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The No Surprises Act Explained
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Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
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Mental Health Parity and Addiction Equity Act Explained
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The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
Gag Clause Prohibition Compliance Attestation
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Balance-Billing: What Patients Need To Know
Employee Rights With COVID-19 Vaccines
The No Surprises Act Explained
Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
Gag Clause Prohibition Compliance Attestation
Industry Terms
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Phia Group Media
2nd Quarter Newsletter 2015
On July 16, 2015
The past few months have brought so much intrigue to our industry. Everywhere you looked, something or someone was affecting health care and the insurance industry as a whole. We saw the Supreme Court make a few monumental decisions that will affect how plans are written in the future and the viability of the ACA. We saw interesting court cases placing more potential fiduciary risks upon brokers and administrators. We watched and reacted as more states attempted to limit the ability for smaller employers to self fund their benefits through the use of stop loss coverage and last, but certainly not least, we have seen a monumental increase in the DOL audits to our clients and the industry at large. If there ever was a time that The Phia Group’s services were needed, this is it! There is no question that health claims costs continue to skyrocket and the use of so called wrap discounts on many of these claims isn’t helping to reduce the burden. If you are looking for some innovative options to stand out from the pack, please contact me as there are so many great ways to truly make a powerful impact on behalf of your employer plans. We can save you and your plans significant claim dollars, you just need to strategize and identify your major pain points. The next quarter will continue to be eventful so while you enjoy your summer weather, please be sure to let us know if you need some assistance – we are here for you. Happy reading
Second Quarter Newsletter 2015 – Phia News
On July 15, 2015
Phia News. New faces, Acknowledgements, Additions to the team, and Charity Updates.
Beating Medical Trend – Managed Care vs Reference Based Pricing
On July 6, 2015
Medical inflation continues to rise. Facing rate increases year after year, plan sponsors, with their financial backs to the wall, have historically resorted to cost shifting
The Problem with Wraps
On July 6, 2015
TPAs and self funded plans complain about their networks all the time.Everyone seemed to complain about them yet need them to attract clients that aren’t willing to go the reference based pricing route. Read More.
The Road to Recovery: Subrogation Gets Its Day In Court
On July 6, 2015
Most might be surprised when they realize the amount of attention that subrogation has received in The Supreme Court of the United States, the highest court in the land, over the last 25 years.
Size Doesn’t Matter- But the Regulators Do
On July 6, 2015
What is the perfect size for a self-funded plan? This is one of my favorite questions and I love to ask it at any conference at which I happen to have the pleasure of attending and speaking.