“We offer the latest information regarding regulatory compliance, forward thinking cost containment, and knowledgeable employees that stay abreast of all the things you need to know.”

LAUREN BISHOP
Manager, Phia Group Consulting


Plan with us - Plan Drafting Services
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Plan Drafting FAQ's
Case Studies
Leave of Absence Flyer

“Setting the Industry Standard for Plan Language™” by combining cutting edge technology with forward thinking creativity, and a client-centric customized approach.

Plan Document Assistance and Collaboration

Regardless of how you choose to develop your plan document, The Phia Group’s team of plan drafting experts is available to assist in the process. Our team will ensure that your language is best-in-class, your questions are answered accurately, and that your plan drafting experience proceeds smoothly.

Some employers are looking to self-fund for the first time, while others are approaching self-funding with an existing policy or plan document. If you have a plan document or insurance policy, whose terms are acceptable, but need improvement to stay viable, The Phia Group’s team of expert plan drafters can maintain the integrity of the existing benet structure and limitations in a new and improved template plan document.

All Plan Document Review, Revision, and Drafting

We combine a forward thinking ideology with years of experience to analyze benet plan documents, identify areas of concern, make recommendations, and apply strategies to strengthen plan rights.    

Gap Free Review

When plan documents, stop-loss policies, networks, employee handbooks, and service agreements fail to align, claims go unpaid and nancial ruin is a real possibility. By comparing pertinent documents to ensure uniform coverage, nancial security and a smooth operation are assured.

Phia Certification

Any self-funded plan document can become Phia Certified. The Phia Group will review plan documents to ensure they meet our stringent standards. A tangible report card is produced to identify areas of need and ensure compliance with applicable laws and regulations. 

Leave of Absence Review

Both states and the federal government are starting to enact richer leave of absence requirements, and employers have begun implementing policies in their employee handbooks to comply with the law. These policies can be very comprehensive and have significant implications for eligibility and continuation of coverage. Employers face a tough task in ensuring that plan documents, employee handbooks, and applicable stop-loss policies all align with regard to leave policies. A single variation in terms or conditions can result in a coverage gap, state compliance issues, or even fiduciary liability.

The Phia Group routinely evaluates plan documents, employee handbooks, and stop-loss policies to identify variances. This conflict – between employee handbooks, health benefit plan documents, and the law – is both prevalent and becoming more common every day.  To this end, The Phia Group has developed the Leave of Absence Review service.

What is The Phia Group’s Leave of Absence Review?

Similar to our “Gap Free”™ service, a Leave of Absence Review reviews an employee handbook in an effort to identify potential variances between employer policies and applicable health benefit plan documents. We review three major areas:

(1)  Eligibility provisions
(2)  Leave of absence provisions (state and federal)
(3)  Continuation of coverage provisions

*Note that our analysis is limited to eligibility for health benefits and those benefits which have a direct impact on health insurance coverage or continuation of coverage (such as a leave of absence). We do not consider whether particular employee groups are entitled to other benefits, such as life insurance, private disability insurance, social security disability insurance, overtime compensation, workers’ compensation, retirement benefits, or fringe benefits.