In this episode of The Phia Group’s Empowering Plans podcast, attorneys Nick Bonds and Corey Crigger, discuss Direct Primary Care (DPC). This was a hot topic at a recent conference Nick attended and a subject near and dear to Corey. Join them as they discuss the benefits and practical issues to consider when looking to this tremendous option for augmenting your employee benefits plan. 

In this episode of The Phia Group’s Empowering Plans podcast, attorneys Jen McCormick and Jon Jablon discuss some emerging law and trends that impact the self-funded industry, with an emphasis on what it means for the TPA/employer dynamic. Relationships are key in this industry, but since the law imposes responsibilities on health plans that often can’t be met without significant help from a TPA, things can get a bit messy. There’s a lot of content to cover on this one, and Jen and Jon try to at least scratch the surface of this complex topic.

 Congress has proposed a $35 cap on patient cost-sharing for a month supply of insulin. Join Attorneys Cindy Merrell and Micah Iberosi-Parnell, as they discuss the insulin cost crisis, Congress’ band-aid on insulin prices, and what’s really needed to lower costs for employers and patients. 

The CAA, passed in part due to the rising mental health issues, added enhanced DOL enforcement mechanisms.  Join special guest Jen Berman of MZQ, and Jen McCormick, as they discuss the DOL’s evolving approach on MHPAEA which is moving from a "compliance assistance" model to a "proactive enforcement" model.  This approach puts a ton of pressure on plan sponsors – administrative, compliance, logistical – and plans need to be prepared.

On this week’s episode of Empowering Plans, Attorneys Chris Aguiar and Cindy Merrell, discuss the balancing act of health plan members’ reduction requests and Plan’s fiduciary duties, why a reduction can be in the Plan’s best interest, and more. Listen in as we dive deep into reduction requests and Plan’s fiduciary duties.

With one year under his belt, President Biden delivered his first State of the Union address, in which he showcased his domestic policy agenda. In this episode of the Empowering Plans podcast, Brady Bizarro and Andrew Silverio break down the important healthcare policy items the president discussed, and as importantly, which ones he did not.

On this week’s episode of Empowering Plans, Kelly Dempsey and Kevin Brady discuss over-the-counter COVID testing and the complications surrounding up-front payment by participants with account-based plans (HSA, FSA, HRA).

February 10 marks a full year since the requirement to provide a written report document a plan’s comparative analysis of its NQTLs took effect. In today’s podcast, Jon Jablon and Nick Bonds discuss some of what they’ve learned from a year’s worth of analyzing NQTLs, some practical considerations for health plans, and their takeaways from the recently-published report on MHPAEA compliance from the DOL, HHS, and Treasury.

This week on Empowering Plans, Jen McCormick and Katie MacLeod discuss the controversial new OTC COVID-19 Testing coverage requirement that went into effect on January 15, 2022 for plans – how it interacts with other COVID-19 coverage requirements, what plans need to cover and available safe harbors, and how plans can be prepared for compliance. This won’t be the last you hear of this topic, plans should not delay in getting their action plan and policies in place.

Kicking off the first episode of Empowering Plans in 2022, Phia’s Chief Legal Officer, Ron E. Peck, and Attorney Micah Iberosi-Parnell, talk value-based care, what it is, where it’s at right now, and where it’s headed. Listen for a preview of what action self-funded plans can begin taking now to reduce costs without sacrificing the quality of coverage.