Ghost Enrollees in the ACA Marketplace Explained

ACA Filing Season Survival Guide for Health Plans

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, ClearFile President Joe Boyle breaks down how health plans can retain control during ACA filing season by prioritizing state filing risk, strengthening version control, managing system access and keeping communication moving across internal teams, regulators and reviewers. This episode covers: * How to prioritize states based on filing deadlines, complexity and regulator expectations • Why version control becomes harder as submission deadlines approach • How a source of truth can help teams track issuer IDs, product IDs, plan IDs, variants, owners and deadlines • Why SERFF, HIOS, MPMS, SFTP and state platform access should be confirmed early • How daily huddles and organized reviewer communications can reduce rework and filing delays Filing season does not require a perfect process. But health plans do need clear ownership, clear accountability and clear communication to reduce risk and keep submissions moving. Subscribe to Regulatory Joe for more insights on ACA filings, QHP certification, CMS requirements, regulatory strategy and health plan compliance.

ICHRA Reality Check: What Health Plans Need to Operationalize Now (feat. Lindsey Miller, Softheon)

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 what ICHRA actually changes for health plans across enrollment, billing, member experience, and long-term individual market strategy. They explore where operational complexity is already showing up, why many plans may already have ICHRA members without knowing it, and how fragmented workflows across enrollment pathways, payment models, and communications are creating new pressure points. The conversation also dives into what it takes to operationalize ICHRA at scale—from data strategy and member identification to reconciliation processes and ecosystem coordination across employers, brokers, and technology partners. If you work in ACA product strategy, enrollment operations, billing, or regulatory compliance, this episode breaks down what to prepare for as ICHRA continues to grow. Subscribe to get all of Regulatory Joe’s insights or visit https://www.regulatoryjoe.com [https://www.regulatoryjoe.com]

What the 2027 NBPP Means for Catastrophic Plans and ACA Strategy (feat. Greg Fann)

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 explores how expanded eligibility could affect bronze plan relevance, low-premium positioning, and decision-making for issuers heading into the 2027 filing cycle. It also looks at where catastrophic plans actually fit in the ACA market today—and why this targeted policy change could create broader strategic implications than it may seem at first. Joe and Greg also discuss how carriers may respond, what to watch across state-level dynamics, and why this change is most relevant for a specific segment of the market rather than a broad affordability solution. If you work in ACA product strategy, pricing, regulatory filing, or exchange operations, this episode breaks down what matters most as you prepare for the 2027 cycle. Subscribe to get all of Regulatory Joe’s insights or go to https://www.regulatoryjoe.com.

ICHRA for Health Plans: What Issuers Need to Know

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, billing, and premium flow—not a separate product strategy. This episode of Regulatory Joe focuses on where that complexity actually shows up, including enrollment pathways, payment coordination, lockbox flow, and internal ownership across product and operations teams. It also covers why early alignment matters, especially as plans prepare for filing season and evaluate ICHRA growth. If you’re responsible for individual market strategy, enrollment, or billing, this is where ICHRA decisions start to create real impact.

Breaking Down the 2027 NBPP: Key ACA Marketplace Changes to Watch

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 the most important provisions in the 2027 NBPP and what they could mean for issuer portfolio strategy, enrollment operations, and marketplace participation across states. The proposed rule was released later than usual in the regulatory cycle, creating a compressed timeline for issuers evaluating potential impacts ahead of the next filing season. Together, these proposals could influence how issuers approach plan portfolio design, enrollment verification workflows, and multi-state regulatory strategy as the ACA marketplace continues to evolve. For regulatory and compliance teams, the key question isn’t just what the rule says — it’s how these changes could affect operations, filings, and strategic positioning for plan year 2027. Episode Guide: * 00:00 Introduction: PY2027 NBPP overview and timeline * 02:00 Standardized plan design removal and ACA portfolio strategy * 07:20 Expanded catastrophic plan offerings * 10:00 SEP verification and enrollment changes * 13:05 State-based marketplace (SBM) expansion * 17:05 Network adequacy review flexibility for states Watch the episode for Joe’s breakdown of the provisions regulatory teams should be tracking now. Want more Regulatory Joe? https://www.regulatoryjoe.com [https://www.regulatoryjoe.com]