Benefit plans and their TPAs are contemplating alternatives to classic networks in response to rising costs. Many, however, are tied to their networks or simply feel alternatives aren’t viable. It is imperative that these plans implement best practices to contain costs while operating within the network’s parameters. Join The Phia Group as we analyze PPO and PBM contractual terms, offer suggestions to revise these agreements, and reveal strategies to limit costs; all without breaching your contracts.
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From differing language to differing interpretations of plan provisions, stop-loss policies have always seriously impacted benefit plan management. In the face of reform as well as a new focus on the cost of care and network relationships, we must all consider the power of our words. Join The Phia Group as we discuss these matters, review classic stop-loss provisions in light of self-funded plans, and consider how to make all of the pieces fit.
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This informative webinar will present the most current and relevant information on the recent (and pending) SBC regulations. The webinar will offer information in a concise and informative format.
Topics will include:
•SBC requirements
•SBC concerns
•Gaps between plans and the SBC
•Action items to stay ahead of the curve
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Audio Presentation with PowerPoint Slides
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As PPACA and rising costs of health insurance incentivize organizations to consider other options for their benefit plans, many employers will be embarking upon their maiden voyage into the mysterious realm that is “self-funding.” One of the first things these newly minted self-funded plans will need to do is retain a third party administrator, (“TPA”). The health of that relationship… from implementation to claims processing, network usage to stop-loss submissions… will hinge upon the quality of the administrative services agreement (“ASA”), between the TPA and their client. When the difference between success and failure relies heavily upon a clear, concise, yet all encompassing ASA, the importance of an effective agreement cannot be overemphasized.
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Audio Presentation with PowerPoint Slides
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