The Phia Group Recognizes Diversified Group with 2018 Empowered Plan Award

MyHealthGuide Source: The Phia Group, 6/8/2018, http://www.PhiaGroup.com

phia-mvp-awardbadgeFoxboro, MA — The Phia Group, LLC, at its annual MVP (Most Valuable Partners) event, was pleased to recognize this year’s winner of The Phia Group “Trophy of Empowerment.” It is with appreciation that they now publically announce the name of their 2018 Empowered Plan Award winner, Diversified Group.

After analyzing all of their MVPs based on a number of parameters including, but not limited to, collaboration with The Phia Group, a willingness to innovate, as well as application of a forward thinking methodology – reflected through efforts taken to secure the future of our industry – Diversified Group of Marlborough, CT – was a clear winner.

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Phia Group’s 2018 Empowered Plan Award Winner, Diversified Group

The Phia Group’s CEO Adam V. Russo, Esq. remarked, “More than a decade and a half ago, Diversified Group took a chance on us… and since then both of our organizations have grown and thrived, in large part thanks to the friendship and partnership we have in force. We’re grateful for that relationship, as well as the work Diversified Group does on behalf of our entire industry.”

“We are so very honored to have earned this recognition from The Phia Group. Empowering plans is the core value we bring to our customers seeking effective alternatives to the traditional carrier based ASO and fully insured plans – the market is hungry for empowerment! Over the last 15 years, their team of experts have provided prompt and efficient resources; they are dedicated to understanding and adapting, and having them as a reliable partner is a huge asset,” Diversified Group’s President & Principal Partner, Brooks Goodison said. “When we receive recognition from a trusted partner like Phia, completely in line with the promise we make to our clients, it is like receiving a standing ovation!”

About Diversified Group
Like The Phia Group, Diversified Group is comprised of numerous organizations, all working toward a common goal. Comprised of Diversified Group Brokerage, Diversified Administration Corporation, Corporate Managed Health Services, and Corporate Fitness & Health – Diversified Group focuses on customer service and a customized approach to improving health; maximizing benefits and minimizing costs. Through their family of companies, they provide a wide variety of services, ensuring their vast portfolio of offerings addresses all the needs of the entities they aid. This emphasis on variety as well as their customer first mentality – along with a daring focus on innovation and selfless advocacy for the entire industry – are what makes Diversified Group this year’s winner. For more information about Diversified Group, please visit www.dgb-online.com.

About The Phia Group
The Phia Group, LLC, headquartered in Braintree, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive claims recovery, plan document and consulting services designed to control health care costs and protect plan assets. By providing industry leading consultation, plan drafting, subrogation and other cost containment solutions, The Phia Group is truly Empowering Plans. Contact Garrick Hunt, Sales Executive, at 781-535-5644, Info@PhiaGroup.com and visit www.PhiaGroup.com.

Why employers should be thinking TPA

The article below was published on September 5, 2017 by Employee Benefit News, written by Arthur Jonokuchi.

When it comes to healthcare plan administration, ASOs (administrative services only) say they offer a big discount to self-funded plans. If you look closer, however, you’ll see that they actually do come with a cost, both monetarily and in terms of lack of flexibility.

ASO’s omnipresence would make you think they are the only game in town. The reality, however, is that a combination of a third party administrator, along with robust internal plan administration, can do everything and more than an ASO does.

Here are five benefits of working with a TPA.

Unbundling drives down rates. When you unbundle plans, you invite competition for medical, prescription, dental, vision, wellness, disease management and stop-loss plans, and plan administration. Employers can choose premium providers with the services at the best rates.

This is a very powerful advantage not only for your current plan choices, but also for future rate increases. Competition helps reduce future rate increases by improving your company’s negotiation leverage. The big insurance carriers would like you to think that bundling saves money, but that’s often a lot of smoke and mirrors. Yes, some of the plan will be competitively priced, but other parts may be excessively high; there is no transparency. Transparency encourages competitive pricing.

Claims analysis catches errors and excessive billing. We’ve all heard about the $100 Tylenol tablet that appears on hospital bills. A strong TPA will perform comprehensive claims analysis. It will catch billing errors and line items that are excessive, egregious and unnecessarily expensive and go back to the provider before paying. The Tylenol tablet can be just the tip of the iceberg; some of these charges can be tens of thousands of dollars more than they should be.

Claims adjudication. ASOs often pay claims without performing due diligence; this is referred to as auto-adjudication. When ASOs occasionally go back and audit payments to doctors and hospitals, they keep a portion of the recovered amount. So they first overpay, then they keep some of the overpayment. But employers end up paying. As impartial third parties, TPAs will review large bills for accuracy. It is part of their service to contest bills that appear out of line and save the employer money, which could add up to six figures or more.

Cost containment through data analysis. For all the money that you pay an ASO, you would think that you get to own your own data. But think again. Information is power and, despite ERISA regulations, ASOs are not into sharing. In contrast, with a TPA, the employer owns the plan and member-level claims data.

When you own your data, your company can measure claims activity, such as top diagnoses and high claimants, evaluate preventative care and routine exam usage, make more informed decisions about plan strategy, develop better financial models and forecasts, and compare your company’s activity to industry and regional benchmarks.

Increased plan flexibility. ASOs limit clients to their own carrier’s plans. Large carriers can and often do curtail offerings to pre-defined plan options. What makes it easier for them doesn’t necessarily make it right for your company. With a TPA, you get to pick the best providers with the services that are right for your company and employees.

A strong TPA can make all the difference in how your self-funded healthcare benefit program is managed. It will make the difference in employee satisfaction, cost savings and quality service.

Don’t be misled by what appears to be bundled discounts. Dig deeper and you will see that savings is a relative term. Once you take apart the pieces and competitively price each service plan, you see that the parts add up to a lot less than what you are being charged for. TPAs offer savings and flexibility, transparency and objectivity. Isn’t that what you want for your company and employees?

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Dig Deeper Into Your Self-Funding Options

In an earlier post, we discussed the key differences between TPAs and ASOs, and why you should know these differences if you’re currently self-funding or considering self-funding your group health plan. For those of you unfamiliar with these terms, an Administrative Services Only (ASO) firm is a division or wholly-owned subsidiary of a national health plan, while a Third Party Administrator (TPA) is an independent business entity that does not carry risk.

tpas-vs-asos-part2-blogToday, we take a closer look at the different approaches TPAs and ASOs typically take with regard to designing and managing the plan itself. Here are the key points to consider:

1. Bigger is NOT Necessarily Better. ASOs answer to major insurance companies where the focus is on quantity and generating economies of scale. This can translate to a loss of focus on the plan management needs of each individual client. As smaller, more entrepreneurial organizations, independent TPAs continuously monitor plan performance to detect fraud and protect your interests.

2. Carrier Affiliations Can Cost You. When you dig a little deeper into the carrier/provider network affiliations of ASOs, you may be surprised to discover that the ASOs may be receiving a percentage of every dollar billed to your plan by participating providers.

3. Giving Up Control is Like Giving Up Your Checkbook. ASOs tend to operate like manufacturing sites with a focus on automation and yearly premium increases. An independent TPA will regularly review plan performance and recommend alternatives to reduce plan expense, so yearly increases are minimized or avoided whenever possible.

To learn more, click to view our TPAs vs. ASOs: Part 2 whitepaper, To Pay or To Pay Attention. Or click on the graphic below.

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