Hot Topics Impacting the Health Benefits Industry Addressed by The Phia Group's Legal Team

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In its recent newsletter, The Phia Group’s legal team addressed some of the biggest issues impacting benefit plan sponsors today, including PPACA’s impact on foreign employers, providers paying patients’ premiums, how employers can influence member decision making, and the Supreme Court’s DOMA decision. To read more about these issues, other topics, view the newsletter in its entirely, or learn more about The Phia Group – an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services – visit their website at http://www.phiagroup.com.

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PPACA – International Law of Mystery
By: Jon Jablon, Esq.

We were recently asked whether a group located outside the United States will be obligated to comply with the employer mandate (affectionately known as “pay or play”), and whether non-citizen employees of that group, lawfully present and working within the United States, will be obligated to comply with the individual mandate. Though foreign citizens present within the United States for a certain amount of time may be penalized for not complying with the individual mandate, the employer mandate is not quite as sweeping as PPACA envisions...Continue Reading

Attack of the Killer P’s – Providers Paying Patients’ Premiums
By: Sean Donnelly

A recent and unsettling trend in the healthcare industry involves medical providers paying insurance premiums on behalf of their patients in order to ensure that the patient’s coverage remains active. Surprisingly, the Internal Revenue Service actually condones this practice. Don’t lose hope! Insurers and group health plans can discourage this practice...Continue Reading

How the Supreme Court’s Ruling on DOMA Affects Self-Funded Plans
By: Jennifer McCormick, Esq. and Corrie Cripps

In United States v. Windsor, the U.S. Supreme Court struck down “Section Three” of the Defense of Marriage Act (DOMA), which prevented the federal government from recognizing any marriages between gay or lesbian couples for the purpose of federal laws or programs. We can help guide you through the maze of these and other potential issues and implications surrounding the Windsor decision...Continue Reading

Grabbing the Wheel: Directing Member Steerage
By: Jon Jablon, Esq. and Sean Donnelly

Many TPAs have recently been inquiring about methods to drive utilization. Useful techniques include incentives for participating in wellness programs and disease management programs. By giving your employees or plan members “skin in the game,” you can eliminate the waste and inefficiency in your employee benefit plan and save a great deal of money in the long run...Continue Reading

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Andrew Milesky
@ThePhiaGroup
since: 11/2010
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