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Phia Group Media


Freedom Fighters Abound…

On March 14, 2018
There is no question that the vast majority of folks in self-funding, whether benefit or service providers, have a goal in mind; providing cost effective benefits to the insured.

The DOL’s Proposed Rule … A Sleeper Provision for Self-Funding?

On February 12, 2018
Proposed regulations by the Department of Labor (DOL) make two important modifications to self-funding. Learn about them here and how they could be affecting you or your business.

Montana SB44 and State Efforts to…Do What, Exactly?

On November 6, 2017
Jon Jablon, Esq. discusses Montana's recently passed SB44 and its impact on payment amounts due to out-of-network air ambulance providers in Montana.

The Irony of Equity – It’s Almost Never Fair

On October 25, 2017
Chris Aguiar, Esq. shares a recent case involving equitable claims and the importance of having trusted advisors.

Change is Good

On September 5, 2017
Learn more about designing a valuable benefit plan for employees with ERISA in mind.

A Win for the Good Guys!

On June 7, 2017
Is an SPD enough when standing up against benefit plan reimbursement rights? We explain why the 5th Circuit ruling helps. Read more now.

A Call for Defensive Legislation

On May 3, 2017
Find out more about how the House of Representatives bill passed April 5th, 2017 helps regulate stop-loss insurance redefinition.

Independent Consultation & Evaluation

On November 22, 2016
The Phia Group has for more than a decade been a source of document review, claim analysis, and regulatory compliance consultation for the health benefits industry. Today, statutory changes are occurring with greater frequency, and the industry needs objective analysis and expert consultation now more than ever before. With an ICE subscription fee, clients can preemptively budget for and share the cost of this invaluable resource – allowing The Phia Group and their clients to focus on what is really important – results.

Independent Consultation & Evaluation: ICE, ICE, Baby!

On September 22, 2016
Our industry is plagued by issues related to compliance, contracts, and cost-containment – and a myriad of other legal issues as well. Engaging an expert for a second set of eyes is a chore in itself, requiring approval from management or an individual group as well as a cost-benefit analysis of the expert’s fees – sometimes resulting in the decision not to consult a neutral third-party at all.

Back to Basics: Plan Documents 101 (Part 2)

On July 13, 2016
When we think of hot topics in the self-funded industry, plan document drafting is hardly the first thing that come to mind. Instead, issues such as fiduciary duties, reference-based pricing, transgender coverage, employee incentives, and provider abuse are on the tip of everybody's tongues. All these topics, however, share a common feature: they're all reflected, in some way or another, within the plan document. Without compliant and effective plan document language, a plan can't offer robust benefit programs while containing costs.

Back to Basics: Plan Language 101

On June 15, 2016
Most situations that involve self-funded benefit plans revolve around language within the plan document. Whether deciding if a service is experimental, or figuring out whether a dependent is actually covered, or deciding whether a leave of absence will extend coverage, the plan document controls in just about all situations. For that reason, it's all the more disastrous when poor plan language handicaps plans and TPAs. Like we always say, your rights are only as good as your language.