Phia Group

Empowering Plans: P152 – The Contemporary Fiduciary: Emerging Law on an Old Topic

On January 5, 2023
In this installment of The Phia Group’s Empowering Plans podcast, join attorneys Katie MacLeod and Jon Jablon as they discuss fiduciary status, both traditionally and in the new age of self-funding. This industry is faced with changes all the time, even to some of its oldest rules; in the spirit of consumer protection, the legal and regulatory winds are once again changing to challenge certain long-held understandings about fiduciary duties. TPAs in particular should tune into this one!

Empowering Plans: P151 – The Who, What, and When of Offsetting Benefits

On December 20, 2022
In this installment of The Phia Group’s Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss offsetting benefits and when a Plan may want to consider it.

Empowering Plans: P150 – Manufacturer Assistance Programs

On December 8, 2022
Attorneys Brady Bizarro and Andrew Silverio discuss manufacturer/copay assistance programs and outline some of the different approaches being utilized to manage specialty drug spending. Also on the agenda is a current lawsuit against one such program administrator, and how the landscape might be shaped in the coming months.

Empowering Plans: P149 – Another Ping-Ponging of IC/EE Rules?

On November 17, 2022
In recent history there have been several rules that have been amended and re-amended (or just overturned and new rules published). Join Kelly Dempsey and Kevin Brady as they explore the ever-changing world of employee classification rules. The 2021 rule is viewed as leaving workers vulnerable to misclassification and was inconsistent with existing federal court decisions, thus the current administration is seeking to make a change. Tune in to learn more and why this rule matters to self-funded health plans.

Empowering Plans: P148 – The Ever Changing Times of Healthcare

On November 3, 2022
“It’s an ever-changing time…” in the healthcare landscape. Corey Crigger and Nick Bonds are back on the podcast mics to discuss some of the more interesting developments they’ve seen in 2022. Tune in to be sure these developments aren't burdensome and rest assured that the dreams you believe in will still come true.

Empowering Plans: P147 – Transparency & More: Burning CAA/NSA FAQs

On October 27, 2022
In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon bring up some of the most common questions that The Phia Group’s consulting team has been asked to field over and over again. From the so-called broker compensation rules to a TPA’s obligations related to a group’s No Surprises Act compliance, Jen and Jon highlight some of the main points to keep in mind when making important decisions regarding your business.

Book of Russo: Chapter 5

On October 21, 2022
In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Mike Ferguson, President & CEO of the Self-Insurance Institute of America (SIIA), have to say about SIIA’s 2022 National Conference, the history of SIIA, and what to expect from SIIA in years to come.

Empowering Plans: P146 - A Possible Threat to a Plan’s Discretionary Authority

On October 14, 2022
Currently before the Senate, a new bill has been announced that would ban all references to a plan administrator’s discretionary authority, as well as remove all deference courts give to their claims determinations. Regardless of whether this bill will be passed, what does this and similar rhetoric say about public and political attitudes towards self-funded health plans? Ron Peck, Chief Legal Officer, and attorney Kaitlyn MacLeod are here to talk about this and more. Enjoy!

Book of Russo: Chapter 4

On September 22, 2022
In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Dr. Jeffery Gold, have to say about Direct Primary Care and why Dr. Gold decided to open his own practice in Massachusetts.

Empowering Plans: P144 - The Latest Developments Involving Patient Assistance Programs

On September 16, 2022
In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Andrew Silverio discuss patient assistance programs. They explain what these programs are, how they have been utilized in the industry, and the latest regulations and litigation surrounding them. Tune in to find out what plan sponsors need to know!

Empowering Plans: P143 - Is Wrongful Death the Death of a Subrogation Claim?

On September 2, 2022
In this installment of the Empowering Plans podcast, attorneys Chris Aguiar and Cindy Merrell discuss the murky waters of wrongful death and healthcare subrogation claims.

Book of Russo: Chapter 3

On August 26, 2022
In the latest episode of The Book of Russo, tune in to find out what The Phia Group’s CEO, Adam Russo, and guest host, Ernie Clevenger, have to say about Ernie’s famous Saturday night newsletter, CareHere, and much more.

Empowering Plans: P142 - The (Healthcare) Times They Are A-Changin’

On August 19, 2022
In this installment of The Empowering Plans podcast, attorneys Nick Bonds and Corey Crigger discuss two recent shifts in the healthcare landscape: The FDA’s stance on OTC hearing aids and recent developments showing that not all debt is created equal, especially medical debt.

Empowering Plans: P141 - Do You Mind (…The Gap)?!

On August 5, 2022
In this installment of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon discuss the age-old topic of stop-loss gaps, with a modern twist. Emerging law and industry trends color so many decisions that self-funded plans and those who service them must make on a daily basis, and one player that sometimes gets forgotten about is stop-loss. Since stop-loss coverage expectations don’t always align with reality, health plans, TPAs, and brokers need to be proactive to find potential gaps and try to rectify them before they evolve into real problems.

Should Plans Better Address Mental Health Benefits? | The Phia Group

On July 22, 2022
In the wake of the COVID-19 pandemic, the government has announced that we are facing another crisis – one on mental health. Participants are clamoring for more access to mental health care than ever before. The COVID-19 pandemic only highlighted the lack of availability of mental health care in the US, including care that is covered by plans. Ron Peck, Chief Legal Officer, and attorney Kaitlyn MacLeod are here to talk about what plans are doing to address the mental health crisis and how mental health parity comes into play for plans, patients, and providers.