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Understanding Non-Quantitative Treatment Limitations (NQTLs)
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In-Network vs Out-of-Network Claims
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The No Surprises Act Explained
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Understanding Non-Quantitative Treatment Limitations (NQTLs)
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Phia Group
Phia Group Media
Empowering Plans: P221 – Saying What You’re Thinking
On June 20, 2025
Join The Phia Group’s Corey Crigger and Ron Peck as they discuss some of the things many in our industry seem to be thinking, but are often afraid to say aloud. Does being a good fiduciary mean being a bad guy? Tune in and find out.
Empowering Plans: P220 – Algorithms and Adjudication: How AI Is Affecting the Self-Funded Industry
On June 4, 2025
On the latest installment of the Empowering Plans podcast series, join attorneys Jon Jablon and Kendall Jackson as they discuss the integration of AI into the self-funded industry. From HIPAA considerations to current case law, this episode explores the impact of AI on health plans and TPAs thus far. It is an episode you can’t afford to miss!
Empowering Plans: P219 – Executive Orders, Tariffs, and a Crystal Ball
On May 21, 2025
Join attorneys Bryan Dunton and Cindy Merrell as they explore President Trump’s latest moves to address the rising cost of prescription drugs. Cindy and Bryan discuss potential impacts of recent Executive Orders and proposed tariffs.
Empowering Plans: P218 – Unreasonable Plan Fees on Trial: Cunningham v. Cornell University
On May 8, 2025
In this episode, we unpack the Supreme Court’s unanimous decision in Cunningham v. Cornell University — a landmark ERISA case with major implications for retirement and health plan fiduciaries. We explain the facts behind the case, what “prohibited transactions” really mean, and why the Court's ruling on affirmative defenses matters. If your health plan pays fees to TPAs, PBMs, IDR vendors, or brokers, this episode is for you.
Empowering Plans: P217 – The Most Exciting Two Minutes in Cost Containment
On May 1, 2025
The Run for the Roses is here! Join two of Phia’s Louisville, Kentucky, employees, Corey Crigger and Cindy Merrell, as they discuss the event that takes over their city once a year! Coming on the heels of a historic weather event, Corey and Cindy discuss all things Derby. From Cindy’s experience at Dawn at the Downs to predictions for winners, this podcast has it all. Don’t be fooled, this podcast isn’t just about horse racing. Corey and Cindy also discuss pitfalls of AI use in the legal world. Can attorneys depend on AI for their legal research? Meanwhile, which horse has the best chance to win the Derby? Can Corey hit the trifecta for the second year in a row? Tune in to the Empowering Plans Podcast for these answers and many more!
Empowering Plans: P216 – Why 2025 is the Year to Go Self-Funded
On April 22, 2025
Our consulting team has received numerous questions in Q1 2025 about employers considering self-funding their health plans. Join Attorneys Jennifer McCormick and Kelly Dempsey as they go through what the driving factors are behind employers considering self-funding, the pros and cons of self-funding, and some of the major differences employers will encounter. If you’re considering taking the leap, take a listen first!
Empowering Plans: P215 – Plan Sponsor Discretion Advised
On April 8, 2025
ERISA gives plan sponsors great power and great responsibility. On this week’s podcast, attorneys Ron Peck and Nick Bonds get back to ERISA fundamentals to talk about how to really embrace fiduciary status and properly exercise discretionary authority.
Empowering Plans: P214 – Unpacking Weight Loss Drugs
On March 28, 2025
On this episode of the Empowering Plans podcast, attorneys Corey Crigger and Kendall Jackson discuss the hot button topic of weight loss drugs. Tune in to learn more about the latest advances in this space and the various coverage and exclusion options plans may pursue.
Empowering Plans: P213 – Error 304: Good Faith Negotiation Not Found
On March 13, 2025
Artificial intelligence may be changing the trajectory of the self-funded industry – but can it negotiate? In this episode of The Phia Group’s Empowering Plans podcast, attorneys Brian O’Hara and Jon Jablon break down real-life examples of AI-driven responses in the No Surprises Act’s Open Negotiations process that range from nonsensical to outright misleading, where negotiating with AI is like trying to haggle with a toaster. From missing claim numbers to automated counteroffers that make no sense, Brian and Jon discuss whether AI is making negotiations easier, or defeating the purpose of the statutory process to begin with. Tune in for an honest discussion of the pitfalls of AI in No Surprises Act negotiations.
Empowering Plans: P212 – Lewandowski v. Johnson & Johnson – Big win or warning?
On February 27, 2025
On this episode of the Empowering Plans Podcast, attorneys Brady Bizzaro and Cindy Merrell delve into the details of the Lewandowski v. Johnson & Johnson case. Is this case a big win for plan fiduciaries or a warning?
Empowering Plans: P211 – Network Adequacy Under MHPAEA
On February 13, 2025
Attorneys Kelly Dempsey and Bryan Dunton dive into the results of the 2024 MHPAEA Report to Congress. The EBSA and CMS have continued to improve their focus on network design and adequacy for group health plans. In this episode, Kelly and Bryan discuss how these parity problems manifest themselves in testing and what plans can do to resolve them.
Empowering Plans: P210 – Mental Health Parity: New Year, New Rules, New Lawsuits
On January 30, 2025
Attorneys Jen McCormick and Nick Bonds ring in the Lunar New Year by breaking down the ERIC v. HHS lawsuit in which an industry advocate challenged the federal regulators’ new Final Rules enforcing the MHPAEA and mental health parity rules. Could this case blaze a new path for challenging agency actions in a post-Chevron Doctrine world? Join us as we discuss the potential implications for group health plans.
Empowering Plans: P209 – 2025 Healthcare Hot Takes
On January 16, 2025
It’s a new year, and a new type of Empowering Plans podcast! In a world full of talking heads and 2-minute news cycles, hot takes have become the norm. This is true from mainstream news media to sports talk radio. Ron Peck and Corey Crigger throw their hat in the hot take ring by speculating on what some of the biggest news stories could be in 2025. From AI to RFK Jr, join Ron and Corey as they gaze into the crystal ball and make their bold predictions of what we will be talking about all year.
Empowering Plans: P208 – The Evolution of the Birth Control Benefits Mandate
On January 2, 2025
On today’s episode of the Empowering Plans podcast series, attorneys Kendall Jackson and Brian O’Hara discuss the Biden administration’s decision to withdraw proposed rules that would have expanded the birth control benefits mandate. Join us in our discussion of the mandate and how it has evolved throughout the Obama, Trump, and Biden administrations.
Empowering Plans: P207 – Denied Claims Beyond the Headlines
On December 19, 2024
On this episode of the Empowering Plans podcast series, attorneys Corey Crigger and Cindy Merrell discuss the murder of UnitedHealthcare’s CEO, which fueled public outcry over denied claims.
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