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Phia Group Media


Jason Ruhl
Jason Ruhl
Jason Ruhl's Blog

California / Recovering Benefits from Workers' Compensation
California / Recovering Benefits from Workers' Compensation

In May of 2012, the California Workers’ Compensation Appeals Board (“WCAB”) adopted amendments, which impact the ability of lien claimants to obtain recovery.

•  To secure reimbursement when filing a “green-lien,” lien claimants must pay a fee of $150.00.

•  To secure reimbursement when filing a “green-lien,” “…lien claimants must appear at a lien conference and/or trial …”

We have already developed a strategy to ensure a smooth progression in light of these rules, and have the legal expertise in place to secure recovery.  Please note, however, that the filing fee and appearance by local counsel will result in additional expense to the Plan.  In an effort to maximize recoveries for our clients while minimizing costs, The Phia Group and its clients will have to conduct a cost-benefit analysis when deciding whether to pursue reimbursement, on a case by case basis.

PLEASE MARK YOUR CALENDAR!  The Phia Group will be hosting a webinar specifically regarding these issues on January 23, 2013 at 4 PM EST / 1 PM PST.  We have limited invitations to you and entities like you, directly impacted by these new rules.  We will be discussing the new rules in greater detail, will field your questions, and will discuss the many issues benefit plans should keep in mind when assessing their options.  It is important to us that you attend.

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January 2013 Newsletter
I cannot believe that New Year’s Eve was over 2 weeks ago – where have these days gone?  Time certainly seems to fly by when I keep myself busy working to ensure that all of you are protected this year. I have been spending much time researching the options available to employers in 2014.  Where will they go?  Will they decide to self fund or will they join the exchanges?
 

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The State of the Subro-Union Address
The State of the Subro-Union Address

The Phia Group’s CEO (Adam V. Russo), Sr. VP and General Counsel (Ron E. Peck), and resident subrogation litigation expert (Christopher Aguiar) will delve into current events, litigation, and changes in law (official and otherwise), as they share the current state of affairs for anyone and everyone interested in subrogation.  You may think your time-tested methods for cost containment via claims recovery are safe and sound… and you’d be wrong.  This is a discussion you will not want to miss.

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December 2012 Newsletter

Happy Holidays to all of you!  As we enter 2013, I just wanted to say thank you for the opportunity to serve you and the entire industry over the past 12 years and I look forward to doing so in 2013.

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9 Secrets For Coordinating Leave Under the FMLA and ADA
HR professionals may often see the following scenario: An employee is granted FMLA leave to treat a serious health condition that poses long-term restrictions and limitations; 12 weeks pass; the employee fails to return to work; company terminates employee under a “no-fault” absence policy. The employer granted the full 12 weeks allowed by the FMLA, so it is free to terminate, right?

Missouri Slayer Law Preempted by ERISA
In Mitchell, et. al. v. Marcus Tyrone Robinson, Sr., et. al. the Plaintiffs are the grandparents of some minor children of Marcus Tyrone Robinson and his deceased wife. The allegation is that Mr. Robinson killed his wife. The wife had $121,000.00 in life insurance through her employer, Unilever, and insurer MetLife. Mr. Robinson made a claim for benefits under the policy which was paid. Thereafter, the grandparents filed suit alleging that Mr. Robinson was not entitled to recover under the Missouri Slayer Statute, and claimed that the benefits were wrongfully paid as a result thereof. Plaintiffs asserted several state law claims to recover the money and named Unilever and MetLife as Defendants. In the attached order the court is deciding Unilever’s motion to dismiss the state law claims based upon ERISA preemption. The court holds that the Missouri Slayer Statute is preempted.

Looking Forward to 2013 - The Phia Group Looks Back at 2012 and Forward to 2013
Looking Forward to 2013 - The Phia Group Looks Back at 2012 and Forward to 2013

If you thought 2012 was a wild ride, wait until you see 2013.  Obamacare is the law of the land, and it’s here to stay.  The entities empowered by PPACA to issue mandates are prepared to unleash a tidal wave of regulations in 2013.  Subrogation and coordination of benefits once again appear before the Supreme Court.  The very definition of self-funding, rights under ERISA, and access to stop-loss have come under attack.  Join The Phia Group’s CEO, Adam V. Russo, Sr. V.P. and General Counsel, Ron E. Peck, and V.P. of Consulting Services, Jennifer McCormick, as they discuss what we can expect to see in 2013, and how best to prepare for what’s coming.

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November 2012 Newsletter

The elections are over and regardless of who you voted for, the fact remains that PPACA is here to stay.  While many of you have been utilizing our firm to assist in your compliance needs, we have never publicly announced that our team of experts can assist your organization with Regulatory Compliance issues until now.

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The Bay State Crystal Ball - How Massachusetts May Predict the Future for America's Healthcare
The Bay State Crystal Ball - How Massachusetts May Predict the Future for America's Healthcare

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Mitt Romney has been distancing himself from the healthcare reform he signed into law whilst governing Massachusetts.  His team has responded to comparisons between “Romneycare” and “Obamacare,” stating that the two laws are vastly different, and vary based on scope of coverage, communities they apply to, and terms themselves.  That being said, we can still draw many parallels between the two.  Those of us who fail to look at the Bay State as a prototype for post-PPACA America are missing an opportunity to gaze into the future.  From early successes, to a gradual bloating of the program… from red-tape, to recent moves to address the actual cost of care… the Commonwealth of Massachusetts is certainly a crystal ball.  Join us as we dissect The Phia Group’s home state, and attempt to predict the nation’s future.


Trick Or Treat
Trick Or Treat

Plan sponsors are looking for ways to cut costs without limiting benefits. New solutions are popping up everywhere, from medical tourism, to carving out dialysis; from placing a Medicare + cap on allowable expenses, to having outside auditors reprice claims. The industry is shifting from a pure PPO focus, but with change comes uncertainty. Believe it or not, but these programs present risks along with rewards. Conflicts with providers, balance billing, accusations of discrimination, stop-loss denials, and other negative repercussions are only some of the “tricks” we will help you avoid as you seek to indulge in the newest, innovative “treats” our industry has to offer.

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