Recent Posts

• A Duty to Serve and Protect … the Plan
  
  August 17, 2023
  Think you can’t be sued for breaching a fiduciary duty? Think again! Lawsuits filed by plan sponsors against their claims administrators are gaining increased media attention. Between talk of a possible recession and passage of new laws such as the No Surprises Act, employers are tightening their belts and examining their partners with renewed vigor. Accusations suggest that anyone managing plan assets has a fiduciary duty to do so prudently. Regardless of fiduciary status, only those who carefully examine claims, manage appeals, navigate disputes, curb plan spending, and leverage all possible sources of reimbursement will likely avoid such scrutiny. Join The Phia Group for another complimentary webinar. Their team will contemplate strategies applicable to every stage in a claim’s lifecycle, and divulge best practices that will keep you out of the court house.
• Illuminated by Phia Ignite! Leveraging A/I and Multifaceted Price and Quality Data
  
  July 11, 2023
  Benefit plans are struggling with the No Surprises Act, are overburdened by disproportionate expenses, and are butting heads with stop-loss over inadequate risk disclosures and network terms. Meanwhile, too many are ignoring modern technology, and are overdependent on cost data while ignoring quality metrics. Join The Phia Group’s leadership team as they present and dissect case studies addressing regulatory compliance, claim appeals, and dispute resolution. From the NSA and IDR, to transparency rules and provider pricing, The Phia Group’s best and brightest will show you a defensible payment strategy with Phia Ignite, as well as determine what role artificial intelligence will play. Drive costs down and address today’s most pressing industry issues by registering for this complimentary webinar. There are sure to be some fireworks!
• The Business of Benefits
  
  May 18, 2023
  Those who service health benefit plans are usually focused on delivering the most robust coverage for the least cost. Yet, all too often we forget that our industry, like any other, only thrives when our own businesses prosper. From adjustments to a post-pandemic environment (and employee populations working remotely from numerous locations), to conflict resolution between entities (such as disputes between plans, stop-loss, and TPAs over reimbursement of fees for savings and management of the NSA), join The Phia Group as we discuss the current events and case studies that will impact whether your own organization sinks or swims.
• Before and After – Examples of Mistakes that Were Addressed and How to Avoid Them
  
  April 20, 2023
  Accidents happen, but they aren’t all inevitable. Often, errors that lead to conflicts and costly outcomes could be avoided. Join The Phia Group’s team as they dig into real case studies, and share examples where The Phia Group was called upon to address some avoidable losses, as well as compare them to scenarios where the proper preemptive steps were taken. This April, remember what Benjamin Disraeli said: "The fool wonders; the wise man asks." Register today for this free and informative webinar!
• Love is in the (Health)Care!
  
  February 15, 2023
  Roses are red, violets are blue, and The Phia Group has some hot tips for you. Whether you sponsor, administer, or service self-funded health plans, The Phia Group’s free webinar will thrill and amaze you. The Phia Group’s team presented a variety of important issues, best practices, and case studies. From disputes with providers, to subrogation, to regulatory updates, and beyond… this webinar is better than a box of chocolates. Don’t wait to unwrap your gift!
• An Omnibus Edition to Kick Off 2023
  
  January 19, 2023
  It’s only January, but 2023 already promises to be a momentous year in healthcare law. From the recent passage of The Consolidated Appropriations Act of 2023—and its inclusion of protections for pregnant and nursing mothers—to regulatory updates regarding the No Surprises Act and manufacturer assistance programs, there’s quite a bit to break down as the new year unfolds. Join The Phia Group’s panel of experts as they discuss how such sweeping changes will impact your group’s health plan.
• A Flip of the Calendar: Looking Ahead to Healthcare in 2023
  
  December 13, 2022
  With a new year comes new developments in healthcare — and 2023 will be no exception. While ever-increasing healthcare costs remain at the forefront of our attention, landmark healthcare legislation — in particular, the No Surprises Act (“NSA”) — continues to cause unforeseen issues for health plans and stop-loss carriers. Additionally, evolving business trends involving mergers, acquisitions, and investments from non-traditional entities promise to impact the industry. Join The Phia Group’s panel of cost containment experts as they look ahead to the challenges and opportunities that await us next year.
• Down the Stretch: Wrapping up a Historical 2022
  
  November 15, 2022
  We are entering the home stretch. With a couple months to go, we can confidently say that 2022 has been one of the most momentous years in the history of American healthcare. The Phia Group’s panel of experts will revisit what they feel were the ten most impactful healthcare developments of 2022, covering a broad swath of topics that includes price transparency (the Consolidated Appropriations Act and No Surprises Act), governance (state laws that preempt ERISA), and equitable benefit coverage (Mental Health Parity and Addiction Equity Act). Who knew one year could have such a profound impact on our industry? Join the fun and find out how impactful 2022 has been.
• The Witching Hour for Healthcare Plans
  
  October 20, 2022
  Quite a few treats are in store for those tuning into The Phia Group’s next webinar, one that will cover some tricky topics. From breaking down regulatory changes impacting the healthcare industry (i.e., mental health parity, discretionary authority) to developments concerning plan drafting language, Phia’s roundtable of experts will keep you in the know. Oh, and did we mention that there’s also going to be a discussion of what to expect from a health policy standpoint in next month’s midterm elections?
• A Prescription for Success? The Unknown Impact of Recent Legislation on Prescription Expenses
  
  September 15, 2022
  The Inflation Reduction Act, signed into law by President Biden last month, includes provisions to lower prescription drug prices for Medicare recipients. But what about most Americans who are on employer-sponsored plans? Could they be adversely affected by pharma companies potentially elevating prices in response? In its next webinar, The Phia Group takes a deeper dive into the residual effects of this landmark act on your plan—as well as how the recent Johnson & Johnson lawsuit involving patient assistance programs may heighten the risk for companies using such PAPs. For good measure, Phia’s panel of experts will also provide an update on final rules just released regarding the No Surprises Act.
• Unfinished Business: Legal Fallout Leaves Plans in Limbo
  
  August 18, 2022
  Do you feel that Dobbs is already history? Does Build Back Better feel like old news? If so, think again! The domino effect of the Supreme Court’s recent decision is still raging across the country. Executive orders, legal challenges to state laws, and a deal to pass a massive healthcare bill should all be on your radar. The Phia Group is monitoring all of these developments in real time and in our new webinar we will reveal what you need to know to stay compliant.
• Supreme Decisions – A Proactive Approach for Health Plans to Dobbs and Marietta
  
  July 19, 2022
  The U.S. Supreme Court may be in recess until October, but its landmark healthcare rulings over the past month continue to reverberate across the country and across our industry. These decisions will have strong implications for plan sponsors in particular and The Phia Group is here to explain how your health plan, and its administrators, may be affected by these momentous developments. Please join us as we delve into such current affairs (not to mention history in the making) from a unique healthcare cost containment perspective.
• Fiduciary Liability & The No Surprises Act | The Phia Group
  
  May 24, 2022
  View our full webinar with a candid roundtable discussion on what the Fiduciary Liability and No Surprises Act is and how they continue to evolve.
• Healthcare Opportunities and Concerns | The Phia Group
  
  April 19, 2022
  Learn about case studies and recent developments in the healthcare industry from relationships to regulations, from plans to politics and more.
• Healthcare Cost & How Plans Must Prepare | The Phia Group
  
  March 22, 2022
  We may be entering a series of expensive years in health care. Learn about the risks, what to look for and best practices to deal with them.
• The ERISA Compliance Landscape for 2022 | The Phia Group
  
  February 15, 2022
  Learn about major compliance concerns and what plan sponsors can do to best prepare a compliance strategy to keep up with ERISA law and COVID-19.
• Tune in to Win – Are You Ready for 2022?
  
  January 25, 2022
  Learn more about litigation to political developments, regulatory developments to procedural best practices and more with The Phia Group in this podcast.
• The 11th Hour - Last Minute Moves to Make for 2022 as a New Era in Cost Containment Begins
  
  December 13, 2021
  Learn about what the new era of cost containment will bring in 2022 and how to prepare for increased regulatory attention and enforcement.
• Act Now, Plan Ahead – The 2021 Endgame and 2022 Outlook
  
  November 16, 2021
  Did you start 2022 on the right foot? Learn about the No Surprises Act and transparency, threats posed by prescription drugs and rehab facilities, and more.
• A Spooky Surprise: NSA Regulations on IDR Released
  
  October 19, 2021
  Are you aware of the No Surprises Act rules on independent dispute resolution? Learn about its implications for claims and appeals with The Phia Group.
• Stories from the Front Lines – A Collection of Recent Relevant Case Studies & COVID-19 Vaccine Mandate
  
  September 21, 2021
  Don't make these same mistakes. Learn from various case studies on mishandled appeals, fiduciary breach, misapplication of plan terms, and more.
• The Provider Perspective – Analysis and Response to How Providers are Reacting to Recent Rule Changes and Reform
  
  August 24, 2021
  Are you prepared for the new healthcare pricing rule changes? Learn about best practices to fight back against abusive provider billing tactics.
• Surprise, surprise! Analyzing the No Surprises Act Part Deux
  
  July 12, 2021
  Wondering how surprise billing regulations will impact you? Learn about the No Surprises Act in this detailed analysis of the new rules by The Phia Group.
• Back on Track: Plan Sponsor Priorities for the Second Half of 2021
  
  June 21, 2021
  Learn about cost containment solutions to help you prepare for challenges with mental health parity requirements and rising prescription drug prices.
• The Light at the End of the COVID Tunnel – Pandemic Fallout and Permanent Changes
  
  May 24, 2021
  Which pandemic era regulations are here to stay? Learn about topics ranging from how we seek and deliver healthcare to rules controlling how we pay for it.
• Face the Change – Plan Design, Administrative Claims Processing and Payment Changes Needed in Light of COVID-19 and New Regulatory Obligations
  
  April 27, 2021
  Learn about ARPA, COBRA, Mental Health Parity, the No Surprises Act and how to remain compliant in light of new federal and state regulations.
• Fallout in the Spring – COVID Claim Disputes, Surprise Billing RBP Opportunities & Return to Work Vaccine Mandates
  
  March 24, 2021
  Are you ready for this new chapter in the pandemic saga? Learn about Covid claim disputes, surprise billing RBP opportunities and vaccine mandates.
• A Blueprint for Success – Lessons from 2020, Expectations for 2021
  
  February 25, 2021
  Join The Phia Group to learn from the past, and plan for the future! In this webinar, The Phia Group will both examine what has happened as well as predict what is to come, as they help you identify what needs to be done to ensure the best possible outcomes for this coming year. They will discuss President Biden’s first month in office, identify whom he has appointed for key roles (and examine their track records on healthcare), as well as dissect the issues that were most relevant in 2020 – ensuring we learn from both the victories and losses of the year that has ended.
• The “No Surprises Act,” COVID Relief, and Plan Design Changes Impacting Your Business in 2021
  
  January 20, 2021
  After a hectic political showdown, the president has signed legislation which includes comprehensive protection from surprise medical billing. This 5,000-page bill, along with a raging pandemic and a new administration, is certain to have our industry scrambling to keep up. Join The Phia Group in a new webinar format as they discuss the COVID-19 relief bill, the impact on the industry, and everything in between. From plan design changes to updates on fiduciary duties and subrogation, we have got you covered as we ring in the New Year. Following the one-hour webinar, there will be two 30-minute breakout sessions, addressing plan design changes, stop-loss issues, and legal and regulatory updates affecting claims.
• A Transparent 2021 - Further Analysis of the Year to Come
  
  December 15, 2020
  Following on the heels of their incredibly informative assessment of what to expect in 2021, The Phia Group will dives back into their pool of predictions in another free webinar. The team targets rules that will impact 2021, including the recently released transparent pricing rules. Additionally, they discuss some best practices developed and applied in 2020 and how those changes will assist plans in 2021. If success in 2021 is in your plans, check out this webinar and look forward to tomorrow.
• Desperately Looking Forward to 2021
  
  November 16, 2020
  The end (of 2020) is near, and we are anxiously looking forward to 2021. Between the Presidential Election, the COVID-19 Pandemic, and the ACA’s “Day in Court” before SCOTUS, any one of these ongoing topics would be enough to keep us busily planning for what is to come. Suggesting that 2021 is poised to be one of the busiest years in our industry’s history might be an understatement. At times, it may be overwhelming to keep up with everything that is impacting us – as employers, as service providers, and as human beings. That’s why The Phia Group is proud to invite you to enjoy another webinar, where we will be discussing these and other hot topics, forecasting what we expect to see in 2021, and giving you a head start as you – like we – plan, and look forward, to 2021.
• New Opportunities to Save, Create Revenue & Avoid Scary Practices
  
  October 19, 2020
  Join The Phia Team as they share some of the industry’s scariest blunders and gruesome practices. Turn down the lights and prepare to be horrified; but fear not... with this trick there are also treats. Not only will attendees learn from others' mistakes, but we will also pull from our bag of goodies new sources of revenue and savings for plans and administrators alike. If you miss this one, it will haunt you for the rest of your life.
• Benefits on the Ballot – A Political Update for Health Benefits Professionals
  
  September 22, 2020
  Election season is underway. The future of healthcare will be decided via the ballot box, court rooms, and congressional halls. Pandemic or no pandemic, the gears of democracy are turning and what happens now will have long term effects for us all. Join The Phia Group as they discuss the most important elections (including candidates’ positions on health), ongoing legal cases, and proposed laws. They will dissect each and provide you with not only thoughts on how they may impact us, but how we can best prepare for likely outcomes.
• Conflicts Abound – Providers & Facilities Fight Back
  
  August 17, 2020
  U.S. hospitals have lost over $200 billion from March to June as a result of canceled services due to the COVID-19 pandemic. In response, providers have changed their tactics. They are raising prices, appealing more denied claims, more aggressively fighting referenced-based pricing, and stepping up collections efforts. Now, more than ever, it is imperative for plans and their partners to be vigilant and protect their members and plan assets. Join The Phia Group’s team as they discuss these new aggressive tactics as well as the conflicts they are causing with networks and stop-loss.
• The Underlying Regulatory Landscape - Don’t Get Lost in the New Normal
  
  July 15, 2020
  As we remain hyper-focused on COVID-19, it is easy to forget other ongoing impactful industry events. Life goes on, and so too does lawmaking and litigation. Statutes, regulations, and case law have been and continue to be considered, debated, and finalized; resulting in serious, lasting effects. It behooves us all to track them accordingly. Luckily for you, The Phia Group’s legal team has done just that – and they will happily inform and advise on what to watch, and how to adjust. Join us for this free, but invaluable event.
• Old Issues, New Environment – Not The Same Old Song
  
  June 16, 2020
  Join our team of experts as we discuss familiar issues such as balance billing, surprise billing, mental health parity, telemedicine and more. Learn more.
• A Pandemic Economy – Industry Risks and Opportunities
  
  May 19, 2020
  As the economy suffers, our industry is impacted when employers furlough employees or implement layoffs, as well when employers can no longer afford to offer benefits or continue operations. Fewer benefit plans, fewer plan participants, and dramatic changes in claim type and volume are certain, leaving health benefits at risk during a time when they are most needed. Yet, there are those that are improving coverage, leveraging opportunities, and preparing to take advantage of the employer, employee, and claims growth likely to follow a lifting of stay-at-home orders. Join The Phia Group as they discuss ways administrators are extending benefits and taking care of those in need. From COBRA to workers' compensation, mandates to stop-loss, join us to discover innovative ways to conquer the challenges and come out on top.
• Reasons for Optimism
  
  April 23, 2020
  Together we are all enduring common trials. It is certainly one of the most difficult periods in our history – as an industry and as Americans; and yet, opportunities exist. Both presently, and heading down the pike, there are reasons for optimism. Join The Phia Group as they discuss the many GOOD and POSITIVE things that have both improved our industry since the end of 2019, and that are on the way. We will discuss opportunities that exist now, that are forthcoming, and why we foresee YOU flourishing post-COVID-19.
• COVID-19: The CARES Act & Workplace Safety FAQs
  
  March 31, 2020
  In the fight against COVID-19, events are unfolding at a breakneck pace. Congress just passed the largest recovery bill in American history. Employers are facing serious questions about their obligations and liability during this crisis. Join The Phia Group for this special edition webinar as we discuss the impact of this historic federal legislation on our industry and answer your questions about workplace safety.
• Special Edition - The Phia Group and COVID-19 FAQs Answered
  
  March 23, 2020
  From inquiries about how to comply with regulations to revising plan documents, The Phia Group has received many questions from brokers, employers, TPAs, and stop-loss carriers about COVID-19.
• The Top 10 of 2020: Cost Containment Measures to Implement Right Now
  
  March 10, 2020
  Self-funding can be great if you know how to use it – but it can also be disastrous if done wrong. Health plans trust their TPAs and brokers to make the right decisions for them, and cost-containment is always the right decision. From choosing a stop-loss carrier all the way to handling appeals, the self-funding market is full of options and customizations, and some are (much) better than others. Join The Phia Group’s legal team as they discuss the cost-containment measures they encounter most frequently, and tell some success stories, some horror stories, and how you can make the best decisions for your clients’ bank accounts.
• Double Dose: Revisiting Rx Drugs and Answering Your Questions
  
  February 12, 2020
  Last month, we discussed some disturbing trends surrounding prescription drugs, and what they mean for self-funding. The overwhelming feedback we received after last month’s webinar was that you, our viewers, want more information on this particular topic – so we’re back with a sequel! Join The Phia Group’s legal team as they take a deeper dive on the topic of Rx drugs, tackle the difficult questions asked in last month’s webinar, and help plans protect themselves while staying ahead of the curve.
• A Dose of Savings – Addressing Drugs, PBMs, and the Controversies Surrounding Them
  
  January 21, 2020
  Whether you are a fan of politics, profits, or identifying savings, you are likely keeping a close eye on pharmaceuticals. From life-preserving medications that have been around for decades (and whose price increases continue to outpace the national GDP) to specialty drugs that are inches away from FDA approval (and bankrupting most benefit plans), the cost tied to drugs is a hot topic. While congressional efforts to curb rising costs have stalled, pharmaceutical companies, pharmacy benefit managers (PBMs), and politicians continue to look for someone else to blame. Join The Phia Group as they discuss the Rx trends to watch for, the biggest threats to health plans, cost-containment strategies to implement, political efforts underway, and an injection of information you can’t do without.
• A Perfect Vision for 2020
  
  December 17, 2019
  Looking back at the year that was, 2019 gives us perspective and allows us to view 2020 with both optimism and concern. Open your eyes (and ears) and join the team as they review the issues, topics, and innovations of 2019 that they believe will impact 2020, as well as the strategies you need to implement now to conquer the coming year.
• Plan Language, Rx, and Lawsuits to Watch (and File): Innovation for a Changing Industry
  
  November 13, 2019
  In the face of evolving pricing models, ever-increasing drug costs, difficulties in administering claims, and increased regulatory burdens, the players in the self-funding industry need change. Not just any change, though; creative change that promotes cost-containment and makes life easier for those who support health benefit plans in one way or another.
• 2020 Forecast - Storm Clouds, Clear Skies, and the Issues that will Dominate Next Year
  
  October 23, 2019
  2020 is almost here, and The Phia Group continues its webinar series dedicated to preparing you for renewals, and the coming year. Join the team for this free webinar as they discuss the issues that impacted 2019, and are poised to dominate 2020, including (but not limited to) Mental Health Parity, Paid Leave, Health Insurance Taxes, Drug Prices, Regulations, and Coupons.
• 2020 Renewal Season - Decisions Today, Uncertain Tomorrow
  
  September 17, 2019
  It’s plan renewal season, and we find ourselves making decisions that will define how plans will operate over the next year. This is no easy task! First, we confront known issues and hurdles – such as increasing drug costs, regulatory crackdowns, and aggressive providers – looming before us. Additionally, despite the need to make these decisions now, the future is more uncertain than ever before. Between litigation challenging the constitutionality of the ACA and an already wild 2020 Presidential election, no one truly knows what next year will look like. How can we make decisions today at renewal, that address the issues of tomorrow – both known and unknown? Join The Phia Group for a “can’t miss” review of important issues impacting plan renewals, address known roadblocks, and perform an assessment of the candidates’ positions on healthcare – with an eye toward what we should be doing today to prepare for an uncertain tomorrow.
• Back to School: 2020 Renewals
  
  August 21, 2019
  As players in the self-funded industry have found out the hard way, keeping business often isn’t easy. Fiduciary obligations and other difficult situations can arise when we all least expect them, and when we are worst-equipped to deal with them (such as in the height of renewal season). By popular demand, this month’s webinar will focus on when fiduciary duties can arise, who needs to be careful, and how those duties might affect your 2020 renewals.
• Trump’s Executive Order on Transparency: How it Will Effect Each Segment of Our Industry
  
  July 23, 2019
  On June 24, 2019, President Trump issued his “Executive Order on Improving Price and Quality Transparency in American Healthcare to Put Patients First.” This Order requires hospitals to publicly post their prices, and is designed to give healthcare consumers more choice and better decision-making capabilities.
• The Impact of State, Federal Laws, and Current Market Trends on Self-Funding
  
  June 20, 2019
  Attention, self-funders: things are happening! State and federal governments have been busy beavers, either passing legislation or at least looking into it. Whether it's surprise billing laws, Medicare-for-all initiatives, or public exchange options, you need to know about it.