The Phia Group Blog

By: Andrew Schulz, Esq. Illinois has presented a unique interaction between federally based health plans and the state common fund doctrine. This includes plans established under the Employee Retirement Income Security Act of 1974 (ERISA) and the Federal Employee Health…

By: Kendall Jackson, Esq. It is no secret that one perk of having a self-funded ERISA plan is ERISA preemption. It acts as a comfortable boundary between ERISA plans and state insurance law, effectively eliminating a state’s control over an…

By: The Phia Group Fiduciary liability tied to final level appeals has never posed a more significant risk for the stewards of self-funded health plans. As we speak, self-funded plans across the nation are staring down medical claims for hundreds…

By: The Phia Group The Independent Dispute Resolution (IDR) rules may be constantly in flux while the No Surprises Act (NSA) flummoxes health plan sponsors nationwide, but Phia Unwrapped continues to be an unparalleled solution for countering devastating out-of-network and…

By The Phia Group Prescription drug costs remain one of the biggest pressure points for self-funded health plans. GLP-1s, specialty drugs, gene therapies, biologics, rebate arrangements, PBM transparency, and Medicare drug pricing reforms all tend to dominate the conversation. But…

By David Ostrowsky For the second consecutive July 4th weekend, a seismic healthcare development has unfolded. A year ago, the newly-introduced One Big Beautiful Bill Act (OBBA) ushered in a wave of healthcare changes. This year, as Americans were firing…