer these steps on ClearShare's behalf.
Step 1: Join and Choose a Plan Tier
Members enroll and select a plan tier based on their preferred Annual Maximum—the amount they pay out-of-pocket before the community begins sharing costs. ClearShare offers three primary tiers with Annual Maximums of $1,000, $2,500, and $5,000 for individuals, with corresponding family options. Lower Annual Maximums generally mean higher monthly contributions, and higher Annual Maximums mean lower contributions. Monthly contributions must remain current, as a lapse in payment deactivates membership and any bills incurred during that gap become ineligible for sharing.
Step 2: Get Care
For planned procedures, surgeries, or major medical events, members or their providers contact ClearShare (through Clearwater's administrative team) for pre-approval before care is received. Pre-approval is required for imaging (MRI, CT, PET), outpatient surgeries, inpatient stays, chemotherapy, childbirth, and a range of other services. Skipping that step carries a real consequence—a 25% reduction in what the community will share. For emergencies, members can seek treatment anywhere, and network requirements don't apply.
Step 3: Use Care Coordination
One of the most powerful and differentiated features of the ClearShare model is Care Coordination. ClearShare maintains a dedicated team (administered by Clearwater) that members can contact to find high-quality, lower-cost providers before receiving care. When a member uses a Care Coordination-recommended provider, their out-of-pocket costs can be waived entirely. In some cases, the member pays nothing beyond their monthly contributions. The goal is to direct members toward care that is genuinely affordable—for the member and the community—keeping contributions lower for everyone.
Step 4: The Provider Submits the Bill
Providers submit bills directly to ClearShare (processed by Clearwater as the TPA). If a provider is unfamiliar with the process or unwilling to bill directly, members can contact Clearwater's support team at the time of service for assistance. The member doesn't need to navigate this alone.
Step 5: The Community Shares the Need
Once the Annual Maximum is met, eligible medical costs are shared from ClearShare's Benevolent Fund. Eligible needs are shared at up to 100% of the usual and customary rate ClearShare determines. There's no annual or lifetime cap on the total amount that can be shared—a meaningful structural difference from many traditional and supplemental plans that impose benefit limits.
Step 6: Understanding What Is and Is Not Shareable
Like any health benefit product, ClearShare doesn't cover everything—and the organization is explicit about that. Pre-existing conditions known before membership have a one-year waiting period, with phased sharing over four years. Maternity care is shareable only when conception occurs after membership begins. Services such as dental care (unless accident-related), fertility treatments, hearing aids, allergy testing, and sleep apnea equipment aren't shareable under standard membership.
This is where ClearShare's commitment to transparency functions as a genuine brand value. Rather than obscuring limitations in dense policy language, the Member Guidelines detail exclusions clearly—with the goal being that members understand what they are entering before they need care, not after.
Why Transparency Is the Point
There's a version of the health sharing model that buries its limitations and lets members discover them at the worst possible moment. ClearShare takes the opposite approach. The organization's position is that being honest about what it is—and what it is not—isn't a liability. It's the product.
Traditional insurance markets often compete on the perception of broad coverage, leaving members to discover gaps only after receiving care. ClearShare inverts that—telling members upfront what's shareable and what isn't, helping them use Care Coordination to minimize their costs, and giving them a community that genuinely shares in their hardships when they do occur.
That philosophy extends to ClearShare's inclusivity. Unlike many healthshares that have historically required religious affiliation, ClearShare accepts members regardless of background, denomination, or sexual orientation—because the model depends on mutual commitment to the sharing mission, not doctrinal agreement.
The Bottom Line
Is Clearwater Benefits health insurance? No. Clearwater Benefits is a Third Party Administrator—a company hired to administer health benefit products on behalf of carriers, employers, and organizations. Clearwater does not own, underwrite, or fund any of the products it administers.
What Clearwater does is run the operations—from major medical and self-funded group health plans to dental, vision, MEC plans, and health sharing programs like ClearShare. Across all of these products, Clearwater's role is to make administration seamless, support members and employers, and ensure the plans function as designed.
ClearShare specifically is not insurance. It is a community-based, nonprofit health sharing membership that prioritizes transparency, affordability, and access. ClearShare isn't an insurance policy, nor is it offered through an insurance company. Members are always personally responsible for the payment of their own medical bills.
For independent contractors, self-employed people, and families who find traditional insurance too expensive or too opaque, ClearShare—administered by Clearwater Benefits—provides an alternative built to be honest about what it offers. The Annual Maximum model, the Care Coordination team, the Benevolent Fund, and the absence of a lifetime shareable cap are all features of a model designed intentionally and from the ground up to work differently.
Understanding the difference between a TPA, an insurance company, and a health sharing organization isn't just a legal formality—it's the key to knowing what kind of protection is right for each person's situation. Clearwater Benefits makes that distinction central to everything it does, because an informed member is the foundation of a system that actually works.
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