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Empowering Plans: P170 – PSA on the NSA

On 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

On 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

On 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!

On 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

On 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: P164 – The Key to a Successful Self-funding Experience: Knowledge!

On 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

On 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

On 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)!

On 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

On 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

On 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

On 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: P156 – Accommodating Reasonably: Navigating the ADA and PWFA in 2023

On 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

On 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

On 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.