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Hosted by ClearFile · 🇺🇸 US · EN · 43 episodes
Established thought leaders with verified media credentials.
Are you struggling to understand the many components of regulatory filing for health plans? Regulatory Joe demystifies these complexities with clarity and insight for everyone from seasoned managers to new professionals in the industry. Subscribe to stay up to date with the ever-evolving landscape of new guidelines for health plans.
ClearFile hosts Regulatory Joe, a business show with 43 episodes published.
State-based exchanges are changing how ACA issuers file. When a state runs its own marketplace, your timeline, templates, reviewer contact and network review all shift. ClearFile President Joe Boyle breaks down the move
Submitting a QHP application is a major milestone, but it is not the end of the certification process. After submission, ACA issuer teams still have to manage state and federal review, respond to objections and deficienc
This year's PY2027 NBPP didn't just arrive late. It compressed the entire ACA filing season for issuers nationwide. CMS didn't finalize the rule until May 15, weeks after the QHP application window opened and past some s
QHP filings touch five systems. A missed handoff between any of them can delay certification. Here's how data moves from SERFF through to CMS. In this episode, ClearFile President Joe Boyle maps the full QHP filing ecosy
Filing season can move quickly, especially when federal guidance arrives late, state deadlines shift and filing updates create downstream changes across documents, templates and systems. In this episode of Regulatory Joe
ICHRA adoption is accelerating—but for health plans, the real challenge isn’t strategy. It’s execution. In this episode of Regulatory Joe, ClearFile’s Joe Boyle sits down with Lindsey Miller of Softheon to break down wha
In this episode of Regulatory Joe, Joe Boyle sits down with Greg Fann of Axene Health Partners to break down what the proposed 2027 NBPP could mean for catastrophic plans and ACA market strategy. The conversation explore
ICHRA can introduce operational risk long before it shows up in membership. For health plans, it functions as a new distribution pathway inside the individual market, which means added complexity across enrollment, billi
The PY2027 Notice of Benefit and Payment Parameters (NBPP) introduces several proposed policy changes that could reshape ACA marketplace strategy for health plans. In this episode of Regulatory Joe, Joe Boyle breaks down
Ghost enrollees in the ACA marketplace can distort enrollment reporting, affect risk adjustment transfers and increase CMS scrutiny. Even small pockets of unsupported enrollment can ripple through operations and financia
Enhanced APTCs expired at the end of 2025, shaping ACA 2027 filing assumptions. With no subsidy extension in place (and any new legislation still uncertain), issuers have to build Plan Year 2027 assumptions off current l
Cost sharing has always been foundational to plan design. But heading into the 2027 filing cycle, it’s carrying more weight (and more risk!) than usual. In this episode of Regulatory Joe, Joe Boyle breaks down how issuer
Healthcare interoperability isn’t just about standing up APIs—it’s about ensuring the data being exchanged is accurate, consistent, and usable across systems. In this episode of Regulatory Joe, we’re chatting with Will T
2025 brought major ACA, PBM and TPA regulatory shifts—and teams across the healthcare ecosystem felt the impact. This episode recaps the year’s most important compliance lessons and what every organization must prepare f
In this episode of Regulatory Joe, ClearFile president Joe Boyle down the fundamentals of Market Conduct Annual Statements (MCAS) for ACA health plans—what triggers an annual call, how regulators use the data, and why or
After APTCs will likely expire at the end of this year, ACA risk adjustment is set to shift significantly—and health plans need to prepare now. In this episode of Regulatory Joe, ClearFile President Joe Boyle explains ho
In this episode of Regulatory Joe, Joe Boyle talks with Jennifer S. Berman, Chief Legal Officer at Lumelight, about how TPAs can strengthen compliance through operational discipline, smarter training, and proactive regul
ACA reporting mistakes are more common—and more costly—than most employers realize. In this episode, Joe Boyle talks with Jordan Smith of Lumelight about how automated IRS enforcement is catching even well-intentioned em
ACA compliance for health plans is more complex than ever. In this episode of Regulatory Joe, ClearFile President Joe Boyle shares five essentials every issuer needs to streamline filings, strengthen regulator relationsh
TPA licensure and compliance essentials for administrators Learn core requirements, surety bonds, timelines, renewals, and exemptions. In this episode, ClearFile President Joe Boyle walks through what states actually ask
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Regulatory Joe is hosted by ClearFile. The show is categorised under business (management) and has published 43 episodes.
Regulatory Joe has published 43 episodes.
Regulatory Joe regularly covers business, management. It sits in the business category, with a management focus.
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