Phia Group

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.

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.

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.

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.

"Phia Case Studies" - When Silence is Loud and Assumptions Mean Disaster

On August 4, 2015
Thanks for joining The Phia Group’s legal team on September 17th, at 1:00 PM EST, as they analyzed recent cases featuring communication breakdowns, regulation popping up in its wake, and best practices to make sure you know your role and do your job.

"Stories From The Front Lines" - Real Wins, Losses, & Difference Makers

On May 20, 2015
Join The Phia Group on Wednesday, May 20th, from 1 to 2 PM EST, as its attorneys discuss their experiences providing plan administrators with guidance as it relates to difficult claim processing decisions, conflict resolution, and bill negotiation… as well as dissect the small factual differences between otherwise similar scenarios that made all the difference.

"Survival of the Fittest" - Best Practices to Perfect a Modern TPA

On April 23, 2015
Join The Phia Group’s legal team as they discuss the best practices for TPA’s and how this can help you!

"To Be Or Not To Be"... A Fiduciary - Do You Even Have A Choice?

On March 25, 2015
Being a fiduciary is serious business. Determining whether you are one can also be very complicated. Case law increasingly establishes that being a fiduciary has more to do with the action one takes, than the contract one signs. Entities working on behalf of self-funded benefit plans may be unknowingly taking on fiduciary status. Are you a fiduciary? What are the advantages and disadvantages of taking on that burden? What can you do to protect yourself?

Pushback & Counter-Attack

On February 12, 2015
Pushback & Counter-Attack – How attorneys, providers, and the government are combating your efforts to contain costs… and what you should be doing about it!

IMPLANT WARS!

On January 14, 2015
IMPLANT WARS: How monitoring provider self-referrals, & negotiating based on actual costs can result in major plan savings!

"In Reference To The FAQ"... The DOL FAQ Dissected - Part Deux!

On November 20, 2014
Join The Phia Group’s CEO, Adam V. Russo; Sr. VP & General Counsel, Ron E. Peck; and other members of the legal team as we continue to dissect the FAQ, its key provisions, and how it impacts “RBP Plans .

Creeping Around Pitfalls on the Way to Scary Savings? - How to Avoid Horror When Implementing Cost Containment Schemes

On October 30, 2014
DON’T MISS OUT! Whether you’re embarking on a new cost containment adventure in-house, or with the help of a vendor, most programs are not simple “plug and play” affairs. Those who head into the dark unprepared will undoubtedly find themselves spooked by what hides around the corner.

"Dude, Where's My Subro?" - Integrating Subrogation - Sought by Employers & Loved by Administrators

On May 15, 2014
As plan sponsors and administrators examine their benefit plans in light of recent legal upheaval, now is our chance to implement important cost containment mechanisms.

Taking It To The Limit - Accurately Identifying and Taking Advantage of Network Contractual Boundaries

On March 27, 2014
While it is true that some network contracts restrict a benefit plan’s ability to audit claims – or as is more often the case, simply prohibits the benefit plan from doing anything with the information so identified; some contracts apply unrealistic deadlines and still others contractually compel payment of claims otherwise excluded by the plan document… There are key provisions plan administrators can use to limit or eliminate the negative impact of such provisions.

To Pay or Not To Pay - Examining Exclusions, Definitions, and Other Things That Really Matter

On February 12, 2014
Whether you are a plan administrator or claims processor trying to determine eligibility of a claim, or a stop-loss carrier trying to determine whether a submission is reimbursable, how applicable provisions apply to specific facts make all the difference.