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In-Network vs Out-of-Network Claims
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Phia Group
Phia Group Media
The Affordable Care Act in 2019: A Look Ahead
On January 16, 2019
This year, we mark the ninth anniversary of the healthcare law that transformed our industry. The Affordable Care Act has been under assault from the White House, from Congress, and now, it has been declared unconstitutional by a federal court. Despite the embattled state of the ACA, the Trump administration has set an agenda for the ACA's implementation this year, and it remains the law of the land. In this webinar, The Phia Group's legal team will explore the many legal and political battles that threaten the ACA's existence while covering those key provisions that have changed, those that have remained the same, and everything in between.
What to Expect in 2019 – Part 2
On December 12, 2018
To build on last month’s webinar (Part 1), join The Phia Group’s legal team for an hour on December 12, 2018, as they present the second part of this two-part series on What to Expect in 2019. Touching on topics such as appeals, stop-loss trends, reference-based pricing, and much more, this webinar will highlight current industry happenings and our predictions to help you look forward to the coming year. Just like last month: miss this one, and you’ll be left behind.
What to Expect in 2019 - Part 1
On November 13, 2018
The future is here! As we’re about to enter 2019, the undercurrents of the self-funded industry are as exciting as they are dynamic, and changes are happening at an unbelievable pace. Join The Phia Group’s legal team as they present Part 1 of this two-part series on What to Expect in 2019, which will highlight current industry happenings and our predictions to help you look forward to the coming year. Miss this one, and you’ll be left behind.
Specialty Drugs: Trends and Issues Affecting Self-Funded Plans
On October 18, 2018
No matter what corner of the industry you’re in, you know that health plans have had a constant need to contain costs as a result of skyrocketing medical bills. The rising cost of Rx drugs has certainly been an issue as well – and specialty drugs are a hot-button issue as health plans struggle to find ways to manage them.
Back to School: Renewal Time
On September 18, 2018
In the self-funded industry, being diligent with respect to employer groups, vendors, and contracts is always important – but sometimes knowing what to put on a checklist in the first place is more difficult than checking off the items. Renewal time means it’s time to impress prospective clients, keep existing clients happy, and make sure the vendors and contracts being utilized are the best possible fit for your groups. Join The Phia Group’s legal team for an hour on September 18, 2018 at 1pm EDT as they outline a laundry list of what employers, TPAs, brokers, and stop-loss carriers should look for this time of the year – and provide some guidance on how the industry’s players can stay ahead of the curve.
Breaking the Mold: Creative Solutions for Everyday Problems
On August 14, 2018
Network contracts, stop-loss claims, and intricate medical claim determinations are just a few of the complications that self-funded health plans and their partners need to be able to successfully navigate. Check out our webinar that includes creative solutions for managing these.
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.
The Case for Collusion: How the Power Players May Have Defrauded Us All
On May 15, 2018
At long last, after a lengthy investigation, we are ready to present the allegations of collusion. It is alleged that powerful forces have been working together in a complex scheme to mislead us. To be clear, we are talking about Big Pharma and certain PBMs. A new class action lawsuit has been filed against CVS Health alleging that it knowingly colluded with PBMs to raise generic drug prices. The claim is that health plans and consumers alike have been overpaying for drugs. We have seen this playbook before. This time, however, there is potential for TPAs and their groups to join the lawsuit to recoup funds allegedly overpaid to CVS. Join The Phia Group’s Special Counsels for an hour as they share reports on this alleged fraudulent scheme and discuss the ways in which our industry can fight back and tackle the underlying problem of specialty drug prices.
4 Horsemen of the Plan-pocalypse
On April 19, 2018
Nostradamus? Miss Cleo? The Phia Group? In a psychic feat of foresight, The Phia Group’s team has gazed into their crystal ball and identified four issues that may not presently be keeping you up at night, but will certainly be disturbing your slumber very soon. From being forced to pay for surrogate pregnancy and births, to the IRS actively issuing letters notifying employers of 2015 tax year penalties; from a new wave of fraud, errors, and abuse leading to heretofore unseen overpayments, to case law addressing the rights of plans to utilize reference based pricing – you’ve been warned! We predict this complimentary webinar will open your eyes. Miss this webinar at your own peril… You’ve been warned!
Transparency: Using it to Your Advantage
On March 20, 2018
Join The Phia Group’s legal team as they discuss the need for, and effects of, contractual and price transparency on the self-funded industry – and how health plans, TPAs, and brokers can use transparency to their advantage.
Evolve or Dissolve – Responding to Today’s Tax Law to Save the Health Benefit Plan Industry Tomorrow
On February 27, 2018
Join The Phia Group's Adam Russo, Ron Peck, and Brady Bizarro as they discuss what you need to know about the new law, and how to navigate the treacherous path that lies ahead.
Keeping it Under Wraps: What the Networks Don’t Advertise
On February 22, 2018
It’s 2018, and the importance of cost-containment is at an all-time high. Everywhere you look in the self-funded industry is a vendor trying to help health plans control costs; as can be expected, some methods are effective and maximize savings, whereas others…well…not so much
Plan on Saving by Saving Your Plan – Applying Lessons Learned to Create the Perfect Plan Document
On January 30, 2018
Join The Phia Group’s legal team as they explain the Flagship template, differences from the existing template, and why the Flagship may be right for you.
A Taxing Time: The Tax Bill’s Impact on Self-Insurance
On January 18, 2018
On December 22nd, President Trump signed a $1.5 trillion tax bill. Among other things, it effectively ends the Affordable Care Act’s individual mandate. It will have a major impact on individual and employer-sponsored health insurance. Millions of Americans may be without health insurance coverage in the coming years. For self-funded plans, this bill may lead to higher costs due to ripple effects across the entire health insurance market while also opening doors to increased cost-containment opportunities. There are other legislative proposals and agency action which could impact our industry, and many states are considering proposals of their own.
With Great (Cost-Containment) Power Comes Great (Fiduciary) Responsibility!
On December 19, 2017
Join The Phia Group’s legal team for an hour at as they describe various ways to cut costs, what must be done to ensure that fiduciary duties are being met, and what happens if they are not.
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