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MedBen University: Guest Speaker Russo Stresses Importance Of Plan Design


  05:49:09 pm, by MedBen5   , 211 words,  
Categories: News, Health Plan Management

MedBen University: Guest Speaker Russo Stresses Importance Of Plan Design

Phia Group CEO Adam Russo speaks at MedBen University

At a special MedBen University presentation on September 26, Adam Russo, CEO of The Phia Group, explained “How Innovative Plan Design Can Help to Mitigate the Cost of Health Care".

Russo stressed that no two groups of employees are alike, which means that employers must shape their health plan design to best suit the unique needs of their workers. Additionally, he warned that overly broad plan language can end up costing the employer in the long run.

For example, merely defining a spouse as a “covered Employee’s husband or wife under the laws of the state where the covered Employee lives” leaves the employer open to having to cover a dependent who is legally separated from the employee. It’s best, Russo said, to include more direct language, such as stating that the spouse cannot be engaged in a trial separation for more than 12 consecutive months.

Another common generality that can end up costing the employer is not going into sufficient detail about hazardous pursuits, hobbies or activities. In cases where it’s likely the employee population will be engaging in such risky endeavors as hang gliding, skydiving, or car or motorcycle racing, Russo noted that it’s best to spell out in detail that coverage exclusions include (but are not limited to) these actvities.

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