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In-Network vs Out-of-Network Claims
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Employee Rights With COVID-19 Vaccines
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Mental Health Parity and Addiction Equity Act Explained
Understanding Non-Quantitative Treatment Limitations (NQTLs)
The Insulin Cap Bill Offers Hope for Americans With Diabetes
In-Network vs Out-of-Network Claims
Gag Clause Prohibition Compliance Attestation
AI in Healthcare
Understanding Prescription Medication for Weight Loss
Industry Terms
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Empowering Plans: P95 - 2020 Election Results (So Far) – Our Takeaways
On November 9, 2020
In this episode of Empowering Plans, Ron and Brady are joined by Attorney Nick Bonds to discuss the 2020 election results. For now, it looks like we will have a new president in 2021. What will that mean for the healthcare industry? If the Senate stays in Republican control, is a public option likely? Will Obamacare be replaced? What will happen to popular issues such as prescription drug reform and surprise billing bans? We are covering all of the angles and breaking down all of the possibilities.
Benefits on the Ballot – A Political Update for Health Benefits Professionals
On 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.
The Top 10 of 2020: Cost Containment Measures to Implement Right Now
On 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.
Empowering Plans: P72 – The Young & The Restless
On November 21, 2019
Adam Russo and Brady Bizarro sit down with Craig Clemente, Chief Operations Officer at Specialty Care Management and outgoing Chairman of the SIIA Future Leaders Committee, to discuss the future of the committee and the many ways they intend on engaging the younger generation. Make sure you tune in to find out what SIIA has in store for 2020 and beyond.
Faces of Phia: Episode 19 – Shauna Makes a Comeback
On November 15, 2019
Join Adam Russo and Ron Peck as they interview Shauna Mackey, The Phia Group’s Associate General Counsel. Shauna is back in New England after moving to London, and was fortunate to have had private health insurance through her husband’s company, as opposed to utilizing the public healthcare offered to all residents in England. Tune in to learn more about Shauna and her experience with both public and private healthcare throughout her pregnancy and delivery.
Plan Language, Rx, and Lawsuits to Watch (and File): Innovation for a Changing Industry
On 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.
Faces of Phia: Episode 18 – Battling Balance-Billing
On November 4, 2019
Join Adam Russo and Ron Peck as they interview Lyneka Hubbert, a Medical Claim Negotiator here at The Phia Group. Lyneka has worked in six different departments throughout her five years at Phia, and has more in store for her future here. Tune in to learn more about Lyneka and her experience with protecting patients from balance bills.
Tales From the Plan: Episode 5 – Translating Phia’s Benefit Plan
On October 24, 2019
Join Adam Russo and Ron Peck as they interview The Phia Group’s Human Resources Manager, Linda Pestana. Learn how Linda was able to navigate our health plan and negotiate with a provider to make her son’s hearing aids affordable. Additionally, Linda discusses another story regarding Phia’s health plan, and how it has completely erased the out-of-pocket expense for a medication another employee previously paid $800.00 a month for.
2020 Forecast - Storm Clouds, Clear Skies, and the Issues that will Dominate Next Year
On 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.
Tales From the Plan: Episode 4 - A Vision for Savings
On September 23, 2019
Join Adam, Pat, and this episode’s guest – Michael Vaz – to hear from a valued employee, whose experience in the industry and as a consumer of healthcare will open your eyes and help you appreciate how much difference a plan can make in a person’s life. Containing costs and rewarding employees – it’s a win-win.
Empowering Plans: P71 – Politics! Politics! Politics!
On September 18, 2019
Brady and Ron do what they do best, say the things you are thinking! This time, they wax poetic about Obamacare, the state of health care versus health insurance, and the political environment as we move toward the 2020 election.
2020 Renewal Season - Decisions Today, Uncertain Tomorrow
On 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.
Faces of Phia: Episode 16 - Crunching Numbers with Desmond Campbell
On September 4, 2019
Join Ron Peck as he interviews Desmond Campbell; the man, the myth, the legend. Desmond has spent time crunching numbers over the past 4 years – first for clients, now for The Phia Group. A man with experience elsewhere in the industry, Desmond will share what brought him to The Phia Group, and what keeps him here.
Back to School: 2020 Renewals
On 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.
Faces of Phia: Episode 15 - The Fine Fan Club!
On August 16, 2019
In this episode, learn more about the life and background of Andrew Fine, Phia’s Lead Intake Specialist. Listen in as Andrew discusses his family, the fan club behind him, compliance being the number one priority for plans, and the bittersweet nature of the Celtics. Listen in closely, as the former sports analyst might give you some insider tips!
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