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New Guidance on HIPAA – Using PHI to Contact Recovered COVID-19 Patients Regarding Plasma Donation

On September 21, 2020
Protected Health Information can be used to identify and contact individuals who have recovered from COVID to inform them about plasma donation. Read on.

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.

An Overview of the Recent New York Federal Court Decision and its Potential Impact Moving Forward

On September 9, 2020
The State of New York sued the Department of Labor for several of the Families First Coronavirus Response Act provisions. Read about the court's ruling.

Empowering Plans: P89 - Healthcare Policy at the DNC/RNC

On September 2, 2020
In this episode of Empowering Plans, Ron and Brady assess what we learned from the candidates on healthcare policy at the virtual Democratic and Republican national conventions. Over the course of two weeks, both parties showcased their platforms; one focused heavily on restoring the Affordable Care Act and a nationwide COVID-19 response, and the other on lowering prescription drug prices and covering all pre-existing conditions. What can our industry learn from the talking points? Join us as we cover all the angles and discuss what comes next as the presidential election draws ever closer.

Plan Mirroring: What Does It Really Mean?

On August 26, 2020
Plan mirroring provisions can be marketed to make a stop-loss policy airtight for the plan, but there is still the potential for a gap. Learn more!


On August 24, 2020
Many of the temporary COVID legislations are set to expire by the end of 2020. Will more economic aid be on the way? Learn more.

Conflicts Abound – Providers & Facilities Fight Back

On August 17, 2020
U.S. hospitals have lost over $200 billion from March to June as a result of canceled services due to the COVID-19 pandemic. In response, providers have changed their tactics. They are raising prices, appealing more denied claims, more aggressively fighting referenced-based pricing, and stepping up collections efforts. Now, more than ever, it is imperative for plans and their partners to be vigilant and protect their members and plan assets. Join The Phia Group’s team as they discuss these new aggressive tactics as well as the conflicts they are causing with networks and stop-loss.

Returning to Work Safely and Smartly. Who Bears the Cost?

On August 13, 2020
The rise in mandatory return-to-work COVID testing has led people to question who bears the cost of covering these tests? Read on to find out.

New Rules on Prescription Drug Importation Are Released – Or Are They?

On August 11, 2020
On July 4, 2020, an "Executive Order on Increasing Drug Importation to Lower Prices for American Patients" was issued. Is this a real step forward? Read on.

The Phia Group, LLC Announces the promotion of Nick Fitzsimmons as Senior Director of Provider Relations

On August 7, 2020
Nick Fitzsimmons’ cost-containment journey began with Global Excel Management in 1996, managing a team of over 50 employees comprised of negotiators and sales representatives. He also led the network utilization, negotiation strategies, and later rose to the ranks of senior executive leadership. “The Phia Group is a good fit for me as we they are all about innovation, which is what I am looking for.” stated Nick Fitzsimmons. “I want to be where the action is, and The Phia Group never sits still pursuing their deep commitment to lower the cost of healthcare.”

Empowering Plans: P88 - SCOTUS & HHS – ICYMI

On 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.

The Phia Group, LLC Announces Promotion of Jason Davis to Senior Vice-President of Provider Relations

On August 3, 2020
Canton, MA - The Phia Group LLC, the health benefit industry's leading cost-containment service provider, announces the promotion of Jason C. Davis to the role of Senior Vice-President of Provider Relations. "Jason has been partnered with The Phia Group for nearly 7 years, and we have grown tremendously during this time; we now want to highlight and reward his contributions with a seat at the executive table” stated Adam Russo, CEO of The Phia Group. “Jason has proven himself to me and our clients as a person of intelligence and integrity, and I believe he is the right person to lead our Provider Relations department to the next level."

Texas Still Working On Mental Health Parity Rule Implementation

On August 3, 2020
The Texas House Bill 10 is made up of four divisions that can impact self-funded non-ERISA plans. There may be new requirements on the horizon. Learn more.

A Brief Anecdote on Testing for COVID-19

On July 29, 2020
There are several COVID-19 testing options, but each of those options has a myriad of issues that convince people not get the test. Learn more!

Simple Negotiations Made Not-So-Simple

On July 23, 2020
Something as simple as a plain old claim negotiation can still develop certain unexpected hiccups. Learn more about how to navigate these with this informative post!