Phia Group

Unraveling FAQ Part 31

On May 4, 2016
Reference-based pricing is unquestionably a hot topic in the self-funded industry today. So hot, in fact, that the federal government has taken an active interest in it for the third time now; in its latest FAQ, published just last week (FAQs about Affordable Care Act Implementation, Part 31), the regulators reiterate concerns regarding network adequacy and how it relates to - and regulates - reference-based pricing arrangements.

A Changing Industry: Navigating the current (Events)

On April 14, 2016
The self-funded industry changes rapidly and without notice. In recent memory, the biggest culprit has been the ACA - and in its aftermath, there have been numerous regulatory guidelines and court cases that have helped interpret the ACA's provisions. Still, though, there are many other changes occurring at any given time. Examples include assignments of benefits, discrimination, preemption, bankruptcy, subrogation, stop-loss, and more.

Saving Stop-Loss - Protecting a Key Self-Funding Ingredient in a Hostile World

On January 19, 2016
Thank you for joining The Phia Group’s legal team on Tuesday, January 19, 2016, as they provided first-hand insight into the self-funded market’s reliance on stop-loss and threats to that industry, including what TPAs and brokers should look for – and look out for – when advising health plan sponsors regarding stop-loss options.

Issue of the Year: Reference-Based Pricing and Balance-Billing

On December 28, 2015
Thank you for joining The Phia Group’s legal team on December 15th as they discussed reference-based pricing and balance-billing from the ground up and debunked common myths associated with it. This webinar will ended the year with a comprehensive primer on reference-based pricing and balance-billing, the rights of all parties involved, and what you can do to be proactive and successfully administer a reference-based pricing program.

Less Takes More - The Phia Group Addresses the Summary of Benefits & Coverage Requirement

On December 22, 2015
Benjamin Franklin, Blaise Pascal, and Mark Twain are all credited with having said, “I would have written a shorter letter, if I’d had the time.” Unfortunately, efforts to simplify complex matters often constitute the greatest challenge. This fact of life is certainly proven by the Affordable Care Act and its requirement that health plans provide consumers with a concise document detailing, in plain language, information about plan benefits and coverage. This summary of benefits and coverage document ( or “SBC”) is meant to help consumers better understand the coverage available to them, and allow them to easily compare options by summarizing key features such as the covered benefits, cost-sharing provisions, coverage limitations and exceptions.

Keeping PACE With The Trends

On December 7, 2015
Thanks for joining The Phia Group’s legal team on November 30th as we explored the numbers behind our industry’s growth and provided real-world discussion on the topic, while we explored real solutions to the issues presented.

The Phia Group, LLC Comments on Recent Industry Developments

On October 23, 2015
These last few weeks have brought with them a whirlwind of controversy and concern. The Phia Group, LLC is pleased to announce that it will be addressing three of the hottest topics during its monthly webinar. If you have not yet signed up for our FREE webinar, to be held on Thursday, October 30th, 2014, from 1:00 – 2:00 PM EST, then you will most certainly be missing out!

Plan Appointed Claim Evaluator (PACE)

On October 16, 2015
We at The Phia Group are pleased to offer our Plan Appointed Claim Evaluator (PACE) service to the self-funded industry. PACE spent a great deal of time in the development, testing, and “beta” phases – and we are now ready to roll it out to the industry at large.

A Call To Action!

On October 15, 2015
Thanks for joining The Phia Group’s legal team on October 14th as we discussed many such ongoing instances, and shared with you opportunities to take an active role in the preservation of our industry.

The Phia Group, LLC Announces the Release of its New "Phia Document Management" (PDM) Software

On October 2, 2015
Braintree, MA — A first of its kind plan document drafting solution, Phia Document Management (PDM) was created to satisfy the needs of the entire health plan industry. PDM allows for instant population of an online template featuring The Phia Group’s critically acclaimed plan language, while still ensuring customization to meet each client’s unique needs.

The Phia Group, LLC Announces Exclusive U.S. Relationship with Jason Davis

On September 4, 2015
Braintree, MA — The Phia Group LLC, one of the health benefit industry’s leading cost-containment service providers, announces that we have agreed to a U.S. exclusive consulting agreement with Jason C. Davis. Mr. Davis will assist The Phia Group with sales and product development.

Inc. Magazine Unveils Its Annual Exclusive List of America's Fastest-Growing Private Companies - The Inc. 500|5000

On August 26, 2015
New York, August 22, 2013 — Inc. magazine today ranked The Phia Group on its annual Inc. 500|5000; an exclusive ranking of the nation’s fastest-growing private companies. The list represents the most comprehensive look at the most important segement of the economy—America’s independent entrepreneurs. The Phia Group joins LivingSocial, Edible Arrangements, CDW and Lifelock, among other prominent brands featured on this year’s list.

"Phia Case Studies" - When Silence is Loud and Assumptions Mean Disaster

On August 4, 2015
Thanks for joining The Phia Group’s legal team on September 17th, at 1:00 PM EST, as they analyzed recent cases featuring communication breakdowns, regulation popping up in its wake, and best practices to make sure you know your role and do your job.

2nd Quarter Newsletter 2015

On July 16, 2015
The past few months have brought so much intrigue to our industry. Everywhere you looked, something or someone was affecting health care and the insurance industry as a whole. We saw the Supreme Court make a few monumental decisions that will affect how plans are written in the future and the viability of the ACA. We saw interesting court cases placing more potential fiduciary risks upon brokers and administrators. We watched and reacted as more states attempted to limit the ability for smaller employers to self fund their benefits through the use of stop loss coverage and last, but certainly not least, we have seen a monumental increase in the DOL audits to our clients and the industry at large. If there ever was a time that The Phia Group’s services were needed, this is it! There is no question that health claims costs continue to skyrocket and the use of so called wrap discounts on many of these claims isn’t helping to reduce the burden. If you are looking for some innovative options to stand out from the pack, please contact me as there are so many great ways to truly make a powerful impact on behalf of your employer plans. We can save you and your plans significant claim dollars, you just need to strategize and identify your major pain points. The next quarter will continue to be eventful so while you enjoy your summer weather, please be sure to let us know if you need some assistance – we are here for you. Happy reading

"Stories From The Front Lines" - Real Wins, Losses, & Difference Makers

On May 20, 2015
Join The Phia Group on Wednesday, May 20th, from 1 to 2 PM EST, as its attorneys discuss their experiences providing plan administrators with guidance as it relates to difficult claim processing decisions, conflict resolution, and bill negotiation… as well as dissect the small factual differences between otherwise similar scenarios that made all the difference.