Phia Group

Autism Benefits: DOL Enforcement for Sufficient Coverage

On May 22, 2023
About 1 in 36 children in the United States has autism spectrum disorder, which is a lifelong condition that can affect a person’s behavior, communication, interactions, and ability to learn. The Department of Labor (DOL) continues strongly advocating for more comprehensive autism coverage under group health plans and Employee Benefits Security Administration (EBSA) has been working to ensure individuals who need treatment are able to access it. The Phia Group is also working hard to ensure plans are offering robust benefits while remaining compliant with mental health parity laws.

New Year, New Rules – But Don’t Forget About the Old Ones

On January 3, 2023
The self-funded health plan industry continues to evolve every year based on new rules, guidance, and medical advancements; however, the Department of Labor (DOL) doesn’t overlook old rules either. In case you missed it, there was a case in mid-2022 that seeks to remind us that the DOL is still considering all Affordable Care Act (ACA) rules when they review complaints and perform audits. In Walsh v. Board of Trustees of Local 272 Welfare Fund and Local 272 Welfare Fund, 22-cv-592 (S.D.N.Y August 2, 2022), the DOL filed suit against a Taft-Hartley welfare plan and its trustees for alleged violations of certain amendments that the ACA made to ERISA, including the maintenance of grandfathered status.

The Fair Labor Standards Act (FLSA): Who Benefits and Who Doesn’t

On November 4, 2022
It’s hard to fathom today, but less than a century ago, America was a country in which elementary-school-aged children were accustomed to laboring in coalmines, glass factories, and shipyards; an untold number of employees earned less than $1 per day; a typical workweek consisted of six 12-hour shifts. Such was life for tens of millions of Americans barely scraping by during the depths of the Great Depression before FDR implemented his landmark New Deal, which, among other initiatives, provided workers greater protection with the passage of the Fair Labor Standards Act (FLSA).

A Joint Final Rule: Extending COBRA, HIPAA , and Claims / Appeal Deadlines

On May 20, 2020
The DOL and IRS issued a Final Rule to extend a number of deadlines and timeframes that are relevant to group health plans such as HIPAA and COBRA. Learn more.

Department of Labor Issues FAQs to Clarify Mental Health Parity Regulations

On September 19, 2019
The Department of Labor (DOL) issued FAQs in an effort to promote compliance and clarify the confusion surrounding the final mental health parity regulations. The Department of Labor (DOL) issued FAQs in an effort to promote compliance and clarify the confusion surrounding the final mental health parity regulations.

The Final AHP Rules Take a Hard Hit (Part 2)

On April 29, 2019
The courts recently vacated the provisions set by the AHP rules. Learn more about future implications these changes may have for you and your employer.

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.

Insurers Commissioners Signal Retreat on New Stop-Loss Insurance Regulation and Discuss MEWA Issues

On August 26, 2013
Comments made by regulators over the weekend at the summer meeting of the National Association of Insurance Commissioners (NAIC) in Indianapolis made it clear that ongoing pushback by SIIA and other stakeholder groups has dampened enthusiasm for new stop-loss regulation.