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Final Rule on Association Health Plans and YOU: Phia's Take

On June 21, 2018
On Tuesday, June 19th, the Department of Labor issued a final rule on Association Health Plans. Supporters claim the rule will allow millions of Americans to access more affordable coverage options. Critics contend that it will reduce patient access and weaken the insurance markets, leading to increased costs for all. Join The Phia Group's legal team in this special edition webinar in which they will break down the final rule and explain the significant impact it is expected to have on the self-funded industry.

Right to Try... Right for You? Understanding What is Right, and Wrong, for Self-Funded Plans in Response to the New Right to Try Law

On June 21, 2018
Are you seeking insurance coverage options for drug treatment? If so, this article will explain everything about the new Right To Try legislation.

The MHP Hits Just Keep on Coming

On June 20, 2018
Mental Health Parity violations keep resurfacing in court cases more frequently. Learn more about the recent case involving Catholic Health Initiatives here.

An Addiction to Health Insurance

On June 18, 2018
Health insurance continually blinds people from the actual cost of healthcare. Read why more people are more addicted to health insurance more than ever.

The Complicated Issue of ACA’s Section 1557 and Gender Identity Protections

On June 13, 2018
The Affordable Care Act prohibits health programs to discriminate people based on their attributes. But is gender identity protected? Click here to find out!

The Buck Stops…Where? Pointing Fingers in the Self-Funded Industry

On June 12, 2018
In a financial climate where saving money has to be made a top priority, so many entities within the insurance industry have fallen victim to someone trying to shift blame onto them. Regardless of fault, it’s in everyone’s best interests to work together to overcome issues rather than point fingers – but it’s not always that simple.

Empowering Plans: P44 - The Phia Group “MVP” Post-Mortem

On June 12, 2018
Welcome to Empowering Plans a show dedicated to identifying waste and undo expense in the health benefits industry. Discovering ways to maximize benefits while minimizing costs, and empowering employers, administrators, and consultants to emphasize once again the benefit in benefit plan. Today’s episode is brought to you by the Phia Group Empowering Plans Since 1999, now here are your hosts the Phia Group’s own CEO Adam Russo, and senior vice president and general counsel Ron Peck, and Brady. ADAM: Hello everybody, and welcome to another episode of Empowering Plans with the Phia Group. I am your co-host, co-founder, CEO of the Phia Group, Adam Russo. With me as always is our senior VP, general counsel, my good friend, Phia Forum collaborator, whatever you want to call him, Ron Peck. Say hello Ron RON: Hello Ron. ADAM: In addition, as always the great, the infamous, Brady Bizzaro. Say hello Brady. BRADY: Hello Brady. ADAM: And as Ron likes to say, and I feel bad because I always talk about Pat at the end. Ron’s right nobody is listening by the end. Our great producer Pat Santos, say hello Pat. He has nodded, He’s waving. It’s amazing. Folks we have some exciting news, even though our internal HIPAA people, security people are frowning upon our decision. The minute this podcast ends Pat, Ron, Brady, and myself are going to tear down the room, take all the equipment out, and we are moving our studio into the hallway, into a corner, right near one of our unisex bathrooms. We will have yes, video not just audio, but now in the future you will be able to see all of us. You will be able to see the Phia swag, the bobble heads. We are going to make this way better than any ESPN studio, and we do not care if there is a concern that all the equipment is going to be stolen. If somebody wants to steal this stuff, we will find him or her and punish him or her. We are excited about the move. I think all of you (we have been hearing it over and over again) want us to have some live feeds occasionally. We are going to appease you. In addition to all the Phia Groupies out there who love our podcast, who decided this week to come to our Forum. Yes, they stalked Ron for a little bit. (Ron: they were not actually invitees of the event; they were just crowding around the stadium). When they hand write their name into the badge that’s when you know those are the people that weren’t actually invited, but you couldn’t say no to them because you are petrified they might do some bodily harm to you. (Ron: Yes, the smiley face with the googley eyes instead of the photo of the attendee was a dead giveaway.) We wanted to let everyone know. I want to thank personally Ron Peck for putting on a great show. I did all the actual live work at the event that people saw so I am the front man, but trust me the work that Ron did behind the scenes: every slide, every topic, and every speaker. We raised over $1300 for the Boys and Girls Club of Brockton with our silent auction, which was amazing. Ron’s choice of venue at Gillette Stadium was unbelievable. Seeing the Phia Group logo at Gillette Stadium right next to that horrible cheating Patriot’s logo (even though I hate the Pats), it was inspiring to see our logo up there on the field. RON: I have to tell you it was a lot of work from the original concept to actually seeing it come to life. It meant a lot. I was happy to see it all come together as it did. I just wanted to take a moment, if you don’t mind, Adam, to give some credit where it’s due, a lot of other individuals that helped me bring it to reality. (Adam: C’mon just say it you did all the work, its fine). I will admit that I was the seed of creation. I was the creative inspiration. (Adam: So now, you are calling yourself God). I’m not going to, but the other speakers were awesome, Adam. Your co-owner Mike Bronco did a lot of work with the venue, the people there. He obviously made a good impression because they threw many bells and whistles in that were not necessarily part of the package. Because of the reputation, because of the relationship he built with them. (Adam: That’s right). Mike’s right hand and left hand, Cindy Monfils, was on the phone, getting on people, RSVPs. The clients obviously, the attendees they were amazing. The people over at the Boys and Girls Club and the resources they provided to us, to help get that auction up and going, their connections were amazing. ADAM: Well, you know what I am noticing and hearing from Ron. What did Ron actually do? Sounds like everybody else did the work. Everything I thought Ron did he’s now telling me somebody else was doing. RON: Adam, what I actually did was I came up with concepts, and delegated the actual work. I’m learning from the best (Adam: I am the king of that.) I have to throw Hannah’s and Matt’s names out there too. They were helping with a lot of the packaging, the flyers, the folders, the swag that we gave out that I was in love with this year. ADAM: I don’t think our listeners need to know every person that made a box, or hung something up on a wall. Anyways I know we are going to get bombarded with this “why wasn’t I invited?” Folks this was an invitation only event. This was 9th year we have done this conference. Back in the day, we literally had it open to anybody, and hundreds of people came. However, we realized that we were going to get a lot more use of our time if we focused on our actual clients, our biggest clients. Not only the biggest in revenue, but also the clients that are most collaborative and willing to be our beta. The ones that have new ideas for us to come up with new services. Organizations that are leaders in our industry, and those are the folks that we wanted to make sure we had in the room. We invited 75. We got 75. Then we added about 20 people from our own organization as well because obviously we want them to mingle. It was a three-day event. It was unbelievable. Next year my goal is to have it at Progressive Field. Yes, Jacob’s Field in Cleveland for the 10th year anniversary of the Phia Forum. What better place than in the land. RON: Is that a rhetorical question or a real question? I thought you were trying to keep this podcast short. ADAM: This podcast already went over time. Couple of things I want to bring up. Pat Santos will be working very hard over the next two weeks to put together a nice, detailed, video, audio show that we can share with all of you. Just the highlights of the Forum, so even if you were not there, even if you weren’t cool enough to get the invitation to the Peck, Brady, and Russo party, you will still be able to watch it for free. RON: We were videotaping. We were audio recording. What better way to honor the Patriots at their own stadium than to have video and audio equipment everywhere. Tracking everyone’s movements, and listening to everything everyone said. BRADY: I think we left some behind too, for the practices. RON: It’s in the visitor’s locker room. ADAM: We had a podcast with Pat Patriot, and he can’t talk which is amazing. RON: That is innovation. That is how you do it. ADAM: I saw him in the corner with the cheerleaders. I wanted to find out if he was talking to them. He was not he is in character. That man thinks it’s 1776, the musket, he’s all about it.Okay. Folks just so you know we did an awesome survey during the Phia Forum. I think we learned a couple lessons from it. It was a live survey during the actual event. It told us a lot about not only where we are today as a company, but also what we need to focus on going forward. This is what I got out of it. What I learned was people are very interested in reference-based pricing. Not as the end, all be all solution to our health cost problem, but as a step in the right direction. I thought that was so amazing to hear that most of the people think that it is the right direction. Because there are some vendors out there, their whole marketing, their whole pricing model is based on RBP being the actual final solution to the problem. Whereas most of our industry thinks, it is just a step in the right direction. I think it is very important when you look at RBP you speak to different vendors that are out there doing it: What is it that they believe? Is it the end result or is it a step in right direction? RON: I think you are right, Adam. I think when you look at the way we have been pricing claims for so long, it’s almost like hitting things with a rock, and reference based pricing is a lot like a hammer. It’s a tool that is far more advanced than what we have been doing, but ultimately it’s still just one tool in the tool box. ADAM: Right. In addition, what people also care about is balance billing of patients. The biggest thing (and we are going to have a Webinar about it in July) is specialty drug trends. That is a huge issue that people have. Moreover, one of the biggest ones that we knew, but didn’t realize it was such a big problem is overpayments. So there are a lot of overpayments in our industry, and the reason why you don’t see a lot of information about it anywhere is because most TPAs and administrators are afraid to talk about them because it makes it look like they did something wrong. When most of the time there is no negligence on the part of the administrator, it is just because of their proactiveness they found something after paying the claim that nobody else would have found, but they are still afraid to come out of the shadows. RON: I think we need to start a trend. Have it go viral and push back against overpayment shaming. Because honestly the fact that people think the only reason there is an overpayment is because the claim’s processor made a mistake is OP shaming, and it’s not a good thing. How many overpayments occur because of fraud, or mispricing, or a mistake on the part of the provider? How often does an overpayment occur because of miscommunication on the part of some third party or whether somebody is actually enrolled or properly enrolled? Maybe a plan member reports somebody is their spouse when the truth is they are not actually married. That is not on the TPA, yet it is being wrapped up in this shame. ADAM: In addition, what I think we found is that finally people looked at themselves and were honest. Even though a TPA in their administrator’s agreement is not looked upon as a fiduciary, when we asked the audience what they thought; 80% of them said they were not confident that the actual plan makes the claims decision and not the TPA. 80% of the TPAs feel that an argument can be made that they are the ones making the claim decision, which is not good. That is why Ron is going to be sharing some information with our clients on how to get around that. But what more and more brokers and plans are also asking is that TPA to take on that fiduciary risk which is a big part of our PACE product, and something that I think is helpful. However, the biggest thing I think I realized more than anything else, and I’m not even talking about claim negotiation or Phia unwrapped. Here is what we learned: Folks I love doing these podcasts, we love doing the webinars. We get 5,000 people on a webinar, we get hundreds of people listening to the podcasts, we get emails from our Phia groupies across the country. Thank you by the way, keep those emails and love letters coming. But here is what we realized, the number one way people learn about our services isn’t from these podcasts. It isn’t even from our sales team, which you would think is the number one way. It’s from seeing us perform somewhere speaking, somewhere else at a conference. Number 1 way people learn about our services. So I guess I am on the road that is why we have all these people on the road all the time. I thought because of social media it may shift, but no, people still want to touch you, people still want to see you. Even though the voice is there, our studio is going to be awesome, nothing makes up for me actually being able to spit on somebody in the first row of my speech. RON: Adam, I think you are right it is great to watch a game high definition surround sound, but sometimes you have to go sit in the seat, feel the weather, see the players, and enjoy a beer. ADAM: So what am I missing Ron? What did you get out of the Forum? It’s great to see the clients. So many of them came to our open house the next day. So many of them saw where this podcast takes place, which is by the way going to be moving. But what else did you guys get out of this? As far as what I got out of it, I saw a huge interest in the industry. Something I didn’t bring up is a lot of people have that same belief and interest in getting future leaders involved. More and more people want young people involved in the industry. They are turning to Phia to help them know how to do it, and more importantly from a training standpoint; how we train, how we educate the industry about self-funding, and the right way to do it versus the wrong way is another big take away I got which I wasn’t necessarily expecting. RON: Tied to what you just mentioned, Adam. I was happy to see pretty much all the same faces when it comes to leadership at the organizations that represent our MVPs (most valuable partners). What I saw this year that I have not seen years in the past is that those leaders brought with them new faces, fresh faces, and a I feel that among these MVPs they are starting to expose that next level of leadership, those future leaders to their partners (that being the Phia Group). Kudos to those clients that did bring new people with them to expose them, and get them trained. The other thing that I noticed, Adam, was that a lot of our clients even though they think that their issues, their problems, and their concerns are unique to them, when we did these surveys and we asked “What’s troubling you? What are you seeing in the industry?” The vast majority of people all agreed. 75%, 85%, 95%, of people were all answering the same way, which goes to show you they all agree on what the problems are. The difference lies in the vision of what the solutions will be. Lastly, everyone seemed to mention that there is not enough collaboration in the industry. Not enough crowdsourcing when it comes to coming up with these solutions. The fact that everyone is having the same issues, one comes up with a great solution, but no one else ever hears about it, and then they end up suffering the same problem. That in itself is a problem. BRADY: Whenever you are asked to speak last it’s always the case that you have nothing left to say because it’s been said already. I think the topic of future leaders is huge, and I think I scared them when presenting and saying “look we are getting older as an industry, and millennials you may hate a lot of them but they are the future whether you like it or not. You got to take action now” ADAM: Just so you know while Ron was talking, I got two emails asking for more information of the future leaders program. So I’ll just forward those over to Brady. BRADY: Great. I’ll add that to my plate. But yes, that’s a big deal. I was also surprised about how popular direct primary care was. There was a number of questions asked during the presentation by Dr. Gule. I think that is the way of the future. People like the idea of less red tape, these direct contracts, skipping all the bureaucracy and all the administrators. ADAM: The only thing that I’m not surprised about is when we asked the one thing to improve about Phia. The answer was replacing Brady. I’m not joking folks we have the slides and results to prove it. Replacing Brady was number one. I want to take that slide and frame it, and put it in our podcast room. Replace Brady was by far there’s not even a top three. It was replace Brady and then everything else. BRADY: I think that is because they want me to work for them. RON: Sure, they want to be a free agent. I’ll actually tell you a quick, funny story because you know we were at Gillette Stadium when we were doing that slide. We had the survey up and people were filing in the blank about what they felt was the number one thing we needed to improve. Replace Brady came up in big letters and obviously everyone jumped on the bandwagon. Thought it was hysterical. At that moment, Adam, a tour was passing at the next level, over the balcony. They were looking down at this group of professionals wearing suits at Gillette Stadium with a big slide that says “Next Step: Replace Brady.” And you have these tour people taking pictures with their phones sending it to Barstool and ESPN thinking they just stumbled upon…. (Adam: are you serious) I kid you not, the children were crying up on the balcony, I kid you not there was a tour going around the stadium at that moment. ADAM: Replace Brady was definitely there. Who knows maybe they will take us up on it. That would be Ron’s worst nightmare. Anything else you want to add? (No) So listen folks as we said in a couple weeks we will have all the information about the forum. If you want any information about our services, or even want the slides please feel free to contact Brady, Ron, or myself. On behalf of Ron Peck, Pat Santos, Brady Bizarro, and myself thank you so much for empowering your plans with the Phia Group. Have a great day.

May Day: Two States Enact Individual Health Insurance Mandates

On June 11, 2018
Many states have defied the Trump Administration’s repeal of Obamacare, but why? Click here to learn more.

Bridging the Gaps Between...Everything

On June 4, 2018
Our new Phia Certification Program is to ensure all our employees understand our industry and how we operate. Click here to learn more.

Empowering Plans: P43 - A Debrief of SIIA’s Fly-In on the Hill

On June 1, 2018
Welcome to Empowering Plans a show dedicated to identifying waste and undo expense in the health benefits industry. Discovering ways to maximize benefits while minimizing costs, and empowering employers, administrators, and consultants to emphasize once again the benefit in benefit plan. Today’s episode is brought to you by the Phia Group Empowering Plans Since 1999, now here are your hosts the Phia Group’s own CEO Adam Russo, and senior vice president and general counsel Ron Peck, and Brady. ADAM: Hello, welcome to another episode of Empowering Plans with the Phia Group. I am your co-host the one that matters the most, Adam Russo, CEO and co-founder of The Phia Group, with me not in studio again, this guy just likes to stay home. Brady, what’s going on with Ron? BRADY: I don’t know ADAM: Ron, do you have a bad case of acne or something, is there a reason why you do not want to come to the office? Do you have a big zit or is there something going on that we are not aware of? RON: I am working on a project at home Adam, and it’s going to change the industry forever. BRADY: Oh boy ADAM: Really? So he must have gotten some facial reconstruction, somethings that’s a cosmetic surgery; not covered by the plan, that’s why he paid for it cash. Pure transparency. With me as always on the phone is Ron Peck, our senior VP and general counsel, say hello Ron. RON: Hello Ron, it’s a pleasure to be there? ADAM: Our newest co-host, the infamous, the Washington insider, the guy who just wants to be in DC all the time Brady Bizzaro. Say hello Brady. BRADY: Hello Brady ADAM: And as always even though he does not have a mic, he’s sitting here, he’s smiling, he’s happy, our producer Pat Santos. Say hello Pat. He has waved to us. Pat has waved. So guys, today’s a special edition, we needed to do this once because yesterday was a very special day here at the Phia Group. And I’ll be honest there was no reason for me to go to DC other than the fact that I wanted to see Brady Bizzaro in action in Washington D.C. on Capitol Hill, where this guy just fits. It’s like bees with honey, it’s like peanut butter and jelly. Brady just belongs on Capitol Hill. It was absolutely amazing. Yesterday and the day before, Brady, Ron, and I flew down to DC with SIIA (which is the Self Insured Institute of America). We did what the annual trip is called “The walk on The Hill” or “The attack on The Hill” or “Let’s go meet with our Democratic representatives and actually get nothing accomplished Day” whatever you want to call it. But it was pretty interesting, and all I got to say is..(Ron you have t to agree with me) I mean Brady was light on his feet yesterday wouldn’t you say? RON: It was amazing to see Brady Bizarro in his habitat. It was like watching a penguin on land is just so clumsy, but once it hits the water, it is a thing of beauty. ADAM: So for those of you who don’t know, I like to walk fast and I sort of have people trying to keep up with me. We leave the hotel and I’m like you know guys “lets walk” and Brady goes “Uh, it’s like twenty minutes.” “Oh twenty minute walk it’s no big deal” Folks we walked for forty five minutes, Brady I think purposely had us walk by certain things so he could say “Oh I went to school there” “Oh I was an intern at this building” “Oh I used to go to this Starbucks.” I mean literally this guy took us on his own personal Brady Bizzaro tour. Ron? RON: Yes, but now I know where Washington D.C.’s best Shawarma cart is so it was worth it. ADAM: Folks you should have seen Ron walking, Ron had a jacket on and Ron’s jacket is a very..let’s just say thick coat (Brady: It’s like a wool coat almost) yes wool. Ron was sweating three minutes in there was no way Ron would have made it to the Capital building with his jacket intact without dying. I truly believe that. RON: Adam, I think it was actually more about the pressure and stress of meeting our nation’s leaders. You know it was getting to me. ADAM: So let’s talk about those leaders, so Brady I know this is all about you. It was funny we walked into these meetings and Brady was supposed to lead every meeting. Brady was supposed to be the person that started the conversation. I think Brady just got nervous. I think he just got scared. Brady walked into these offices, and he could not take the stage. He just froze (Ron laughing: he was star struck) he was star stuck Ron and I were like “Uh well Brady supposed to lead but I guess…” and he just sat there with a smile and a stare, and would just stare at these aids and not say a damn word. That is just what happened. BRADY: I seem to have a different recollection, (Adam: Uhh) but as far as I can recall I think I got us in with the right people, and shepherded us around the right tunnels, and got us in at the right spots at the right time. ADAM: You asked random people which tunnels for us to take, Brady. You had no idea (Brady: It has been a long time they changed the tunnels up I think.) Okay, so Brady since you know we were making fun of you a little bit, I mean that’s part of our routine right? Can you tell the fine folk who we met with, and what you think we accomplished yesterday? BRADY: Sure, well I think we accomplished a lot. We met with and I think this is actually in order: Jim McGovern, a democratic representative from Massachusetts, and Stephen Lynch, who represents actually our district in Boston, and part of where you grew up Adam. Then we met with the two senators, and I say senators, I mean they are staffs: Ed Markey and Elizabeth Warren. The last one there I did a little solo act for, but essentially it’s a busy day on Capitol Hill. Every day is busy but because there is a long weekend coming up there was almost no chance that the member themselves would be there, and they were not. But (Adam: Even though we had Brady with us) right I try to pull all the strings I could, but you know it only goes so far even for me unfortunately. ADAM: So my question for you is this Brady in order of I would say the type of influence that we had. Would you agree that when you had your solo act with Elizabeth Warren’s office that was probably the least productive of the four meetings? BRADY: It was and it was because (Adam: it was because you were by yourself) yes when you have one person with you, and because there was four other groups there, and she is by far the most in demand person and arguably one of the most in the senate. I met with a person that probably just started that day. ADAM: But you know what the funny thing is right, and again we met with these folks… I think part of this was more about just I would say explaining our interests. That being how we are trying to lower the overall cost of health insurance and health care, and to improve health care options for the typical American worker and their families. I think one of the thing we realized after yesterday was, and again I apologize for patting ourselves on the back here, but just the amount of lives we represent in the state of Massachusetts, the number of employers that we impact every day in the state of Massachusetts. Let’s face it then guys we have over 100,000 employee lives that we represent directly; lowering the cost of care….union plans, school districts, cities and towns, private employers that are in these folks’ districts. I think once we said that I don’t know about you, but it seems like once we explained the number of employers and employees and voters we represent in their districts; it seemed like they paid a lot more attention to us than before that. What would you think? BRADY: Having worked on The Hill for a while I can tell that in these meetings, you have to watch and see when they are taking notes, what they are writing down. When we were talking about the union plans, the teachers and the firefighters, and the cities and towns that are actually self-funded you saw them taking lots of notes. They were paying attention definitely at those points ADAM: So it’s interesting right. I was talking to my wife about this last night, and what we’re doing: self-funding. It was has nothing to do with being democratic or republican it really doesn’t. At the end of the day if you look at whom we represent most half-heartly plans, most union plans are self-funded. Most cities and towns are self-funded, most public employees are self-funded, so the constituents who typically vote democratic {for the democrats right?} (Brady: Yup) They are self-funded, so we went there to protect SIPAC. Brady you want to explain what that is, and how it’s going to impact our industry going forward. BRADY: Yes, so one of the primary goals and why we were there was to remind the members that they voted for what’s called the Self Insurance Protection Act which passed last year in The House by an extremely rare vote of what I think was 400 to 14 or something insane like that. That Act is designed at preventing the federal government from redefining stop-loss as health insurance. So it’s really just a preemptive measure; we don’t want to see even more regulation at the federal level of stop-loss. It’s bad enough what we have to deal with with the States, but every member we met with voted for that bill, and this was really just getting their staff to understand what stop loss insurance is, why it’s important for self-funded plans to have it, and basically just to get their support moving forward. Just to be aware frankly of self-funding, and how important it is for their constituents who have plans that are self-funded. ADAM: I think all of our followers need to understand is that what we need that message to be is very simple “You don’t break what’s already working.” So all of these plans are already self-funded. Most of these plans have stop-loss coverage. Any state or federal law that would mess around with defining stop-loss as health insurance potentially has the ability to hurt the self-funded industry, and basically impair somebody’s ability to actually offer a self-funded plan. We have 200 people on our plan; the bottom line fact is if we could have purchased stop loss at a $30,000 or $50,000 specific deductible we could not be self-funded. If that number was a $100,000, if that state of Massachusetts mandated that we have stop loss at a $100,000 specific deductible, I’ll be straight forward we would not be self-funded today. We would be fully insured with Blue Cross, and that is unacceptable. We would not be able to do all the innovative stuff that we have been talking about over the past few years in our health plan design. Incentivizing employees, direct primary care, all the things that we are doing would all go away by a simple law that the state of Massachusetts could pass that says, “You cannot purchase stop loss unless you have a $100,000 specific deductible. If that happened, we are out of business when it comes to self-funding, and that’s scary. Ron? RON: One of the things Adam, and this ties in with what you’re saying, is that when we were sitting there talking to these legislative aids. We are talking to them about self-funding and the benefits of a self-funded benefit plan; it is amazing how the conversation eventually goes to that individual telling us about their own health conditions and their family. It just goes to show that even when there lawmakers are focused on “what does these guys want?” and “what’s going on?” and “what’s my next meeting about?”; when you actually start to talk to them about the ability of a self-funded plan to customize its benefits, and provide more benefits for less cost. They actually start to engage you and talk about “Well here’s what the Senate’s health insurance is ... that self-funded plan sounds way better.” (Brady: They are people too.) It does not matter who you are talking to eventually it becomes very personal. ADAM: And I was going to use that word. I actually wrote it down. The word personal. Health care is personal to people, but you are right Ron. I don’t know who the women was; I think it was in McGovern’s office right? (Ron: Yes.) When we started talking to her, she brings up her mom, and when we are telling her about some of the incentives and the innovative ideas, we have at the Phia Group she goes “Don’t tell my mother about this, she would be all over that.” Nevertheless, we are talking about somebody, a truly liberal democrat who probably believes in single payer for all; who his top aid is looking at this going “Wow you guys are really doing some innovative stuff, and you’re able to offer health insurance coverage to your employees at a very low cost, and with some amazing benefits.” Folks let’s not forget (pat on the back again) we won most innovative health plan design for a self-funded plan under 250 lives. Our plan works because it’s innovative. It’s making our patients become consumers. I really think we accomplished a lot yesterday, but I have to say it again I think a lot more could have been done it Ron and I were in that meeting with Senator Warren’s aid and you Brady. Brady on the record you dropped the ball on that last one when you were on your own, but folks I wanted to let you know Brady is a company man. Instead of spending an additional $500 on Phia to take a nice, quick hour and a half flight home, he could have been home by 7 o’clock. I guess he doesn’t have any kids or anything so what’s the difference 7 or midnight? But Brady decided instead to take the Amtrak train, right Brady? BRADY: Just like Joe Biden that’s right. ADAM: And what time do you get home? BRADY: I got home around 2:30 in the morning. So that’s good. ADAM: So 2:30 in the morning. He was still at work bright and early, 9 o’clock. You are the best intern in the business. I just wanted you to know that. Ron any last thoughts? RON: Not today Adam. ADAM: Really? Wow, that is a first. So folks on behalf of Ron Peck, Pat Santos, Brady Bizarro, and myself thank you so much for empowering your plans with the Phia Group. Have a great day.

Empowering Plans: P42 - Eliminating the Noise

On May 29, 2018
In this episode, Adam, Ron, and Brady interview David Contorno, President of Lake Normal Benefits. They discuss emerging trends in the industry; from reference-based pricing to direct primary care. They also address the incentive problem and how HSAs are harming the health insurance industry.

Empowering Plans: P41 - The Case for Collusion (Continued)

On May 24, 2018
Join The Phia Group’s Sr. VP, Ron E. Peck, and healthcare attorney Brady C. Bizarro as they answer the questions that you asked during our webinar on PBMs, specialty drug prices, and lawsuits alleging fraud.

How About Some Evidence? - Montanile v Board of Trustees

On May 23, 2018
You may be curious about the decisions made in the Montanile v Board of Trustees Supreme Court case. Read more about the new approach to third-party liability.

Empowering Plans: P40 - Reference Based Pricing - Yeah, You Know Me

On May 17, 2018
In this episode, The Phia Group chats once again with one of their Partners in Empowerment, Gregory S. Everett, President and CEO of Payer Compass. Greg addresses all of our hosts’ questions regarding reference based pricing, balance billing, the value of physician networks, and the future of RBP.

MHP – Are You Still Paying Attention?

On May 16, 2018
Lawsuits and Department of Labor audits related to Mental Health Parity violations are still arising. Read more about the recent Munnelly v Fordham case!