On today’s episode of the Empowering Plans podcast, attorneys Jon Jablon and Kendall Jackson discuss the current state of the No Surprises Act (NSA) and the Independent Dispute Resolution (IDR) process. From difficulties managing dispute volume to current litigation and legislative proposals, this episode provides key insight into changes to and challenges with the IDR process.

In this installment of The Phia Group’s “Empowering Plans” podcast, attorneys Bryan Dunton and Cindy Merrell discuss what happens when laws evolve faster than contracts, and how many compliance failures live in old documents. This episode breaks down how legacy contract language creates modern risk under HIPAA Part 2 and emerging PBM transparency reforms, particularly where downstream data sharing and compensation disclosures are involved. Brokers, TPAs, and plan fiduciaries will want to tune in and find out how these changes will impact their groups.

In this episode of the Empowering Plans podcast, attorneys Brady Bizarro and Brian O’Hara share the latest information TPAs and employer plan sponsors need to know about the No Surprises Act. The discussion focuses on recent federal guidance, updated arbitration data, key court decisions affecting NSA enforcement, and practical takeaways for managing provider billing disputes and controlling plan exposure in 2026.

Tobacco surcharges have long been a common cost containment wellness tool for self-funded plans, but recent lawsuits are putting them under the microscope. In this episode, attorneys Kelly Dempsey and Naga Vivekanandan break down how tobacco surcharges work, why they are treated differently under federal law, and what recent court decisions mean for employers navigating wellness program risk.

In this episode, Phia Group legends – CLO Ron Peck and EVP Jen McCormick – dive deep into waters rarely discussed.  They contemplate how the rising costs of healthcare impact employers and their employees in areas outside of healthcare – from hiring to counting steps.  Join them as they share insight into this, and how to get employees and their families to embrace healthcare literacy, and positively impact aspects of their lives beyond “just healthcare.”

This week on the Empowering Plans podcast, attorneys Corey Crigger and Nick Bonds dig into the growing movement to use psychedelics in treating mental health and substance use disorders. As states ramp up research and regulation, they unpack what’s driving this shift — and what health plans should watch for in a changing compliance landscape.

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.