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Phia Podcasts

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  • Empowering Plans: P218 – Unreasonable Plan Fees on Trial: Cunningham v. Cornell University
    May 8, 2025
    In this episode, we unpack the Supreme Court’s unanimous decision in Cunningham v. Cornell University — a landmark ERISA case with major implications for retirement and health plan fiduciaries. We explain the facts behind the case, what “prohibited transactions” really mean, and why the Court's ruling on affirmative defenses matters. If your health plan pays fees to TPAs, PBMs, IDR vendors, or brokers, this episode is for you.
  • Empowering Plans: P217 – The Most Exciting Two Minutes in Cost Containment
    May 1, 2025
    The Run for the Roses is here! Join two of Phia’s Louisville, Kentucky, employees, Corey Crigger and Cindy Merrell, as they discuss the event that takes over their city once a year! Coming on the heels of a historic weather event, Corey and Cindy discuss all things Derby. From Cindy’s experience at Dawn at the Downs to predictions for winners, this podcast has it all. Don’t be fooled, this podcast isn’t just about horse racing. Corey and Cindy also discuss pitfalls of AI use in the legal world. Can attorneys depend on AI for their legal research? Meanwhile, which horse has the best chance to win the Derby? Can Corey hit the trifecta for the second year in a row? Tune in to the Empowering Plans Podcast for these answers and many more!
  • Empowering Plans: P216 – Why 2025 is the Year to Go Self-Funded
    April 22, 2025
    Our consulting team has received numerous questions in Q1 2025 about employers considering self-funding their health plans. Join Attorneys Jennifer McCormick and Kelly Dempsey as they go through what the driving factors are behind employers considering self-funding, the pros and cons of self-funding, and some of the major differences employers will encounter. If you’re considering taking the leap, take a listen first!
  • Empowering Plans: P215 – Plan Sponsor Discretion Advised
    April 8, 2025
    ERISA gives plan sponsors great power and great responsibility. On this week’s podcast, attorneys Ron Peck and Nick Bonds get back to ERISA fundamentals to talk about how to really embrace fiduciary status and properly exercise discretionary authority.
  • Empowering Plans: P214 – Unpacking Weight Loss Drugs
    March 28, 2025
    On this episode of the Empowering Plans podcast, attorneys Corey Crigger and Kendall Jackson discuss the hot button topic of weight loss drugs. Tune in to learn more about the latest advances in this space and the various coverage and exclusion options plans may pursue.
  • Empowering Plans: P213 – Error 304: Good Faith Negotiation Not Found
    March 13, 2025
    Artificial intelligence may be changing the trajectory of the self-funded industry – but can it negotiate? In this episode of The Phia Group’s Empowering Plans podcast, attorneys Brian O’Hara and Jon Jablon break down real-life examples of AI-driven responses in the No Surprises Act’s Open Negotiations process that range from nonsensical to outright misleading, where negotiating with AI is like trying to haggle with a toaster. From missing claim numbers to automated counteroffers that make no sense, Brian and Jon discuss whether AI is making negotiations easier, or defeating the purpose of the statutory process to begin with. Tune in for an honest discussion of the pitfalls of AI in No Surprises Act negotiations.
  • Empowering Plans: P212 – Lewandowski v. Johnson & Johnson – Big win or warning?
    February 27, 2025
    On this episode of the Empowering Plans Podcast, attorneys Brady Bizzaro and Cindy Merrell delve into the details of the Lewandowski v. Johnson & Johnson case. Is this case a big win for plan fiduciaries or a warning?
  • Empowering Plans: P211 – Network Adequacy Under MHPAEA
    February 13, 2025
    Attorneys Kelly Dempsey and Bryan Dunton dive into the results of the 2024 MHPAEA Report to Congress. The EBSA and CMS have continued to improve their focus on network design and adequacy for group health plans. In this episode, Kelly and Bryan discuss how these parity problems manifest themselves in testing and what plans can do to resolve them.
  • Empowering Plans: P210 – Mental Health Parity: New Year, New Rules, New Lawsuits
    January 30, 2025
    Attorneys Jen McCormick and Nick Bonds ring in the Lunar New Year by breaking down the ERIC v. HHS lawsuit in which an industry advocate challenged the federal regulators’ new Final Rules enforcing the MHPAEA and mental health parity rules. Could this case blaze a new path for challenging agency actions in a post-Chevron Doctrine world? Join us as we discuss the potential implications for group health plans.
  • Empowering Plans: P209 – 2025 Healthcare Hot Takes
    January 16, 2025
    It’s a new year, and a new type of Empowering Plans podcast! In a world full of talking heads and 2-minute news cycles, hot takes have become the norm. This is true from mainstream news media to sports talk radio. Ron Peck and Corey Crigger throw their hat in the hot take ring by speculating on what some of the biggest news stories could be in 2025. From AI to RFK Jr, join Ron and Corey as they gaze into the crystal ball and make their bold predictions of what we will be talking about all year.
  • Empowering Plans: P208 – The Evolution of the Birth Control Benefits Mandate
    January 2, 2025
    On today’s episode of the Empowering Plans podcast series, attorneys Kendall Jackson and Brian O’Hara discuss the Biden administration’s decision to withdraw proposed rules that would have expanded the birth control benefits mandate. Join us in our discussion of the mandate and how it has evolved throughout the Obama, Trump, and Biden administrations.
  • Empowering Plans: P207 – Denied Claims Beyond the Headlines
    December 19, 2024
    On this episode of the Empowering Plans podcast series, attorneys Corey Crigger and Cindy Merrell discuss the murder of UnitedHealthcare’s CEO, which fueled public outcry over denied claims.
  • Empowering Plans: P206 – Non-Preferred Carrier Fees: Incentives or Control?
    December 5, 2024
    In this episode of the Empowering Plans podcast, attorneys Jon Jablon and Brady Bizarro delve into the details of a recent lawsuit where BCBS of Michigan, in its capacity as a TPA, is alleged to have engaged in anticompetitive practices for charging a fee to a group that chose a stop-loss carrier other than BCBS. This case is in its infancy as of December 2024, but we expect it to have noticeable effects on the stop-loss marketplace regardless of outcome. In this episode, Jon and Brady discuss those potential effects and how a holding either way could impact self-funding as a whole.
  • Empowering Plans: P205 – Lessons From a Florida IDR Case
    November 5, 2024
    On this episode of the Empowering Plans Podcast, attorneys Ron Peck and Nick Bonds talk through a recent Florida case addressing judicial review of IDR determinations and highlight some of the key insights and takeaways for any entity subject to the No Surprises Act.
  • Empowering Plans: P204 – Nightmares on Self-Funded Street
    October 24, 2024
    Join Attorneys Corey Crigger and Kendall Jackson on this Halloween edition of the Empowering Plans Podcast. Corey and Kendall take a look at topics that send shivers down the spine of the self-funded industry. How do you protect your plan from the scary cost of gene therapies? What will the rapidly advancing AI sector mean for you and your clients? What is the best trick or treat candy? Tune in to find the answers to these questions and many more on the Empowering Plans Podcast.
  • Empowering Plans: P203 – Gender-Affirming Care, Is it Covered?
    October 15, 2024
    On this episode of the Empowering Plans Podcast, attorneys Jon Jablon and Cindy Merrell explore the changing landscape of several state and federal laws that affect coverage of gender-affirming care.
  • Empowering Plans: P202 – Senator Sanders: “Stop ripping us off.”
    September 26, 2024
    Attorneys Brady Bizarro and Andrew Silverio discuss the recent senate committee hearing on GLP-1 drug pricing and strategies that self-funded employers are using to manage the extreme costs of these drugs while we wait and hope for congressional action.
  • Empowering Plans: P201 – Diving Into the Parity Pool: MHPAEA’s Latest Updates
    September 12, 2024
    Regulators finally announced the long-awaited MHPAEA Final Rules on September 9, 2024. Many of these changes will directly affect group health plan design and modify the NQTL comparative analysis testing requirements - many of which will be significant for plans as they prepare for 2025. Join attorneys Jennifer McCormick and Bryan Dunton for their discussion on several critical considerations for plans as renewal season approaches.
  • Empowering Plans: P200 – Recognizing Our Blind Spots
    September 5, 2024
    Dr. Marty Makary is a New York Times bestselling author, renowned Johns Hopkins surgeon, and globally recognized expert on medical research. In its most recent edition of the Empowering Plans podcast series (“Recognizing Our Blind Spots”), Dr. Makary was a special guest as he engaged in conversation with CEO Adam V. Russo about his new book, Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, https://geni.us/blindspots. This is an episode jampacked with enlightening and engaging anecdotes that will leave you with new insight into commonly held assumptions about healthcare. After all, in order to fix the healthcare industry, people need to have access to correct information about modern medicine.
  • Empowering Plans: P199 – Summer Regulation Rundown
    August 29, 2024
    The regulators rush to finalize a suite of marquee regulations as the clock gradually runs out on the Biden administration. Even when finalized, these regulations may be vulnerable in the post-Chevron landscape. Attorneys Kelly Dempsey and Nick Bonds pick apart some of the big rules we’re looking forward to and the challenges they may face.
  • Empowering Plans: P198 – Healthcare on the Ballot
    August 15, 2024
    Nick Bonds and Corey Crigger are hosting this political edition of the Empowering Plans Podcast series. With an election looming in November, Nick and Corey take a look at the policies and agendas from the Harris/Walz and Trump/Vance tickets. They discuss the impact that each administration could have on the self-funded industry and the country, in the most civil political discourse you can find. Tune in to hear what each nominee has to say about: Medical Debt, the Opioid Crisis, Public Healthcare options, and more!
  • Empowering Plans: P197 – The Concerns About PBMs and the Demand for Reform
    August 1, 2024
    In this episode of the Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson break down the consequences of PBM steerage. Join us in the discussion of the Federal Trade Commission’s inquiry into PBM practices and the push for legislation to increase transparency in the market and hold PBMs accountable.
  • Empowering Plans: P196 – Exploring Claims Processing Models
    July 18, 2024
    On this episode of the Empowering Plans Podcast, attorneys Andrew Silverio and Cindy Merrell delve into the pros and cons of the pay and chase versus pend and pay models of claims processing. They provide an in-depth discussion on the coordination of benefits and the timing of claims processing when another party may be responsible for payment.
  • Empowering Plans: P195 – SCOTUS Decisions: Harrington and Loper's Impact on Healthcare
    July 2, 2024
    In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Corey Crigger break down two of the most significant Supreme Court cases just decided this term – the Harrington case (rejecting the largest opioid settlement in the country) and the Loper case (in which the Supreme Court ended Chevron deference). How will these cases impact the healthcare landscape? What should self-funded plans and their partners know moving forward? Tune in to hear our expert analysis.
  • Empowering Plans: P194 – The Rapid Evolution of the Pregnant Workers Fairness Act
    June 20, 2024
    Just like the development of a child, regulations evolve in their ability to walk and talk over time. Join Jen McCormick and Kelly Dempsey as they go through the evolution of the Pregnant Workers Fairness Act – from passage in late 2022 to the final rules that took effect on June 18, 2024. They also discuss current court challenges where two courts have reached opposite conclusions and, of course, what this all means for self-funded health plans. It’s hard to keep up as this one went from crawling to running in fewer than two months!
  • Empowering Plans: P193 – Stopping Esophageal Cancer In Its Tracks
    June 7, 2024
    In this episode of Empowering Plans, The Phia Group’s CLO – Ron Peck – sits down with experienced surgeon, Dr. Victoria Lee, to discuss a very dangerous – and costly – threat. Esophageal cancer is generally considered to be a death sentence, and historically screening options are invasive and costly, resulting in a low uptake. With the introduction of EsoGuard, however, plans can identify which participants are at risk, and have them tested quickly, non-invasively, and inexpensively. You can save lives and money… but you cannot afford to miss this episode.
  • Empowering Plans: P192 – Places, Promises, and Plan Documents
    May 23, 2024
    In this installment of The Phia Group’s Empowering Plans podcast series, attorneys Jon Jablon and Cindy Merrell discuss a health plan that lost its ERISA protections because of a pre-cert snafu. Specifically, the provider was quoted benefits at U&C, but that’s not quite what the SPD said – so the court called it a promise outside the SPD, and the security blanket of federal law flew right out the window! Tune in for the full details, and advice on how to not let this happen to you!
  • Empowering Plans: P191 – Derby Reflections and Gambles on Healthcare Strategies (Part 2)
    May 14, 2024
    In this concluding episode of our special two-part series on the Empowering Plans Podcast, Adam Russo and Corey Crigger return to unpack more significant developments in the self-funded space. This episode focuses on Walmart’s surprising withdrawal from the healthcare arena—a sector it heavily invested in just a year ago. Listen as they analyze the impact of this move on rural markets and what it signifies for the industry's future.
  • Empowering Plans: P190 – Derby Insights and Gambles on Healthcare Strategies (Part 1)
    May 9, 2024
    Join us for a captivating two-part episode of the Empowering Plans Podcast. Adam Russo, CEO and Founder of The Phia Group, is back alongside Corey Crigger to delve into the exhilarating 150th Kentucky Derby and share why Corey’s insights are indispensable. This episode also addresses pressing concerns in the self-funded sector that are crucial for our clients. Packed with valuable information, we had to split the discussion into two parts!
  • Empowering Plans: P189 – SCOTUS Showdowns and Derby Delights
    May 3, 2024
    The Empowering Plans podcast gets a southern infusion in this very Kentucky-centric podcast! Cindy Merrell and Corey Crigger get together to discuss the 150th running of the Kentucky Derby. Before you hear about all things Derby, Cindy and Corey review two impactful Supreme Court cases that were argued in the last session and discuss the implications of presidential immunity as well as the role EMTALA can play in state regulations. No other podcast in the country will break down SCOTUS cases and Derby winners like the Empowering Plans Podcast!
  • Empowering Plans: P188 – Fiduciary Duties in the Spotlight – Lewandowski v. Johnson and Johnson
    April 25, 2024
    Attorneys Brady Bizarro and Andrew Silverio discuss the pending case of Lewandowski v. Johnson & Johnson, a lawsuit brought against plan fiduciaries for violating their fiduciary duties under ERISA. How did they violate those duties? By failing to negotiate drug prices and sufficiently oversee their PBM or investigate alternatives. No matter who wins, this case highlights the importance of ERISA’s fiduciary duties and the gravity of the decisions fiduciaries are (or should be) making.
  • Empowering Plans: P187 – Decoding ACA FAQ #66: Essential Health Benefits Unpacked
    April 11, 2024
    Listen in as Kelly Dempsey and Brian O'Hara hit it out of the park in this Empowering Plans episode about Essential Health Benefits (EHBs)! The regulating bodies are at it again and issued ACA FAQ #66 on April 2, 2024! Listen in for a quick refresher on EHBs - how they started, where they are now, and where we’re going - and Phia’s interpretation and analysis of FAQ #66.
  • Empowering Plans: P186 – Xenotransplantation: A Potential Game Changer for Self-Funded Plans
    March 28, 2024
    Ham it up with attorneys Nick Bonds and Jen McCormick from the Phia Group as they dive into the groundbreaking world's first successful genetically engineered pig kidney transplant at MGH in Boston. Explore the details of this medical breakthrough, its implications for the healthcare industry, and the considerations for the future of dialysis, plan language, and stop loss provisions. Tune in to gain invaluable insights into the intersection of law, healthcare, and cutting-edge medical advancements.
  • Empowering Plans: P185 – Weighing the Options
    March 14, 2024
    Over the last twelve months we have seen major interest in GLP-1s (Semaglutide- Ozempic / Wegovy and Tirzepatide – Mounjaro / Zepbound). Although GLP-1s have been around for years as a treatment for diabetes, the recent popularity is due to their use as a weight loss drug. Join Ron Peck and Corey Crigger as they discuss the impact this surge in demand has had on health plans and consumers. Are health plans and consumers informed about the benefits and drawbacks of this drug? Are consumers too focused on the benefits? Are health plans too focused on cost? Find out as Ron and Corey discuss one of the hottest topics in the industry.
  • Empowering Plans: P184 – State of the Union, 2024
    March 8, 2024
    In his third State of the Union address, President Biden touted his administration’s record and outlined the issues he and his team will likely be campaigning on heavily as the 2024 presidential race kicks off in earnest. Sprinkled throughout were a number of policy wish list items, including some key healthcare initiatives that we’ll be keeping a close eye on in the coming months. Attorneys Brady Bizarro and Nick Bonds bring you some of the highlights in this episode of the Empowering Plans podcast.
  • Empowering Plans: P183 – The Therapeutic Equivalence Approach: A New “Pill”ar of Contraceptive Coverage
    February 29, 2024
    The DOL recently issued new guidance on the long-standing contraceptive coverage mandate, and this time they took a different approach. Instead of clarifying prior guidance or issuing novel interpretations of the law, the DOL is giving health plans an alternative way to comply with the contraceptive coverage mandate: either follow the prior guidance issued in 2022… or don’t! The DOL introduced the “therapeutic equivalence” approach, whereby plans can comply with the law in a different, potentially less-burdensome way. Join The Phia Group’s Kendall Jackson and Jon Jablon as they discuss this “therapeutic equivalence” approach to compliance, what it means for consumers, and what it means for health plans.
  • Empowering Plans: P182 – Navigating Post-Settlement Fund Pursuits
    February 15, 2024
    Attorneys Andrew Silverio and Cindy Merrell discuss a newly decided case which provides a roadmap for pursuing settlement funds after disbursement. Who has the burden of proof when the funds have been dissipated? What is lowest intermediate balance rule?
  • Empowering Plans: P181 – Chevron Deference in Peril – What It Could Mean for Healthcare Regulations
    February 1, 2024
    In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Brian O’Hara discuss the legal doctrine involved in two cases now before the Supreme Court – Chevron deference. They’ll explain what it means, why it is important for federal agency action, and how it impacts the entire healthcare industry. With a decision expected by this summer, you do not want to miss our take on how the NSA, the Medicare drug price negotiations, and the ACA itself could be at stake.
  • Empowering Plans: P180 – The Continuing Evolution of MHPAEA
    January 18, 2024
    One might think they’re listening to a broken record when hearing Jennifer McCormick and Kelly Dempsey discuss the ever-shifting landscape of the Mental Health Parity and Addiction Equity Act (MHPAEA), but alas, this is a brand new podcast! As we start 2024, we are reframing our mindset and are making some changes to address the evolving MHPAEA regulations and insights we have received from regulating bodies through the NQTL Comparative Analysis Process. In addition to highlighting the significance of how these issues should be addressed within an employer’s PD/SPD, there are three main changes discussed to create visibility for employers creating new 2024 PD/SPDs.
  • Empowering Plans: P179 – Higher Healthcare Prices (Made From Concentrate)
    January 4, 2024
    The trend of provider consolidation is primed to pick up pace in 2024, distilling some areas into even more highly concentrated healthcare markets. Ron Peck and Nick Bonds break down how this concentration impacts the costs of healthcare and can drive costs upward for employers and employees alike. With fewer provider options, higher prices, and patients caught in the middle, Ron and Nick outline just a few of their concerns and discuss some of the tools health plans have at their disposal.
  • Empowering Plans: P178 – Back to December (Phia’s Version)
    December 21, 2023
    It is the last podcast of the year, and you know All Too Well that it is Phia’s 2023 year-in-review! Sparks Fly as Kendall Jackson and Corey Crigger talk about how Everything in PGC and Provider Relations Has Changed in 2023. If you need to catch up on anything from the No Surprises Act to Gag Clause Attestations, You Need To Calm Down and Stay Stay Stay tuned into this podcast episode. In addition to the big changes in 2023, we look forward to 2024 and ask, are you … Ready For It?
  • Empowering Plans: P177 – Entering the Danger Zone: Cross-Plan Offsetting
    December 8, 2023
    Attorneys Jon Jablon and Cindy Merrell discuss the practice of cross-plan offsetting and the recent settlement between the Department of Labor and EmblemHealth Inc. Who wins and who loses when a TPA decides to use cross-plan offset?
  • Empowering Plans: P176 – Copay Accumulator Programs Take a Hit: What’s Next?
    November 21, 2023
    Attorneys Brady Bizarro and Andrew Silverio discuss a recent federal court decision that saw drug manufacturers and patients alike score a win against copay accumulator programs – programs that help maximize the manufacturer assistance available to patients but decline to count those amounts toward deductibles and out-of-pocket maximums. With the latest rule being struck down, where does the law stand now and what will happen next?
  • Empowering Plans: P175 – No Surprises Act Brings More Surprises & Other Surprises for 2024
    November 9, 2023
    Join Provider Relations Senior Attorney, Brian O’Hara, and Vice President of Consulting, Kelly Dempsey, for a quick rundown of changes to be prepared for as we near 2024. While there are the regular recurring changes to ACA and IRS out-of-pocket limits, this podcast will uncover a couple lesser-known items hidden in some NSA proposed rules and a couple other items for 2024 that might have fallen off the radar, including COVID-19 tolling requirements. (COVID may be over but the impact on certain items could extend well into 2024…).
  • Empowering Plans: P174 – PCORI and Parity and Lawsuits, Oh My!
    October 26, 2023
    It’s the spookiest time of the year, and I’m not just talking about renewal season. In this Halloween episode of the Empowering Plans podcast, Jennifer McCormick and Nick Bonds talk through some of the scary issues creeping up on health plans: rising PCORI fees, proposed regulations on mental health parity rules, and two fascinating court cases that may have significant implications for ERISA plans going forward. But don’t be scared, Phia is here to help!
  • Empowering Plans: P173 – Gene-y in a Bottle: A Magical Overview of Cell and Gene Therapy
    October 12, 2023
    Your wish is our command! Join Ron Peck and Corey Crigger as they discuss how this emerging treatment can impact self-funded health plans. With prices as high as $3.5 million, you can’t just wish for a strategy for dealing with these therapies, you must plan for it. Ron and Corey discuss the motivations to cover, the future benefits, and the concerns they are hearing from clients. You don’t know what we can see, so join us on a magic carpet ride around this life saving, but costly treatment.
  • Empowering Plans: P172 – Navigating the Gag Clause Prohibition
    September 28, 2023
    In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson delve into the issue of the gag clause prohibition, a mysterious law that continues to confound the self-funded industry. With the first attestation requirement approaching at the end of 2023, now is the time to make sure you know what needs to be done, how to do it, and how to keep yourself safe and compliant.
  • Empowering Plans: P171 – Mass Torts 101
    September 15, 2023
    From time to time, do you hear about mass torts in the news but feel like you could use a little more background knowledge? Look no further than the latest edition of the Empowering Plans podcast series, (“Mass Torts 101”) in which attorneys Cindy Merrell and Lisa Hill explain the difference between the two types of mass tort cases -- class action and multidistrict litigation (MDL) – while delving into a couple of the larger MDLs making news of late.
  • Empowering Plans: P170 – PSA on the NSA
    August 31, 2023
    It’s 10’o clock, do you know where your IDR determinations are? Join Attorneys Brian O’Hara and Corey Crigger as they issue a public service announcement on the state of the No Surprises Act, and specifically the challenges with the IDR process. Friends don’t let friends miss this podcast! In addition to the PSA on NSA, Corey discusses a case study highlighting the benefits of the Safeguard Program. Just Say No to skipping this episode of Empowering Plans.
  • Empowering Plans: P169 – Let’s Keep Learning - Back to (Law) School
    August 17, 2023
    In the latest edition of the Empowering Plans podcast series, “Let’s Keep Learning - Back to (Law) School,” Attorneys Kelly Dempsey and Corey Crigger are here to take us all back to school! Listen as they discuss renewal season preparation items and a variety of late breaking lawsuits that pertain to multiple aspects of the self-funded industry. From civil courts hearing cases about NSA administrative issues all the way to ACA compliance (or lack thereof) there is something in this podcast for everyone. Once you listen to the podcast - class dismissed!
  • Empowering Plans: P168 – “Drafting” Plan Exclusions
    August 4, 2023
    In this episode of Empowering Plans, Andrew Silverio and Kevin Brady discuss the unanticipated costs of playing pickleball and then “draft” their favorite (and least favorite) plan limitations and exclusions. Let us know who you think had the better picks!
  • Empowering Plans: P167 – Who is a Fiduciary and Does it Even Matter? Lawsuits Abound!
    July 21, 2023
    In this episode of Empowering Plans, The Phia Group’s Chief Legal Officer – Ron Peck – and Sr. VP of Consulting – Jennifer McCormick, analyze recent lawsuits involving self-funded plan sponsors and their third party administrators, and accusations of fiduciary breach on the part of TPAs. We delve into whether TPAs can be fiduciaries, what this means, and whether it even matters when it comes down to how administrators manage plans. Finally, are plan sponsors signing contracts enabling TPAs to do things contrary to ERISA, and who is to blame when this is the case? Anyone and everyone handling self-funded plan assets needs to tune into this one!
  • Empowering Plans: P166 – Delving Into Dobbs, One Year In
    July 7, 2023
    In the latest episode of Empowering Plans, attorneys Nick Bonds and Kendall Jackson discuss the changes that have occurred in the past year following the Supreme Court’s decision in Dobbs. How will new abortion laws affect self-funded plans and what are the implications for their participants? Tune in to learn how plans can navigate these changes.
  • Empowering Plans: P165 – Artificial Intelligence Meets Subrogation
    June 26, 2023
    We are halfway through 2023, and Artificial Intelligence (AI) remains one of the year’s hottest topics, particularly in the worlds of business and healthcare. In the latest edition of The Phia Group’s Empowering Plans podcast, Attorneys Jon Jablon and Cindy Merrell zero in on how AI could have a monumental impact on the field of subrogation within the larger context of healthcare law.
  • Empowering Plans: P164 – The Key to a Successful Self-funding Experience: Knowledge!
    June 9, 2023
    With many self-funded employers entering the field from a world where their benefits are “set it and forget it,” educating plan sponsors about their obligations, relationships, opportunities, and risks is often the difference between retaining and losing a client. Attorneys Andrew Silverio and Christopher Aguiar muse about the challenges arising when self-funded plans aren’t educated about their benefit offerings, the risk mitigation mechanisms, and the cost containment tools being utilized to ensure the plan’s viability.
  • Empowering Plans: P163 – ChatGPT: Disrupting the Healthcare Industry
    May 19, 2023
    In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Brian O'Hara provide an overview of ChatGPT, the artificial intelligence chatbot developed by OpenAI, and describe how it is disrupting the healthcare industry. In particular, they focus on one emerging use for the technology - acting as a virtual assistant for patient care. What are the advantages of using AI in this manner? What are the concerns? Tune in for what will be a topic that we revisit in the coming weeks and months!
  • Empowering Plans: P162 – Mind the Gap 2.0: Don’t be Afraid to Ask for a Handbook
    May 12, 2023
    In this episode of Empowering Plans, Kelly Dempsey and Kevin Brady outline the relevant details provided within our Handbook Gap Free Reviews. They provide a description of the service, the case studies which gave rise to this service and describe why a review of the Handbook is more important now than ever before!
  • Empowering Plans: P161 – New Challenges to Old Favorites - NSA, ACA, and more (Acronyms)!
    April 28, 2023
    In their latest podcast, Attorneys Nick Bonds and Corey Crigger are back to discuss the No Surprises Act (NSA) and the Affordable Care Act (ACA). Join them as they provide an overview of each of these laws and the recent legal challenges out of Nick’s home state of Texas. Will payment determinations resume? Has the ACA finally been struck down? Tune in to find out!
  • Empowering Plans: P160 – How the Ending of COVID-era National Emergency Impacts Your Health Plan
    April 18, 2023
    On April 10, President Joe Biden signed a bipartisan congressional resolution to terminate the U.S. national emergency in response to the COVID-19 pandemic—weeks before the development was supposed to occur in conjunction with a separate public health emergency expiring on May 11. Unsurprisingly, in the wake of such a stunning announcement, group health plans from coast to coast are scrambling to decide whether they must adjust their processes. In the latest Empowering Plan Podcast, Attorney Jennifer McCormick, Senior Vice President, Consulting, and Joanie Verinder, Director, Service Strategist, discuss the sudden end to the National Emergency, the many ways in which health benefit plans are affected, particularly in regards to timelines, and the information their respective participants need to be aware of.
  • Empowering Plans: P159 – Putting the Patient First: Challenges to Common TPA Operations
    March 31, 2023
    In this episode of The Phia Group's Empowering Plans podcast, attorneys Katie Malkin and Jon Jablon take a dive into three aspects of TPA operations designed to try to make the TPA's job more manageable: simplifying EOB denial codes, sending family EOBs, and recouping overpayments by offsetting. These are three common strategies used by TPAs, but applicable law places certain limits on all of them that are not always so intuitive. Tune in as Jon and Katie discuss some best (and worst) practices, and examine critical issues facing TPAs and health plans in today's self-funded industry.
  • Empowering Plans: P158 – Seek and Ye Shall Find
    March 17, 2023
    In the world of subrogation, there’s (almost) always more funds to recover, you just have to go searching for them—even if that means in unconventional places. In their latest podcast, attorneys Chris Aguiar and Cindy Merrell discuss how, particularly in regards to auto accidents involving participants who have substandard coverage, there is a heightened need to capitalize on opportunities for plans to recover funds. Don’t miss Phia’s veteran subrogation attorneys weighing in on how healthcare plans can be reimbursed so that their participants reap long-term benefits.
  • Empowering Plans: P157 – New TPA Liabilities – Section 1557
    March 3, 2023
    One of the healthcare trends we have been following so far in 2023 is expanded TPA liabilities. In this edition of the Empowering Plans podcast, attorneys Brady Bizarro and Andrew Silverio discuss a recent federal court case in which a TPA was found liable for violations of the ACA’s Section 1557. Despite numerous defenses raised by the TPA, many of which we see regularly used by TPAs, the court rejected them all, potentially expanding the scope of Section 1557. Tune in to hear more about this significant case and what it means for our industry.
  • Empowering Plans: P156 – Accommodating Reasonably: Navigating the ADA and PWFA in 2023
    February 16, 2023
    On this episode of Empowering Plans, Kelly Dempsey and Kevin Brady provide some valuable insights into the reasonable accommodation process under the ADA and PWFA. The PWFA, which will be effective this June, expands the scope of existing federal law with respect to accommodating employees with known limitations related to pregnancy, childbirth, or related medical conditions. Tune in to learn why this is important for employers in 2023 and beyond!
  • Empowering Plans: P155 – The State of the Union 2023: Phia’s Take
    February 10, 2023
    The State of the Union has always served as an important bellwether for our country, but also, for our industry, revealing what the current administration’s healthcare policies will be going forward, and in some cases, which ones enjoy bipartisan support. In this special edition podcast, join attorneys Ron Peck and Brady Bizarro as they break down the president’s speech, providing you with their reaction and analysis, and explain what you should be watching this year.
  • Empowering Plans: P154 – No Ordinary Time in Healthcare
    February 3, 2023
    Corey Crigger and Nicholas Bonds cover a lot of ground in the newest installment of The Phia Group’s Empowering Plans podcast: Whether it’s the National and Public Health Emergencies starting to wind down or what state legislatures have in store for non-profit hospitals that overcharge or Amazon creeping into the healthcare space, Phia’s attorneys are here to keep you up to date on the ever-changing world of healthcare.
  • Empowering Plans: P153 – Living Up To Expectations
    January 20, 2023
    Over the last decade, The Phia Group’s leaders have made quite a few predictions. There have been some hits and misses. Join attorneys Ron Peck and Jen McCormick as they discuss past predictions, their predictions for 2023, and what the best health plans need to do to stay ahead of the game this year!
  • Empowering Plans: P152 – The Contemporary Fiduciary: Emerging Law on an Old Topic
    January 5, 2023
    In this installment of The Phia Group’s Empowering Plans podcast, join attorneys Katie MacLeod and Jon Jablon as they discuss fiduciary status, both traditionally and in the new age of self-funding. This industry is faced with changes all the time, even to some of its oldest rules; in the spirit of consumer protection, the legal and regulatory winds are once again changing to challenge certain long-held understandings about fiduciary duties. TPAs in particular should tune into this one!
  • Empowering Plans: P151 – The Who, What, and When of Offsetting Benefits
    December 20, 2022
    In this installment of The Phia Group’s Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss offsetting benefits and when a Plan may want to consider it.
  • Empowering Plans: P150 – Manufacturer Assistance Programs
    December 8, 2022
    Attorneys Brady Bizarro and Andrew Silverio discuss manufacturer/copay assistance programs and outline some of the different approaches being utilized to manage specialty drug spending. Also on the agenda is a current lawsuit against one such program administrator, and how the landscape might be shaped in the coming months.
  • Empowering Plans: P149 – Another Ping-Ponging of IC/EE Rules?
    November 17, 2022
    In recent history there have been several rules that have been amended and re-amended (or just overturned and new rules published). Join Kelly Dempsey and Kevin Brady as they explore the ever-changing world of employee classification rules. The 2021 rule is viewed as leaving workers vulnerable to misclassification and was inconsistent with existing federal court decisions, thus the current administration is seeking to make a change. Tune in to learn more and why this rule matters to self-funded health plans.
  • Empowering Plans: P148 – The Ever Changing Times of Healthcare
    November 3, 2022
    “It’s an ever-changing time…” in the healthcare landscape. Corey Crigger and Nick Bonds are back on the podcast mics to discuss some of the more interesting developments they’ve seen in 2022. Tune in to be sure these developments aren't burdensome and rest assured that the dreams you believe in will still come true.
  • Empowering Plans: P147 – Transparency & More: Burning CAA/NSA FAQs
    October 27, 2022
    In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon bring up some of the most common questions that The Phia Group’s consulting team has been asked to field over and over again. From the so-called broker compensation rules to a TPA’s obligations related to a group’s No Surprises Act compliance, Jen and Jon highlight some of the main points to keep in mind when making important decisions regarding your business.
  • Book of Russo: Chapter 5
    October 21, 2022
    In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Mike Ferguson, President & CEO of the Self-Insurance Institute of America (SIIA), have to say about SIIA’s 2022 National Conference, the history of SIIA, and what to expect from SIIA in years to come.
  • Empowering Plans: P146 - A Possible Threat to a Plan’s Discretionary Authority
    October 14, 2022
    Currently before the Senate, a new bill has been announced that would ban all references to a plan administrator’s discretionary authority, as well as remove all deference courts give to their claims determinations. Regardless of whether this bill will be passed, what does this and similar rhetoric say about public and political attitudes towards self-funded health plans? Ron Peck, Chief Legal Officer, and attorney Kaitlyn MacLeod are here to talk about this and more. Enjoy!
  • Book of Russo: Chapter 4
    September 22, 2022
    In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Dr. Jeffery Gold, have to say about Direct Primary Care and why Dr. Gold decided to open his own practice in Massachusetts.
  • Empowering Plans: P144 - The Latest Developments Involving Patient Assistance Programs
    September 16, 2022
    In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Andrew Silverio discuss patient assistance programs. They explain what these programs are, how they have been utilized in the industry, and the latest regulations and litigation surrounding them. Tune in to find out what plan sponsors need to know!
  • Empowering Plans: P143 - Is Wrongful Death the Death of a Subrogation Claim?
    September 2, 2022
    In this installment of the Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss the murky waters of wrongful death and healthcare subrogation claims.
  • Book of Russo: Chapter 3
    August 26, 2022
    In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Ernie Clevenger, have to say about Ernie’s famous Saturday night newsletter, CareHere, and much more.
  • Empowering Plans: P142 - The (Healthcare) Times They Are A-Changin’
    August 19, 2022
    In this installment of The Empowering Plans podcast, attorneys Nick Bonds and Corey Crigger discuss two recent shifts in the healthcare landscape: The FDA’s stance on OTC hearing aids and recent developments showing that not all debt is created equal, especially medical debt.
  • Empowering Plans: P141 - Do You Mind (…The Gap)?!
    August 5, 2022
    In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon discuss the age-old topic of stop-loss gaps, with a modern twist. Emerging law and industry trends color so many decisions that self-funded plans and those who service them must make on a daily basis, and one player that sometimes gets forgotten about is stop-loss. Since stop-loss coverage expectations don’t always align with reality, health plans, TPAs, and brokers need to be proactive to find potential gaps and try to rectify them before they evolve into real problems.
  • Should Plans Better Address Mental Health Benefits? | The Phia Group
    July 22, 2022
    In the wake of the COVID-19 pandemic, the government has announced that we are facing another crisis – one on mental health. Participants are clamoring for more access to mental health care than ever before. The COVID-19 pandemic only highlighted the lack of availability of mental health care in the US, including care that is covered by plans. Ron Peck, Chief Legal Officer, and attorney Kaitlyn MacLeod are here to talk about what plans are doing to address the mental health crisis and how mental health parity comes into play for plans, patients, and providers.
  • Stop Loss and Subrogation | The Phia Group
    July 8, 2022
    In this episode of the Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss potential obligations of health plans to their stop-loss carriers in the event of a recovery through subrogation.
  • Book of Russo: Chapter 2
    July 6, 2022
    In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Dr. Marty Makary, have to say about price transparency, price gouging, and who is typically responsible for the high cost of care.
  • The Dobbs Case – What Group Health Plans and Employers Need to Know | The Phia Group
    July 1, 2022
    On June 24th, the U.S. Supreme Court handed down one of its most controversial and impactful decisions in half a century by overturning Roe v. Wade. This decision has sweeping implications for group health plans. In this special edition of the Empowering Plans podcast, The Phia Group’s Chief Legal Officer, Ron Peck, is joined by attorneys Jen McCormick and Brady Bizarro to unpack the Court’s opinion, what’s likely to happen next, and most importantly, how health plans should respond to this historic ruling.
  • U.S. Supreme Court Rules on Dialysis Carve-outs | The Phia Group
    June 24, 2022
    In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Andrew Silverio break down the Supreme Court’s ruling in the Marietta case on dialysis carve-outs. What does the ruling mean for self-funded plans that wish to carve out dialysis claims? Our experts dig deep into the legal analysis and explain how plans can stay within the parameters of this decision. Finally, they address important points raised by the dissent and consider the broader impact on the industry.
  • The Book of Russo: Chapter 1
    June 17, 2022
    In the first episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, has to say about the new podcast series, healthcare transparency, and so much more.
  • Breaking Down Breaks in Service | The Phia Group
    June 8, 2022
    In this episode of Empowering Plans, join Kelly Dempsey and Kevin Brady as they discuss the important considerations surrounding rehired employees and breaks in service. This dynamic duo covers a number of items including the 13/26 week rule, the rule parity, and the need to add plan provisions which account for these situations.
  • The Benefits of Direct Primary Care | The Phia Group
    May 27, 2022
    In this episode of The Phia Group’s Empowering Plans podcast, attorneys Nick Bonds and Corey Crigger discuss Direct Primary Care (DPC). This was a hot topic at a recent conference Nick attended and a subject near and dear to Corey. Join them as they discuss the benefits and practical issues to consider when looking at this tremendous option for augmenting your employee benefits plan.
  • Changing Laws & Changing Relationships | The Phia Group
    May 13, 2022
    Here you can find our podcast explaining the emerging/changing laws & trends as well as changing relationships in our Empowering Plans: P133
  • Congress’ Proposals to Limit Insulin Costs | The Phia Group
    April 15, 2022
    Here you can find a podcast explaining the effects of Congress' proposal concerning the cap on the cost of insulin in our Empowering Plans: P133
  • Empowering Plans: P132 - The Enhanced DOL Enforcement Effort
    April 1, 2022
    This podcast discusses how the CAA enhanced DOL enforcement mechanisms. Learn about the DOL's evolving approach to MHPAEA and the impact on plan sponsors.
  • Empowering Plans: P131–Reduction Requests | Fiduciary Duties
    March 18, 2022
    This podcast features a deep dive into reduction requests and a Plan's fiduciary duties. Learn why a reduction can be in a Plan's best interest and more.
  • Empowering Plans: P130 – Healthcare Policy | The Phia Group
    March 4, 2022
    This podcast talks about Biden's first State of the Union Address. Learn about the important healthcare policy items he discussed and which he didn't.
  • Empowering Plans: P126 – Challenges and Opportunities with Value-Based Care for 2022
    January 6, 2022
    This podcast talks about the challenges and opportunities of value-based care. Listen to learn about what it is, where it's at now and where it's headed.
  • Empowering Plans: P125 – The Night Before an Emergency Room Visit
    December 22, 2021
    This podcast discusses the basics of recovering subrogation dollars. Learn about identifying subrogation opportunities through an entertaining story.
  • Empowering Plans: P124 – Healthcare Subrogation and Plan Document Requests
    December 10, 2021
    This podcast talks about what a health plan should do in the event of a pesky U.S.C. 1024(b)(4) records request. Listen to learn more details.
  • Empowering Plans: P123 – Supreme Court Takes Major Dialysis Case
    November 23, 2021
    This podcast discusses the history of dialysis case law and different legal interpretations. Learn about the important developments and future predictions.
  • Empowering Plans: P118 – You Can’t Always Get What You Want
    September 17, 2021
    Our experts discuss what happens when limited settlement funds force Plans to consider a reduction. Learn more in this podcast by The Phia Group.
  • Empowering Plans: P116 – Right to Repair and Healthcare
    August 20, 2021
    This podcast discusses Biden’s executive order on right to repair. Learn how it impacts healthcare costs, patient safety and intellectual property rights.
  • Empowering Plans: P114 – Time to Vent!
    July 23, 2021
    This podcast discusses key mistakes and false beliefs dominating the media, politics, and the general public. Learn how this impacted recent rulemaking.
  • Empowering Plans: P113 – Ahlborn Revisited
    July 9, 2021
    Listen to this podcast discussing a recent Medicaid case involving conflicting court decisions. Learn about its impact on subrogation and reimbursement.
  • Empowering Plans: P111 – Breaking Down Drug Importation!
    June 11, 2021
    Listen to this podcast discussing state drug importation programs. Learn about whether a participant can be a plan fiduciary after a third party recovery.
  • Empowering Plans: P110 – NQTL? MHPAEA?! OMG, IDK!
    May 27, 2021
    This podcast discusses the NQTL analysis now required by the MHPAEA. Learn about what it is, what it entails and how health plans can protect themselves.
  • Empowering Plans: P108 – A Win/Win Proposition – Better Quality for Patients, Real ROI for Plans
    May 11, 2021
    In this episode of the Empowering Plans Podcast, Jordan Feldman, CEO & Co-Founder of Rightway Healthcare, discusses Rightway's impact. Listen now!
  • Empowering Plans: P106 – A No-Surprises Party – The No Surprises Act Dissected
    April 16, 2021
    Listen to industry legends discuss the No Surprises Act on this podcast. Learn about its impact and what you need to do now to ensure compliance.
  • Empowering Plans: P102 – CYA: Cover Your Assets
    February 12, 2021
    In this episode of the Empowering Plans podcast, Nick and Brady talk through some developing trends in ERISA litigation. Do fiduciary duties apply to the protection of plan data? Could a data breach lead to claims under ERISA and HIPAA? What steps do ERISA fiduciaries need to take? Listen in as we explore where things stand, and where they might be heading.
  • Empowering Plans: P95 - 2020 Election Results (So Far) – Our Takeaways
    November 9, 2020
    In this episode of Empowering Plans, Ron and Brady are joined by Attorney Nick Bonds to discuss the 2020 election results. For now, it looks like we will have a new president in 2021. What will that mean for the healthcare industry? If the Senate stays in Republican control, is a public option likely? Will Obamacare be replaced? What will happen to popular issues such as prescription drug reform and surprise billing bans? We are covering all of the angles and breaking down all of the possibilities.
  • Empowering Plans: P94 - The Final Debate & Election Predictions
    October 26, 2020
    In this episode of Empowering Plans, Brady is joined by Attorney Nick Bonds. They break down the final presidential debate of the campaign season, focusing in on the candidates’ healthcare plans. They discuss “Bidencare” as well as what would actually happen if the Affordable Care Act is finally found unconstitutional. To cap things off, they offer election predictions – which states will decide the election? Will Democrats take over the Senate? This is one October surprise you don’t want to miss!
  • Empowering Plans: P93 - Behind the Scenes – Town Halls, Nominees & Medicare-for-All
    October 19, 2020
    In this episode of the Empowering Plans podcast, Ron Peck and Brady Bizarro take you behind the scenes, avoiding the bright lights of presidential town halls and Supreme Court confirmation hearings. What is really going on? Is Medicare-for-All still a threat? Where is the Trump administration’s healthcare plan? How will a potential Justice Amy Cony Barrett rule on the Affordable Care Act case? Tune in to find out!
  • Empowering Plans: P88 - SCOTUS & HHS – ICYMI
    August 3, 2020
    In this episode of the Empowering Plans podcast, Jen and Nick discuss significant developments in nondiscrimination regulations, and the implications for those in the self-funding industry. They talk through the evolution of Section 1557 of the ACA, the new final rule issued by HHS, the Supreme Court’s recent decision on Title VII of the Civil Rights Act, and the looming legal challenges as the health care field attempts to reconcile what we’re hearing from the Supreme Court and HHS. They piece together what all this means for employer-sponsored plans, and offer some advice as to how employers and plans should respond.
  • Empowering Plans: P86 - COVID, Floyd, and the Fight for Social Justice
    July 17, 2020
    In this special episode, Ron and Brady address recent events that has altered the world as we knew it in a matter of months, and in one notable case, in one day. The emergence of Covid-19, the resulting mandatory restrictions to daily life, and televised tragic death of Mr. George Floyd, an unarmed African American man, at the hands of law enforcement has altered our collective understanding of security and racial equality in the U.S. In a moment of time that has been compared to the Civil Rights Movement, our very own Philip Qualo, Chairperson of the Phia Diversity Inclusion Committee, joins us to provide his perspective on these issues and the importance for Americans to unite in the face of tragedy. For industry leaders who may be uncertain on how to support their workforce in this “cancel culture” era, we also share some of our own internal approaches we have adopted that have not only been well received, but actually celebrated by our staff and the industry as a whole. As racial disparities continue to persist in ...
  • Wicked Awesome Wins: Episode 1 – A Million Dollar Start
    May 6, 2020
    Today, we launch a new series harkening to our Boston roots - “Wicked Awesome Wins.” Here, we will showcase our staff and some of their most successful and noteworthy wins on behalf of our clients. Join Ron and Brady as they interview Attorney Robert Martinez and explore a case in which he secured a massive balance bill write-off from a hospital using some creative tactics.
  • Empowering Plans: P78 – Debating the Debates
    March 6, 2020
    In this episode, Ron Peck and Brady Bizarro assess candidates’ (and EX-candidate’s) proposals, and what it all means for our industry.
  • Empowering Plans: P77 – Care Where? Care Everywhere!
    January 31, 2020
    In this episode, Adam and Ron interview industry legend, Ernie Clevenger, regarding CareHere, LLC, the future of consumer-centric medicine, technology – and most importantly – the MyHealthGuide newsletter!
  • Empowering Plans: P76 – Taking the Stage in 2020
    January 24, 2020
    In this episode, Ron Peck and Brady Bizarro discuss the first Democratic debate of 2020 and the latest ruling from a federal appeals court on Obamacare. Time could be running out, both for the ACA and for the candidates for president. You do not want to miss our take on these issues and more!
  • Empowering Plans: P75 – Free Health Benefits at Phia
    January 3, 2020
    We finally did it! Join Adam Russo and Ron Peck as they discuss the different tactics used to offer Phia's employees FREE health benefits! This is not a podcast that you can afford to miss.
  • Empowering Plans: P74 – Medicare Podcast for All!
    December 19, 2019
    This is it! This is it! Ron and Brady pick apart Elizabeth Warren’s Medicare-for-All proposal, and the concept as a whole; the good, the bad, and the really bad. You can’t afford to ignore this one.
  • Empowering Plans: P73 – Preparing Your Plan Document for 2020
    December 11, 2019
    The Phia Group’s Executive Vice President and General Counsel, Ron E. Peck, and Senior Vice President of Consulting, Jen McCormick, sit down to discuss the top-rated topic chosen by Phia’s webinar listeners. Our webinar listeners spoke (hypothetically) and we listened! Make sure you tune in to find out what Ron and Jen have to say about plan documents and learn the do’s and don’ts when it comes to reviewing and updating your plan document in 2020!
  • Empowering Plans: P72 – The Young & The Restless
    November 21, 2019
    Adam Russo and Brady Bizarro sit down with Craig Clemente, Chief Operations Officer at Specialty Care Management and outgoing Chairman of the SIIA Future Leaders Committee, to discuss the future of the committee and the many ways they intend on engaging the younger generation. Make sure you tune in to find out what SIIA has in store for 2020 and beyond.
  • Faces of Phia: Episode 19 – Shauna Makes a Comeback
    November 15, 2019
    Join Adam Russo and Ron Peck as they interview Shauna Mackey, The Phia Group’s Associate General Counsel. Shauna is back in New England after moving to London, and was fortunate to have had private health insurance through her husband’s company, as opposed to utilizing the public healthcare offered to all residents in England. Tune in to learn more about Shauna and her experience with both public and private healthcare throughout her pregnancy and delivery.
  • Faces of Phia: Episode 18 – Battling Balance-Billing
    November 4, 2019
    Join Adam Russo and Ron Peck as they interview Lyneka Hubbert, a Medical Claim Negotiator here at The Phia Group. Lyneka has worked in six different departments throughout her five years at Phia, and has more in store for her future here. Tune in to learn more about Lyneka and her experience with protecting patients from balance bills.
  • Tales From the Plan: Episode 5 – Translating Phia’s Benefit Plan
    October 24, 2019
    Join Adam Russo and Ron Peck as they interview The Phia Group’s Human Resources Manager, Linda Pestana. Learn how Linda was able to navigate our health plan and negotiate with a provider to make her son’s hearing aids affordable. Additionally, Linda discusses another story regarding Phia’s health plan, and how it has completely erased the out-of-pocket expense for a medication another employee previously paid $800.00 a month for.
  • Faces of Phia: Episode 17 – Reminiscing on Memories with Mrs. Marsh
    October 16, 2019
    Join Adam Russo and Ron Peck as they interview Jen Marsh, a dedicated employee that dates back to 2007, when Phia was one-third of the size it is today. Jen turns back time and goes over the past 12 years of her career here at Phia, from where she started as a Case Evaluator, to where she is today as the Client Satisfaction & Quality Control Manager... and you won't believe who used to work for her!
  • Tales From the Plan: Episode 4 - A Vision for Savings
    September 23, 2019
    Join Adam, Pat, and this episode’s guest – Michael Vaz – to hear from a valued employee, whose experience in the industry and as a consumer of healthcare will open your eyes and help you appreciate how much difference a plan can make in a person’s life. Containing costs and rewarding employees – it’s a win-win.
  • Empowering Plans: P71 – Politics! Politics! Politics!
    September 18, 2019
    Brady and Ron do what they do best, say the things you are thinking! This time, they wax poetic about Obamacare, the state of health care versus health insurance, and the political environment as we move toward the 2020 election.
  • Faces of Phia: Episode 16 - Crunching Numbers with Desmond Campbell
    September 4, 2019
    Join Ron Peck as he interviews Desmond Campbell; the man, the myth, the legend. Desmond has spent time crunching numbers over the past 4 years – first for clients, now for The Phia Group. A man with experience elsewhere in the industry, Desmond will share what brought him to The Phia Group, and what keeps him here.
  • Faces of Phia: Episode 15 - The Fine Fan Club!
    August 16, 2019
    In this episode, learn more about the life and background of Andrew Fine, Phia’s Lead Intake Specialist. Listen in as Andrew discusses his family, the fan club behind him, compliance being the number one priority for plans, and the bittersweet nature of the Celtics. Listen in closely, as the former sports analyst might give you some insider tips!
  • Faces of Phia: Episode 14 – The Magical Kingdom!
    August 1, 2019
    In this episode, prepare to be enchanted by Mattie Sesin, our Director of Recovery Services. Like a toad kissed by a princess, her career has transformed – and we invite you to join the journey. Marvel at the tales of family, festivities, and food. Miss this one, and you’ll likely turn into a pumpkin.
  • Tales From the Plan: Episode 3 – Direct & To The Point!
    July 17, 2019
    In this episode of Empower Plans – Tales from the Plan, The Phia Group’s VP of Legal Recovery Services discusses his experiences before and after becoming a happy participant in Direct Primary Care. If you are one of the many people who’ve heard about “DPC” but still wonder how it will be received by the plan participants, tune in.
  • Tales From the Plan: Episode 2 – Mrs Peck, It’s Cancer…
    July 8, 2019
    In this meaningful episode, Ron Peck tells us about his family’s battle against cancer, and lessons we can all learn from their experience. Health benefits play a role in our health and survival. You can’t afford to miss this one.
  • Empowering Plans: P70 – Surprise? Balance Bills!
    June 26, 2019
    With this episode, the guys define surprise balance billing, discuss movements to curb them (at the State and Federal levels), and harass Pat “The Man” Santos as well. Stop reading this description and start listening!
  • Tales From the Plan: Episode 1 – Putting the Benefit in Benefit Plan with Jennifer McCormick
    June 14, 2019
    In our inaugural episode of “Tales from the Plan,” our own Sr. VP of Consulting, Jennifer McCormick, opens up and candidly discusses her own experience as a consumer of healthcare of healthcare and member of The Phia Group’s health plan. Jen is brutally honest, and will make you realize that anyone can be taken advantage of, and anyone can take advantage of, our nation’s healthcare system. This is mandatory listening.
  • Faces of Phia: Episode 13 – Glutton for Punishment
    June 12, 2019
    Amanda Lima celebrates more than 6 years with Phia (most of that time working closely with Adam), by chatting about her time here, the company, and the amazing work she’s doing on our clients’ behalves – delving deeply into matters of excessive and abusive provider billing. This is a topic about which everyone is buzzing, and Amanda has got the dirt!
  • Faces of Phia: Episode 12 – Pat 'the Man' Santos Has Got it In the Bag
    May 7, 2019
    In this groundbreaking episode, Pat 'the Man' Santos – our silent producer, is silent no longer! Listen (if you dare) as he grabs the mic and goes toe to toe with our hosts. Learn of his daring escape from mediocrity, journey of self-awareness, and eventual role with The Phia Group. This is the one you’ve been waiting for. Don’t miss it.
  • Faces of Phia: Episode 11 - Reminiscing with Andrew
    April 17, 2019
    In the latest episode of Faces of Phia, Adam and Ron reminisce on Andrew Silverio's Undergraduate adventure. Tune in for an episode filled with trips down memory lane, international drug importation, and predictions about the future of prescription drugs!
  • Empowering Plans: P69 – A Healthcare Free-for-All
    April 12, 2019
    Join Adam, Ron, and Brady for a healthcare free for all where they tackle the most pressing issues facing our industry, including surprise emergency room bills, drug pricing, medical necessity, and employee incentive programs.
  • Faces of Phia: Episode 10 - Tales From The Lost Filing Room
    April 5, 2019
    In the latest episode of Faces of Phia, Adam and Ron dig up tales from the days of old with future industry leader and veteran employee, Amanda Grogan. Tune in for an episode filled with trips down memory lane, tests of knowledge, and a Rumspringa?
  • Empowering Plans: P68 – Breaking News - Federal Judge Blocks Expansion of AHPs
    March 29, 2019
    Last night, a federal judge in Washington, D.C. ruled that the Department of Labor’s new rules that expanded the sale of association health plans (“AHPs”) violate existing law. Those rules applied to fully-insured AHPs in September 2018, to existing self-funded AHPs in January 2019, and would have permitted new self-funded AHPs on April 1, 2019. If this ruling stands, it will have a significant impact on the self-funded industry. The Phia Group will have extensive analysis of this decision in the coming days. For now, join Adam and Brady as they unpack this 43-page order and discuss what it all means for employers, TPAs, brokers, and the broader industry.
  • Empowering Plans: P67 – Employee Takeover: Self-Funded Health Plans from the Member's POV
    March 26, 2019
    Listen in as The Phia Group’s Marketing & Accounts Manager, Matthew Painten, and Compliance & Regulatory Affairs Consultant, Philip Qualo, dissect Phia’s very own Self-funded health plan. These guys aren’t holding back and you don’t want to miss out on this podcast!
  • Empowering Plans: P66 - Bigger in Texas
    February 28, 2019
    Join The Phia Group’s Ron Peck and Brady Bizarro as they discuss Brady’s recent trip to Austin and presentation at the Texas Association of Benefit Administrators; with a focus on employee engagement, new ideas for cost containment, and an in depth analysis of pending litigation challenging the legality of ObamaCare. Yeah… You’ll want to tune in for this one.
  • Faces of Phia: Episode 9 - Taking Account with Lisa T!
    February 19, 2019
    In this episode of Faces of Phia, Adam and Brady interview the superpowered controller of The Phia Group. From adventures in the Steel City to conquering “nice problems to have,” the team covers it all in this candid discussion.
  • Empowering Plans: P65 - Hail to the Chief!
    February 15, 2019
    In this can’t miss episode of Empowering Plans, Brady and Ron dissect the President’s State of the Union Address, and focus in on how it will impact those of us servicing health benefit plans – and the entire healthcare industry. This one is going to be huge.
  • Faces of Phia: Episode 8 - It’s Tomasz Time!
    February 8, 2019
    Live from Polska – a journey around the world leads to… The Phia Group. Join Adam and Brady as they take a journey through history and across oceans, to share the story of this unsung hero.
  • Empowering Plans: P64 - Hospital Transparency!
    February 5, 2019
    Let’s Escargot & Meet LCARA: In this episode Ron and Brady discuss the new legal compliance and regulatory affairs team (“LCARA”) with team member Philip Qualo, and specifically address recent efforts to promote hospital transparency.
  • Faces of Phia: Episode 7 - Ashley Turco… International Agent of Security!
    January 30, 2019
    In this episode, the crew once again sit down with a valued team member, whose role sit at the crossroads between technology and healthcare. Ensuring that the privacy and security issues hounding all businesses don’t threaten The Phia Group as it leverages technology to better serve its clients, Ashley is unique not only at the company – but industrywide. Listen in to find out why, and what you need to do to get her seal of approval.
  • Empowering Plans: P63 - Touchdown!
    January 25, 2019
    How payers, providers, and those of us who serve them, can work together as a team and achieve a winning plan for the future of healthcare. In this episode, Adam, Ron and Brady, talk about how providers – like plan sponsors – are concerned with the state of things and want to identify what’s wrong, what’s right, and how we can collaborate on a new approach that works for us all, as members of a single industry – healthcare.
  • Faces of Phia: Episode 6 - Tech Talk with Hemant
    January 17, 2019
    Sit down, turn the volume up, and enjoy as Ron and Brady discuss with our latest Face of Phia – Hemant Dua – data, robots, and how technology is impacting healthcare, health plans, and The Phia Group’s own efforts to empower plans. Tune in, or you’ll be stuck in the stone age!
  • Faces of Phia: Episode 5 – Setting the Pace with Tori: Help me Tori!
    January 14, 2019
    In this most recent episode, Tori Pace – another Phia superstar – shares experiences working with each department, what she’s learned from these experiences, and campaigns for a regular seat on the show.
  • Empowering Plans: P62 - Obamacare is Still the Law, Right?
    January 10, 2019
    Ron and Brady dissect the Texas decision that challenges the legality of the ACA, what it actually means, and what is next – as well as what you could (should?) be doing now.
  • Faces of Phia: Episode 4 – Dishing with Delaney
    January 7, 2019
    Take a moment to meet Katie Delaney, Phia's Senior Training & Development Specialist who has been with the company since 2007. Responsible for training employees, you can thank Katie anytime a team member succeeds. Really? Listen to learn how we got to this point!
  • Empowering Plans: P61 - Leather Patches & Pipes
    January 2, 2019
    The Phia Group’s foray into higher learning! Ron discusses with professors Silverio and Jablon the forthcoming master’s degree program in plan development they will be teaching. If you’re up for the challenge, prepare to learn!
  • Faces of Phia: Episode 3 – Flying High with Judy
    November 29, 2018
    In this episode, Ron and Adam sit down with Judith McNeil. Judith is the most recent winner of our “Employee of the Quarter” award, as well as our second Face of Phia. Judith’s story goes from inspiring to hilarious, and is one you certainly won’t want to miss. Expect to see things differently by the time you’re done with this episode.
  • Empowering Plans: P60 - Politics With Brady
    November 20, 2018
    This Podcast is HUUUUGE – Brady and Ron will dig deep, analyze the recent election results, and determine how they will impact the health benefits and health care industries. Bottom line? If you listen to this episode, you will definitely impress everyone at the Thanksgiving dinner table. You’re Welcome.
  • Empowering Plans: P59 - Talkin’ with TPAC
    November 16, 2018
    In this “Partners in Empowerment” episode, Ron and Brady enjoy chatting with Michael Meloch, President of TPAC Underwriters and valued member of The Phia Group’s own advisory board. Michael isn’t shy when it comes to diagnosing the issues, boiling healthcare cost containment down to simple basics we can all appreciate, and telling it like it is. His employer based perspective and focus on the bottom line (a/k/a “risk”) is as refreshing as it is informative. Don’t miss this one!
  • Faces of Phia: Episode 2 – Not Your “Norma-l” Employee
    November 16, 2018
    In today’s episode, our hosts chat with Norma Phillips… our first official “Face of Phia;” (sorry Matt). Norma explains what makes her different (and special) as well as what makes The Phia Group so unique. From Friday night films, to saving the American workers’ job… Norma and the team touch all the bases.
  • Empowering Plans: P58 - Special Edition: Talking Politics, Elections, and Healthcare
    November 1, 2018
    Like it or not, healthcare is on the ballot – nationally, statewide, and locally. The questions asked and people we elect will have an impact on how we receive and pay for healthcare – and for those of us in the benefits industry – failing to identify the trends, issues, and opportunities is tantamount to waving the white flag. Stay in the know and get ready to go; don’t miss this episode of Empowering Plans.
  • Faces of Phia: Episode 1 – A Chat With Matt
    October 24, 2018
    In this episode we sit down with The Phia Group’s Marketing & Accounts Manager, Matthew Painten. Matt tells about how his time with the organization has changed him, and educated him regarding healthcare and what everyone can do to reduce their expense. Matt will give us insight into his transformation as well as how he accomplishes his work for the betterment of all.
  • Empowering Plans: P57 - AHPs: Will They Live Up to the Hype?
    October 22, 2018
    Have you heard? In 2019 it will be easier than ever to form a self-funded “Association Health Plan” (AHPs) … So what? In the words of Jurassic Park’s Dr. Ian Malcolm (a/k/a Jeff Goldblum), we have been so preoccupied with whether or not we could, we didn’t stop to think if we should. This podcast discusses the pros and cons, as well as benefits and hurdles the final rules have created for these new AHPs. From compliance with State MEWA laws to obeying federal laws such as ERISA’s consumer protections (including the Mental Health Parity and Addiction Equity Act [MHPAEA]), we dissect why we must slow our run towards AHPs to a measured walk.
  • Empowering Plans: P56 - 2019 - Fly Ball or Home Run?
    October 15, 2018
    In this episode, Ron and Adam discuss the many issues, changes and challenges 2018 has lined up for 2019, and how the outcomes we witness in 2019 are certain to change everything by 2020. Tune in, or suffer the consequences!
  • Empowering Plans: P55 - Learn from the Past to Shape the Future
    October 1, 2018
    In this episode, our hosts sit down with industry legend and innovative leader, Jerry Castelloe of Castelloe Partners, to dissect the state of the health benefits universe, identify new issues, repeat offenders, and determine what trends, risks – and victories – from the past are shaping the future.
  • Empowering Plans: P54 - Crossing Bridges
    September 24, 2018
    In this episode, Ron, Brady, and Adam chat with friend and industry ally, Mark Stadler – President and CEO of BridgeHealth. As the leader of an organization whose purpose is to connect patients with the best providers – offering the highest quality care for the lowest price – regardless of geographic location, Mark and his team need to build bridges and interact with all three “Ps” of healthcare – the “P”atient, “P”ayer, and “P”rovider. This gives Mark unique insight that he now shares with our listeners.
  • Empowering Plans: P53 - The View from Nova Healthcare
    September 5, 2018
    In this episode of Empowering Plans, Adam Russo and Jennifer McCormick interview Laura Hirsch, President of Nova Healthcare Administrators. They discuss the latest stop-loss trends, patient assistance programs for prescription drugs, and other issues facing the self-funded industry.
  • Empowering Plans: P52 - The View from SIIA’s Political Perch
    August 15, 2018
    In this episode, Adam Russo and Brady Bizarro speak with Ryan C. Work – Vice President of Government Affairs at the Self-Insurance Institute of America (“SIIA”). They talk politics, D.C., and more importantly, about the efforts of the Government Relations Committee to advocate for the self-insured industry. From stop-loss protections and an updated “ERISA Notebook” to new wellness program rules, Ryan reveals the top issues on SIIA’s political agenda and explains how member engagement can really make a difference.
  • Empowering Plans: P51 - A Healthcare Homerun
    August 8, 2018
    In this episode, Adam Russo, Brady Bizarro, and Ron Peck (yes - he’s back!), chat with Mark S. Gaunya – Chief Innovation Officer and Principal of Borislow Insurance. As an author, innovator, and passionate industry advocate touting more than 25 years of experience, Mark doesn’t pull punches as he addresses the biggest opportunities and threats facing employers, employees, and their plans. If you want to know what’s wrong with the nation’s healthcare system, what we need to do to fix it, and enjoy it when someone teases Adam – this episode is a must listen.
  • Empowering Plans: P50 - Where is Ron? A Very Personal Podcast from the SVP
    July 26, 2018
    In this episode, our Senior Vice President & General Counsel dials in to describe where he's been, what major health issue is impacting his family, and what he hopes we can all learn from their experiences thus far - as members of the industry, potential patients, and human beings.
  • Empowering Plans: P49 - Issues with Inaction: Balance Billing and Wellness Programs
    July 23, 2018
    The FDA issued the nation's first approval for a drug derived from marijuana-based compounds to treat seizures. Click here to learn more about the drug.
  • Empowering Plans: P48 - Make Cost Containment Great Again
    July 17, 2018
    Brady Bizarro and Adam Russo discuss the hot topics impacting the insurance industry today.
  • Empowering Plans: P47 - Coaching the Self-Funded Industry
    July 11, 2018
    In this episode of Empowering Plans, Adam and Brady interview Rick Koven, President of Koven Consulting & Coaching. They discuss his work with health plan startups, small regional TPAs, and micro-insurance in developing countries. Rick also explains his role as a coach for executives and corporate leaders in our industry. As a special treat, they are also joined by Lisa from the claims department.
  • Empowering Plans: P46 - You’ve Gotta Fight, For Your Right, to Try!
    June 29, 2018
    In our first-ever video podcast, join us as we explore the implications of the recently passed Right To Try Laws on health benefit plans. Tune in to understand the actions you need to take.
  • Empowering Plans: P45 - Super-Empowerment
    June 22, 2018
    Join us as we sit down with Brooks Goodison, President & Principal Partner at Diversified Group, winners of The Phia Group’s Most Empowered Plan award. Discover Brooks' innovative insights, from internal strategies to industry advocacy efforts, in this insightful episode.
  • Empowering Plans: P44 - The Phia Group “MVP” Post-Mortem
    June 12, 2018
    Tune in as our hosts recap the Phia Group MVP forum at Gillette Stadium, home of the New England Patriots. From insightful discussions to client feedback and amusing coincidences, this episode of Empowering Plans is a must-listen for attendees and enthusiasts alike.
  • Empowering Plans: P43 - A Debrief of SIIA’s Fly-In on the Hill
    June 1, 2018
    Join Adam, Ron, and Brady as they share insights from their impactful trip to Washington, D.C. Hear about their participation in SIIA’s “Fly-In” event, where they engaged with elected officials on critical self-insurance/captive insurance matters. Discover how they championed self-funded health plans, TPAs, and advocated for the Senate's Self-Insurance Protection Act.
  • Empowering Plans: P42 - Eliminating the Noise
    May 29, 2018
    In this episode, Adam, Ron, and Brady interview David Contorno, President of Lake Normal Benefits. They discuss emerging trends in the industry; from reference-based pricing to direct primary care. They also address the incentive problem and how HSAs are harming the health insurance industry.
  • Empowering Plans: P41 - The Case for Collusion (Continued)
    May 24, 2018
    Join The Phia Group’s Sr. VP, Ron E. Peck, and healthcare attorney Brady C. Bizarro as they answer the questions that you asked during our webinar on PBMs, specialty drug prices, and lawsuits alleging fraud.
  • Empowering Plans: P40 - Reference Based Pricing - Yeah, You Know Me
    May 17, 2018
    In this episode, The Phia Group chats once again with one of their Partners in Empowerment, Gregory S. Everett, President and CEO of Payer Compass. Greg addresses all of our hosts’ questions regarding reference based pricing, balance billing, the value of physician networks, and the future of RBP.
  • Empowering Plans: P39 - Everything's Bigger In Texas!
    May 7, 2018
    In this episode, our hosts interview Third Party Administrator, visionary, and industry expert – Caprock Healthplans’ own Executive Vice President, John Farnsley – as we review some of his recent talking points, cover where he thinks the industry is headed, and dissect the biggest issues he thinks will impact everyone involved.
  • Empowering Plans: P38 - A Labor of Love?
    April 24, 2018
    In this episode, Adam, Ron, and Brady interview in-house specialist, VP of Consulting Attorney Jennifer McCormick, and discuss the many complicated issues surrounding surrogacy, and the costs for which benefit plans may be responsible. What can be denied? What must be paid? Why is this a threat? What can we do to avoid it, or at least minimize the risks? Listen and find out!
  • Empowering Plans: P37 - Arresting the Financial Serial Killers
    April 18, 2018
    Today Adam and Ron interview the industry, and nationally, renown Dr. Keith Smith of the Surgery Center of Oklahoma. This pioneer of transparent pricing and forefather of the Free Market Medical Association waxes poetic regarding everything from issues with provider pricing, the status of medicine today, and his predictions for the future of health care. If you don’t think surgeons can offer a clear and transparent price for care before they provide the treatment is provided, listen to this episode and prepare to be shocked!
  • Empowering Plans: P36 - New Kids on the Block
    April 9, 2018
    In this episode, Ron, Adam and Brady interview one member of our industry’s albeit too small youth movement. Our hosts discuss with Brian Olsen what we all can do to attract new interest, and talent, to the business of risk management and hopefully help our industry not only survive, but thrive.
  • Empowering Plans: P35 - Direct Primary Care – The Pot of Gold You’re Looking For
    April 4, 2018
    In this episode, part of our Partners in Empowerment series, we interview Doctor Jeff Gold of Gold Direct Care (golddirectcare.com). Join us as we ask the questions you want answered regarding this innovative and interesting approach to “real” medical care.
  • Empowering Plans: P34 – Loopholes, Untouchables, and An Unlikely Ally
    March 23, 2018
    In this episode of Empowering Plans, Adam, Ron, and Brady go around the horn discussing a few hot button topics; from exposing what could be a significant loophole affecting health plans to explaining how certain age groups face unique barriers to obtaining health coverage. Finally, they discuss Idaho’s recent attempts to thwart Obamacare and the Trump Administration’s surprising reaction.
  • Empowering Plans: P33 - Partners in Empowerment – A Prescription for Savings
    March 16, 2018
    In this episode Ron and Brady are thrilled to interview LG Hanzel of Rx Results. LG digs deep on topics ranging from Specialty Drugs to PBMs, and what benefit plans can do to curb the cost of drugs in America – an issue that is big, and getting bigger every day.
  • Empowering Plans: P32 - Red Cross Blood Drive Special Episode
    March 1, 2018
    Today The Phia Group in partnership with the Red Cross hosted an on-site blood drive. Join Ron Peck as he interviews members of The Phia Group staff and Red Cross leadership as we discuss the event, personal experiences, and the ever present need for donors. This moving and important episode will hopefully drive you to action!
  • Empowering Plans: P31 - 3 Scoops of Knowledge
    February 26, 2018
    In this episode, Adam, Ron and Brady celebrate the forthcoming change in seasons and warming weather, by each selecting a unique topic that is bugging them, and offering their opinions regarding how we should react. This is one cool sampling of self-funded flavor you won’t want to miss.
  • Empowering Plans: P30 - Fireside Chat with The President
    February 16, 2018
    This is it! Our first Empowering Plans guest, and it’s a doozy. In this episode none other than the Self-Insurance Institute of America’s CEO and President, Michael Ferguson, sits down with Adam, Ron and Brady to discuss everything – from past wins and losses, to plans for 2018. From conflicts within the industry, to threats from beyond… Mike doesn’t hold back, and you – like we – get to enjoy the results.
  • Empowering Plans Segment 29 - Disruption or Not?
    February 7, 2018
    In this episode, our hosts discuss the recent announcement that Amazon, Berkshire Hathaway and JPMorgan are looking to collaborate on “health care.” Is this just a new way to supply medical goods, deliver care, or handle the entire exchange (including enrollment and payment)? How can broker/advisors, plan administrators, and other members of the industry benefit from this change? And who should be most concerned? This and more await you in “Empowering Plans.”
  • Empowering Plans Segment 28 - Game-changers
    January 29, 2018
    This week, our hosts discuss Adam’s recent travels and review events. We are not alone in our attitudes and desires to change the industry for the better, and now we have proof of that fact! What ideas and concepts were shared with Adam, and how can we add fuel to the fire?
  • Empowering Plans Segment 27 - Mandate? We don’t need no stinking mandate!
    January 22, 2018
    In this episode, Adam, Ron, and regular co-hose – Brady Bizarro – address the new tax law, elimination of the individual mandate, and how it may impact benefit plans of all types. In particular, they examine the psyche of low risk lives and ask the all-important question – how do we keep them enrolled without the mandate?
  • Empowering Plans Segment 26 - Lightning Strikes Twice – Top 2017 Issues Impacting 2018
    January 10, 2018
    In this episode, the “Phia Group Boys” freestyle as they share the issues they felt defined 2017 and are likely to impact 2018. From taxes to law; partnerships to reform… nothing is safe from their analysis and we all benefit from their warnings! This is an episode you cannot afford to miss.
  • Empowering Plans Segment 25 - A Taxing Time
    December 21, 2017
    In this special edition of the podcast, The Phia Group's CEO Adam Russo and Attorney Brady Bizarro discuss the new GOP tax bill in depth. Specifically, how does the bill affect employers? What does the repeal of the individual mandate mean for the self insured industry and for the future of Obamacare?
  • Empowering Plans Segment 24 - Protect Your ASA
    December 18, 2017
    In this episode, our hosts (including repeat guest host Vice President of Consulting, Attorney Jennifer McCormick) discuss the rising trend in stop-loss insurance being placed by entities other than the TPA, yet the TPA is held responsible if things go sour. Listen in to see how everyone can proactively avoid issues from emerging.
  • Empowering Plans Segment 23 - Plans and Conspiracy
    December 6, 2017
    Bring your tin foil hats, folks! With today's episode, our hosts (including guest host, VP of Consulting, Attorney Jennifer McCormick) discuss the recent news regarding CVS purchasing Aetna as well as a new opportunity to customize plan document reviews to address different levels of need.
  • Empowering Plans Segment 22 - The Biggest Threats to Self-Funding: A Lightning Round
    November 21, 2017
    In this episode, The Phia Group’s CEO, Adam Russo, Sr. VP, Ron Peck, and Attorney Brady Bizarro discuss the biggest threats to the self-funded industry. From expanded fiduciary liability to stop-loss denials to a real threat to the ACA’s individual mandate, our experts give their thoughts in a fast-paced discussion.
  • Empowering Plans Segment 21 - Planning for Stormy Seas Ahead
    November 3, 2017
    In this episode, Adam, Ron, and their guest star – VP of Consulting Jennifer McCormick, Esq. – discuss all of the many issues creating waves as it relates to benefit plan documents, and what steps we can all take to safely navigate those waters – including setting sail on The Phia Group Flagship Template!
  • Empowering Plans Segment 20 - Trumping Costs and Climbing the Hill
    October 19, 2017
    With this episode, Adam and Ron welcome back a fan favorite – guest star Brady Bizarro – and discuss the wild and crazy happenings in DC. From contraceptives to cost containment; the impact of fully insured subsidies on self funded plans; and everything in between – this is one lively podcast you cannot afford to miss.
  • Empowering Plans Segment 19 - The Man with the Plan
    October 13, 2017
    In this episode Adam and Ron discuss the oft overlooked but – in their opinion – all important plan document. From its purpose to best practices, they discuss why legal compliance, interaction with third parties, and cost containment efforts all start (and end) with the plan terms. Bring a pen and paper – these tips cannot be missed.
  • Empowering Plans Segment 18 - Responsibility - Beyond the Contract
    September 28, 2017
    In this episode, Adam and Ron discuss trends impacting health plans, employers, and employees. While these issues, such as the opioid epidemic, may not seem like the biggest costs facing benefit plans today, the long term costs are real. More importantly, issues like these can be identified by examining claims data; but most administrators are not contractually responsible to do so. Adam and Ron discuss why these entities should consider adding such services to their offerings – despite not being the most impactful cost containment option or being a contractual responsibility of the administrator.
  • Empowering Plans Segment 17 - Cutting Out Conflict
    September 11, 2017
    When it comes to securing stop-loss, too many benefit plans think the ball is only in the stop loss carrier’s court. Today, our hosts explain what plan administrators can do to cut out conflict and tie up loose ends before they suffer a costly loss. Ensuring an ongoing and fruitful relationship between plans and stop loss tomorrow requires intensive work today. Addressing these potential costly issues now will guarantee reimbursements are in the bag later.
  • Empowering Plans Segment 16 - In Reference to Reference Based Pricing
    August 22, 2017
    This week, Adam Russo and Ron Peck accept that an answer to the high cost of healthcare won’t be coming from D.C., and that health plan administrators (with the help of their partners and advisors) need to address the costs internally. Amongst options to do just that, so-called “Reference Based Pricing” is a hot topic in our industry. Join Ron and Adam as they pick apart this method for containing costs, identify the pros and cons of an “RBP” plan, and discuss options to customize such a program.
  • Stopping the Bleeding
    August 11, 2017
    This week, The Phia Group’s CEO, Adam Russo and Attorney Brady Bizarro interviewed Garrick Hunt, Phia’s Sales Executive, about some of the most common burdens self-funded employers are facing in our industry. From out-of-network claims to air ambulance to specialty drugs, we explore cost-containment strategies and discuss the potential compliance concerns for employers. Finally, we answer a question from our mail bag regarding best practices for handling overpayments.
  • Empowering Plans Segment 14 - Repeal & Replace Fails: What's Next?
    August 7, 2017
    This week, The Phia Group's CEO, Adam Russo, Sr. VP, Ron Peck, and Attorney Brady Bizarro discuss the dramatic events on Capitol Hill and the shocking failure of Senate Republicans to repeal and replace Obamacare. Despite this serious setback, Republicans are not ready to give up. We'll discuss the path forward.
  • Empowering Plans P13 - Your Friendly Neighborhood Provider
    July 17, 2017
    Taking a positive view on the industry, Ron Peck, Jon Jablon and Andrew Silverio today share stories and examples of providers working with payers to preserve the private employer based group health plan industry. From price transparency, to direct primary care, to medical tourism – providers that are willing to innovate and work with payers get their moment in the sun with this episode.
  • Empowering Plans Segment 12 - The Cost of Care
    July 10, 2017
    This week, The Phia Group's CEO, Adam Russo and Sr. VP, Ron Peck, interviewed Attorney Jon Jablon - Director of Provider Relations, regarding the seemingly increasing number of excessive charges being billed by providers to health plans, strategies to cut costs, and importantly - ways to work with providers rather than against them, in an effort to implement an arrangement that works for all involved.
  • Empowering Plans Segment 11 - The Senate Unveils its Repeal & Replace Bill
    June 22, 2017
    In this special edition of the Empowering Plans podcast, Sr. Vice President and General Counsel Ron Peck and Attorney Brady Bizarro give their initial thoughts on the Better Care Reconciliation Act. What is in this new bill? What does it mean for the self-funded industry? What is next for healthcare reform?
  • Empowering Plans Segment 10 - Plan Tales: The Good, Bad, and Really Bad
    June 19, 2017
    In this episode, Adam Russo and Ron Peck interview two key members of The Phia Group’s consulting division – Vice President of Consulting, Attorney Jennifer McCormick, and Product Developer, Kristin Spath. These two have tales to tell, regarding their experiences helping clients with unusual questions, and transforming outlandish ideas into real benefit plan innovations.
  • Empowering Plans Segment 09 - In the Land of the Blind
    June 12, 2017
    The Congressional Budget Office (“CBO”) has released its assessment of the American Health Care Act (Version 2.0), and once again the focus seems to be on who will lose insurance, gain insurance, and change insurance. Yet, as lawmakers stumble with blinders on, addressing only the matter of insurance, other important factors – such as the actual cost of care itself – remains conspicuously absent.
  • Empowering Plans Segment 08 - Healthcares? Alternative Provider Payment Programs
    May 22, 2017
    The Phia Group’s CEO, Adam Russo, and Sr. VP & General Counsel, Ron Peck, discuss movements within the healthcare provider community to change how they charge (and receive payment) for services rendered. For better or worse, change is on the way!
  • Empowering Plans Segment 07 - The American Health Care Act
    May 9, 2017
    Repeal and replace, the ACA, the AHCA - what does it all mean? How does it affect us? What’s next? Join The Phia Group's CEO, Adam V. Russo, Sr. VP, Ron E. Peck, and Attorney Brady Bizarro as they discuss the American Health Care Act, which passed the House of Representatives on 05/04/2017.
  • Empowering Plans Segment 06 - An Employer Call to Action
    April 25, 2017
    A podcast dedicated to employers. Our goal is to show employers what they can do to improve their health plan and plan performance, without relying on third parties. It’s time for employers to get into the game!
  • Empowering Plans Segment 05 - The AHCA Failed: Where To Next?
    April 4, 2017
    Join The Phia Group's CEO, Adam V. Russo, Sr. VP, Ron E. Peck, and Attorney Brady Bizarro as they discuss the recent, stunning failure of the GOP's American Health Care Act, the most recent news and predictions on the effort to repeal and replace the ACA, and what this all means for the self-funded industry.
  • Empowering Plans Segment 04 - Attack of the Killer Savings
    March 13, 2017
    Join The Phia Group's CEO, Adam V. Russo, and Sr. VP, Ron E. Peck, as they describe how The Phia Group identifies facilities that provide the best outcomes for the least cost, and encourage plan participants to visit those facilities.
  • Empowering Plans Segment 03 - The Journey Continues
    February 28, 2017
    Once again The Phia Group’s CEO, Adam V. Russo, and Sr. VP, Ron E. Peck, delve into what makes their own company’s health benefit plan unique, and share tips employers (and those that service them) can use to improve their own plan’s performance.
  • Empowering Plans Segment 02 - The Next Episode
    February 12, 2017
    In this second installment of The Phia Group's official podcast, our hosts begin sharing what makes their own health plan a source of savings for the employer and benefits employees love.
  • Empowering Plans Segment 01 - The Maiden Voyage
    January 31, 2017
    Welcome to the maiden voyage of "Empowering Plans," a new Podcast by The Phia Group where our hosts will review the purpose of this new series of Podcasts, reveal what the next few episodes will be about, and open the forum to our partners for comments and ideas.
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