In the latest installment of The Phia Group’s “Empowering Plans” podcast, attorneys Kendall Jackson and Jon Jablon explore Essential Health Benefits – an important facet of self-funded health plans that seems straightforward, but has garnered a great deal of confusion and misconception through the years. This episode touches on the significance of state benchmark plans, the difference between EHBs and state-mandated benefits, application of EHBs to the maximum out-of-pocket limit, and more.

Join attorneys Bryan Dunton and Cindy Merrell as they discuss what happens when the No Surprises Act collides with subrogation. They explore the practical implications of the legislation, including how it intersects with common recovery models like “pay and chase” and “pend and pay.” This conversation offers valuable insights into how the Act may affect your approach to healthcare claims and reimbursement strategies.

The rules around COVID coverage are entering a new phase. attorneys Kelly Dempsey and Naga Vivekanandan as they explore how recent ACIP guidance narrows preventive coverage for COVID vaccines and what it means for both PPO and HDHP plans. They also dig into the gray areas employers face when updating plan documents and how participants may see their costs shift.

Attorneys Jon Jablon and Nick Bonds break down some of the issues around administering prior authorization requirements, including their use as a cost-containment tool, the procedural aspects, perceptions, and the impact that can have on plan participants. They also discuss some of the regulatory guardrails being put around prior authorizations at the state and federal levels, and some of the key questions for plan sponsors to consider when designing and implementing prior authorization requirements.

Join the dynamic duo of Ron Peck and Corey Crigger as they discuss the surge of equity investment into “sin” services – such as  gambling and adult entertainment – and how this is likely only one part of a bigger strategy… A strategy that ties into the same investors’ recent backing of health care providers treating conditions caused, triggered, or exacerbated by the same behaviors.  Conspiracy theory or incredible insight?  You decide!

In the latest episode of the Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson discuss common misconceptions surrounding RBP plans and the NSA. From protections against balance billing to the Independent Dispute Resolution process, we are covering all of the areas of the NSA that you need to consider for an RBP plan.

On the latest and greatest episode of the Empowering Plans podcast series, attorneys Bryan Dunton and Cindy Merrell discuss news that matters to you: how recent headlines signal sweeping changes to adverse claims determinations and prior authorization practices.

In this episode, we take a closer look at two key developments out of CMS that could reshape how provider data and dispute resolution work in practice. First, we explore the agency’s proposed National Provider Directory — an ambitious effort to clean up fragmented provider data and reduce ghost networks. Then, we break down insights from the July 2025 CMS Technical Assistance Seminar, which tackled the growing problem of errors in the Federal Independent Dispute Resolution (IDR) process — from procedural missteps to jurisdictional mistakes and default determinations on ineligible claims. What’s CMS doing to fix the system — and what gaps are still leaving plans vulnerable?

Today, attorneys Kelly Dempsey and Naga Vivekanandan dive into the latest landmark healthcare-related legislation, nicknamed “The One, Big, Beautiful Bill," and how it will reshape High-Deductible Health Plans (HDHPs), telemedicine, and Direct Primary Care (DPC) arrangements. They explore the IRS rules, what's changed, and what it means for employers, employees, and plan administrators.

In this episode of Phia’s Empowering Plans Podcast, attorneys Nicholas Bonds, Esq. and Bryan M. Dunton, Esq., break down the key Supreme Court rulings issued in June 2025 that have direct implications for self-funded group health plans and their fiduciaries. From decisions impacting coverage mandates, nationwide injunctions, and gender-affirming care, Nick and Bryan explore how these opinions reshape the regulatory landscape and discuss practical takeaways for plan administrators and TPAs. Whether you’re updating plan language or keeping an eye out for compliance risks, this is an episode you can’t afford to skip.