Phia Group

Revisiting PPO Contracts & Stop-Loss Gaps

On April 26, 2021
Learn about the risks associated with stop-loss insurance for self-funded health plans and the importance of identifying coverage gaps early. Read more.

Plan Mirroring: What Does It Really Mean?

On August 26, 2020
Plan mirroring provisions can be marketed to make a stop-loss policy airtight for the plan, but there is still the potential for a gap. Learn more!

“Incur”-aging a Review of the Term “Incurred”

On March 12, 2020
The word 'incurred' can mean two different things. Learn why knowing your definitions could be the difference between claim reimbursement and denial.

Bridging the Gaps Between...Everything

On June 4, 2018
Our new Phia Certification Program is to ensure all our employees understand our industry and how we operate. Click here to learn more.

The Gap Doesn't Stop At the Document

On May 9, 2018
There are many types of gaps within coverage including plan documents & network agreements. Click here to learn about all the gaps you should be aware of.

What do All These New Paid Sick Laws Mean for Employers?

On February 28, 2018
What do all these new paid sick laws mean for employers? As many states are starting to beginning to enact paid sick or leave time regulations, employers will need to understand this. If you are an employer or employee that would like to know more about your paid sick laws contact The Phia Group.

Pin the Tail on the Donkey & Other Blindfolded Games of Placement

On December 27, 2017
Our industry (that being the self funded health benefits industry) is primarily a web-work of relationships. Unlike a large, traditional health insurance carrier, where all functions are located under one roof, in our industry key pieces of the greater whole are comprised of various independent entities.

Usually and Customarily Denied

On October 4, 2017
Jon Jablon, Esq. discusses the importance of understanding how your stop-loss policy defines U&C before a portion of your paid claim is denied.

Stop Loss and My Infinite Sadness

On September 11, 2017
Ron Peck, Esq. discusses potential savings opportunities when choosing stop loss coverage associated with your self funded healthcare plan.

A House Divided

On August 7, 2017
Find out how to avoid health plan and stop loss disagreements for self-funded health insurance claims with this helpful article.

Can’t We All Just Get Along?

On July 12, 2017
Every once in a while you come across a plan that doesn’t want to comply with its stop loss contracts and/or obligations. It’s important that everyone realizes that we need each other to survive.

Spinning the Web of the Plan Document

On July 7, 2017
Kelly explains the importance of reviewing plan revisions for errors causing gaps in stop loss policies and further complications. Learn more.

Dear Stop-Loss: A Ballad

On May 15, 2017
With all the concern surrounding healthcare changes, read this ballad about insurance and stop-loss for a laugh...

A Call for Defensive Legislation

On May 3, 2017
Find out more about how the House of Representatives bill passed April 5th, 2017 helps regulate stop-loss insurance redefinition.

The Details of Your Coverage Plan Matter

On February 8, 2017
Employers face many, many regulatory burdens. There is an ever-increasing number of federal regulations to abide by, and each state maintains its own set of regulations