The Phia Group Blog
Welcome to The Phia Group Blog, your source for cutting-edge insights into health plans, cost containment, and industry regulations updates. We break down top stories and trends, share actionable strategies, and provide expert perspectives to help you stay ahead.
Revisiting PPO Contracts & Stop-Loss Gaps
By: Jon Jablon, Esq. There’s no question that stop-loss insurance is important – or, more likely, absolutely necessary – for the viability of a self-funded health plan. As helpful as this measure of protection can be, however, it is not…
Doe v. United Behavioral Health – A Fiduciary Twist
By: Andrew Silverio, Esq. On March 5, 2021, the northern district of California came down with a decision that is causing some justifiable concern among TPAs in California and beyond. The root of the dispute is a self-funded plan’s application…
Here for the Long Haul – Are Employers and Plans Ready?
By: Kelly Dempsey, Esq. Change that creates challenge is nothing new for the self-funded industry, which is why the amount of changes that have been required to address COVID-19 are not a shock to our industry. But now that we’re…
No Surprises Act & “Plan Websites”
By: Jon Jablon, Esq. Our consulting team recently fielded a great question, which is worth mentioning here. The text of the law provides that health plans: …”must have a database on the public website of such plan or…
A COBRA Conundrum
By: Nick Bonds, Esq. COBRA continuation coverage has never been what I would call “intuitive.” Even under the most straightforward of circumstances, COBRA involves a byzantine labyrinth of rules and timelines, for employers and beneficiaries alike. In the time…
By: Andrew Silverio, Esq. On Friday, February 26, the EBSA released its Disaster Relief Notice 2021-01 (available at https://www.dol.gov/agencies/ebsa/employers-and-advisers/plan-administration-and-compliance/disaster-relief/ebsa-disaster-relief-notice-2021-01), addressing a conflict that many commentators had already picked up on – the fact that previous relief (see https://www.federalregister.gov/documents/2020/05/04/2020-09399/extension-of-certain-timeframes-for-employee-benefit-plans-participants-and-beneficiaries-affected#footnote-2-p26352) provided for…
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