The Phia Group Blog

Posted December 22, 2015, 3:11 P.M. ET By Carmen Castro-Pagan A health plan isn’t entitled to reimbursement of $48,000 in medical expenses it paid on behalf of a minor beneficiary who was injured in an all-terrain vehicle accident, the U.S….

By Catherine Dowie The facts of the latest healthcare subrogation challenge on the SupremeCourt’s docket (Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan) will be familiar to many. As you may recall from the June…

By Carmen Castro-Pagan The Federal Employees Health Benefits Act preempts a Kansas administrative regulation prohibiting subrogation and reimbursement clauses in health insurance contracts of federal government employees, the U.S. Court of Appeals for the Tenth Circuit ruled . The appeals…

TPAs Recently Deemed Liable for Failed Overpayment Recoupment Since the inception of ERISA, but with startling frequency in recent years (with major cases being decided in the past year, and ongoing presently), TPAs, brokers, and other entities servicing self-funded plans…

New Faces at Phia James Newell Jr. Hired April 20, 2015 into the Claim & Case Support department Wayne Andrews  Hired May 11, 2015 into the Claim & Case Support department Mia Shabazz  Hired June 1, 2015 into the Case…

MyHealthGuide Source: Bill Rusteberg, 7/2015, RiskManagers.us White Paper <http://www.riskmanagers.us/> The Problem Medical inflation continues to rise. Facing rate increases year after year, plan sponsors, with their financial backs to the wall, have historically resorted to cost shifting. These continued failed…