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Phia Group Media


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.

Secrets to Making Reference-based Pricing Work

On January 18, 2016
Employers, administrators, brokers and courts have begun to realize that determining the value of a health care service must involve something more than considering only a provider’s billed charges.

Anti-Assignment Clauses Bar Provider’s ERISA Claims

On January 7, 2016
An out-of-network health-care provider can’t continue with her claims under the Employee Retirement Income Security Act for unpaid benefits, fiduciary breach and failure to disclose documents against four health benefit plans, the U.S. Court of Appeals for the Eleventh Circuit ruled.

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.

Court Nixes Health Plan’s Subrogation Claim

On December 23, 2015
A health plan isn’t entitled to reimbursement of $48,000 in medical expenses it paid on behalf of a minor beneficiary who was injured in an all-terrain vehicle accident

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 Supreme Court Seeks Solutions to the Latest Challenges to Subrogation Rights in Montanile Case

On December 4, 2015
The facts of the latest healthcare subrogation challenge on the SupremeCourt’s docket will be familiar to many.

FEHBA Preempts Kansas Anti-Subrogation Regulation

On November 3, 2015
The Federal Employees Health Benefits Act preempts a Kansas administrative regulation prohibiting subrogation and reimbursement clauses in health insurance contracts of federal government employees, the U.S. Court of Appeals for the Tenth Circuit ruled

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.

Overpayment Recovery Services Suite | The Phia Group

On October 8, 2015
Why are most TPAs merely sending a few letters to providers and filing away cases that fail to result in a refund? Because they feel that there is no other option available to them… until now.

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.