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.
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To obtain a copy of our webinar slides, please reach out to mpainten@phiagroup.com.
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.
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This is it! This is it! Ron and Brady pick apart Elizabeth Warren’s Medicare-for-All proposal, and the concept as a whole; the good, the bad, and the really bad. You can’t afford to ignore this one.
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A claim arrives. Is it payable? Such a simple question triggers so many complex scenarios. In this era of steadily increasing appeals, to pay or exclude is only the first step. Even if it’s covered, how much is payable? Are there network entanglements or stop-loss issues? Employer bias or HR concerns? Never mind gaps! Even IF the claims are properly handled, has the written notification of adverse benefit determination been issued properly? Who can file an appeal? How? What timelines apply? What steps do you take, to set yourself up to triumph, if and when it ends up in front of a court of law? As so many administrators have discovered the hard way, it is all too easy to make mistakes that can come back to bite you later. DON’T PANIC! Join The Phia Group’s legal team as they discuss the good, bad, and ugly truths about the claims process, and how to safely navigate the various TPA and health plan duties associated with it.
Between a traditional PPO plan, a MEC or “skinny” plan, reference-based pricing, narrow network, cafeteria plan, or high-deductible health plan, who can choose? They all have their nuances, and which plan type is best for a given plan sponsor will depend on factors including risk tolerance, geographical location, employee base, and more. Thank you for joining The Phia Group’s legal team on Tuesday, May 16, as they discussed the different plan options available to plan sponsors these days – including benefits, dangers, best practices, stop-loss and network considerations, and the future. Click Here to Download our Full Webinar Click Here to Download Webinar Audio Only To obtain a copy of our webinar slides, please reach out to mpainten@phiagroup.com.
It’s common knowledge that not every network contract adds real value, nor can medical providers always be relied upon to bill responsibly. As the fiduciary duty to be prudent with plan assets becomes increasingly relevant, it's important that self-funded health plans, and those who service them, not fall behind. Thank you for joining The Phia Group's legal team on March 23, 2017 as they analyzed the various ups and downs we associate with "provider relations," including overpayments, claim negotiations, reference-based pricing, balance billing and more - and discussed some best practices for working within each of these domains. Click Here to Download Full Webinar Click Here to Download Audio To obtain a copy of our webinar slides, please reach out to mpainten@phiagroup.com.
Employers who self-fund their health plan act as a traditional employer, a plan sponsor, and a plan administrator. Juggling this many roles, conflicts and contradictions are bound to happen. For instance, an employee handbook’s handling of disability leave may conflict with the health plan document as it relates to employment and plan coverage. Thanks for joining The Phia Group’s legal team on February 15, 2017, as they discussed top miscues employers make when it comes to their health plans, and what we all can do to become health plan heroes; rescuing employers who have blurred the lines, and will without our help soon be stuck between a rock and a hard place. Click Here to Download Full Webinar Click Here to Download Audio To obtain a copy of our webinar slides, please reach out to mpainten@phiagroup.com.
The past decade has ushered in both outrage and opportunity for self-funded plans, and 2016 was no different. The characteristics of self-funded plans continued to alter in concert with new laws and regulations. While these bureaucratic efforts often hindered our ability to self-fund, for those daring enough to change with the times, we saw increased growth and prosperity. We will no doubt see these issues and opportunities continue to evolve in 2017, and only those that prepare will thrive. Thank you for joining The Phia Group’s team of attorneys on January 19, 2016 as they reviewed the most troublesome and costly issues of 2016 and opportunities that were born from strife - and examined how they will impact self-funding in 2017 while offering some solutions for the new year. Click here to download the video. Click here to download the audio.