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In-Network vs Out-of-Network Claims
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The Insulin Cap Bill Offers Hope for Americans With Diabetes
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The U&C Gap Keeps Rearing Its Ugly Head
On December 8, 2020
What constitutes U&C? Find out more about U&C language gaps between a plan and a stop-loss carrier, with easy-to-follow examples. Learn more now!
Empowering Plans: P95 - 2020 Election Results (So Far) – Our Takeaways
On 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: P92 - Healthcare on Stage & COVID-19 in the White House
On October 13, 2020
In this episode, Ron Peck and Brady Bizarro guide you through a chaotic week for healthcare news. What did we learn (if anything) from the first presidential debate? With COVID-19 infecting the President and much of the West Wing, what can we learn from the President’s experimental treatment? Would self-funded plans cover this treatment? What impact could all of this have on the Affordable Care Act lawsuit? Join us to find out!
Benefits on the Ballot – A Political Update for Health Benefits Professionals
On September 22, 2020
Election season is underway. The future of healthcare will be decided via the ballot box, court rooms, and congressional halls. Pandemic or no pandemic, the gears of democracy are turning and what happens now will have long term effects for us all. Join The Phia Group as they discuss the most important elections (including candidates’ positions on health), ongoing legal cases, and proposed laws. They will dissect each and provide you with not only thoughts on how they may impact us, but how we can best prepare for likely outcomes.
Empowering Plans: P90 - IRS Notice 2020-29, COVID-19 and Cafeteria Plans: Self-Funded Plans Beware!
On September 15, 2020
The COVID-19 pandemic has brought about an unprecedented wave of federal legislation in a short period of time specifically aimed at regulating employer-sponsored group health plan coverage. Similarly, the Internal Revenue Service (IRS) has followed suit and released several formal Notices aimed at extending COVID-19 relief options to cafeteria plans. In the most recent notice issued by the IRS, however, IRS Notice 2020-29, there are certain provisions that impact employer-sponsored coverage. If adopted by a cafeteria plan sponsor that also sponsors a self-funded health plan, these provisions can result in significant cost liability for the plan and create issues for stop-loss reimbursement.
The Supremes Weigh In
On July 15, 2020
The Supreme Court of the United States recently wrapped up its first full term with Associate Justice Brett M. Kavanaugh. Learn more about a number of high-profile opinions here.
A Pandemic Economy – Industry Risks and Opportunities
On May 19, 2020
As the economy suffers, our industry is impacted when employers furlough employees or implement layoffs, as well when employers can no longer afford to offer benefits or continue operations. Fewer benefit plans, fewer plan participants, and dramatic changes in claim type and volume are certain, leaving health benefits at risk during a time when they are most needed. Yet, there are those that are improving coverage, leveraging opportunities, and preparing to take advantage of the employer, employee, and claims growth likely to follow a lifting of stay-at-home orders. Join The Phia Group as they discuss ways administrators are extending benefits and taking care of those in need. From COBRA to workers' compensation, mandates to stop-loss, join us to discover innovative ways to conquer the challenges and come out on top.
“Incur”-aging a Review of the Term “Incurred”
On March 12, 2020
The word 'incurred' can mean two different things. Learn why knowing your definitions could be the difference between claim reimbursement and denial.
Empowering Plans: P79 - COVID-19 Preparedness: What Self-Funded Plans Should Be Doing Right Now
On March 11, 2020
In this special edition of Empowering Plans, Brady Bizarro and Jennifer McCormick discuss the recent outbreak of COVID-19 (coronavirus). Join them for their insight into how you should be preparing, what concerns you should have about your benefits documents, and how to navigate applicable law.
The Top 10 of 2020: Cost Containment Measures to Implement Right Now
On March 10, 2020
Self-funding can be great if you know how to use it – but it can also be disastrous if done wrong. Health plans trust their TPAs and brokers to make the right decisions for them, and cost-containment is always the right decision. From choosing a stop-loss carrier all the way to handling appeals, the self-funding market is full of options and customizations, and some are (much) better than others. Join The Phia Group’s legal team as they discuss the cost-containment measures they encounter most frequently, and tell some success stories, some horror stories, and how you can make the best decisions for your clients’ bank accounts.
New Insight on Provider Surprise Billing
On February 17, 2020
Many states have enacted protections against balance billing and surprise billing, however, these state laws have limited applicability. Learn more.
More Thoughts on The Cigna Racketeering Case
On January 28, 2020
If Cigna truly issued insufficient EOBs and didn’t follow applicable regulations, the providers have a good case that appeals are futile. Read more.
WORLD AIDS DAY 2019: Three Decades of Progress in Treatment and Healthcare
On December 11, 2019
December 1st is World AIDS Day, an opportunity for the world to unite in efforts to stop HIV, support those affected and have lost their lives by HIV.
The More You Know, the More You Save: How Transparency in Health Care Can Help Empower Patients and Plans
On December 5, 2019
The goal of the executive order and the resulting proposed rules is to make the cost of healthcare transparent for patients. Learn more about changes.
New Transparency Rules Released, But Will They Last?
On December 2, 2019
The Trump administration released two rulings: A final rule on hospital price transparency & a proposed rule on transparency in coverage. Learn More.
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