Regulatory Joe

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 regulatory monitoring.

The pair discuss how to:

Watch now to learn what will define next-generation TPA leadership.

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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 employers and what brokers can do to protect their clients.

You’ll learn:

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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 relationships, and gain speed to market.

You’ll learn:

How proactive regulator engagement prevents delays and hearings

Why association partnerships amplify your voice on policy changes

The role of technology in reducing filing errors and rework

How strong reporting protects expansion opportunities

When and how to leverage vendor support

Stay ahead of shifting state and federal requirements with a complete compliance toolkit.

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 for, how long licensure can take, why Q1 renewals catch teams off guard, and when ERISA self-funded work may be exempt.

You’ll learn how to budget for bonding, align filings to payer market strategy, and centralize your process so approvals move faster and renewals don’t become fire drills.

Clear, actionable takeaways for leaders who own compliance and market entry.

Watch the full episode and get more resources: https://www.regulatoryjoe.com

The ACA individual market is facing its biggest shakeup yet.

With the elimination of enhanced subsidies, a shorter Open Enrollment window, and sweeping reforms under the “One Big Beautiful Bill,” health plans must rethink their strategies.

In this episode of Regulatory Joe, Joe Boyle sits down with Wesley Sanders, founder of Evensun Health, to discuss what these changes mean for carriers, members, and the sustainability of the individual market. You’ll learn:

📌 Why ACA membership will shift and how plans should target long-term, sustainable growth

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The ACA Open Enrollment Period is changing—are you ready?

Millions of members typically enroll after December 15, but that window is now gone.

In this episode of Regulatory Joe, Joe Boyle breaks down what health plans need to do to protect enrollment, adjust crosswalk strategies, and seize growth opportunities heading into Plan Year 2026.

You'll learn why revalidating assumptions, preparing ops early, and acting on competitive intel is more important than ever.

▶️ Don’t miss a key update—subscribe for more insights: https://www.regulatoryjoe.com

PBM compliance is changing fast. Licensure, reporting, and state regulations now require more than just a checklist—proactive PBMs must treat compliance as strategy.

In this episode of Regulatory Joe, Joe Boyle sits down with Mallory Mojarro of True Rx Health Strategists to break down how pharmacy benefit managers can build smarter compliance operations. From the role of centralized tracking tools to the growing influence of state-level legislation, Mallory shares practical steps PBMs can take to stay ahead of the curve—and avoid costly mistakes.

You’ll learn:

What systems help PBMs avoid compliance gaps

Why collaboration across legal, finance, and analytics matters

How to evaluate licensure costs strategically

And more!

Listen to the full episode and get more insights at regulatoryjoe.com

PBM licensure requirements are evolving fast—and compliance mistakes are getting costly. In this episode, we break down what every pharmacy benefit manager needs to know to stay licensed and competitive.

From rising state fees to unpredictable reporting timelines, regulators are putting more pressure on PBMs than ever before. Joe Boyle, President of ClearFile, explains the full licensure process, how to avoid common mistakes, and why proactive PBMs are gaining a strategic edge. 🔍

You’ll learn:

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ACA staffing strategy is now mission-critical for health plans.

In this episode of Regulatory Joe, Joe Boyle explores how health plans can align their staffing models with enrollment growth, new filing demands, and evolving regulatory oversight.

From role-based to market-based models—and everything in between—Joe breaks down what works, when to transition, and how to onboard for long-term success.

💭 Check out all of Regulatory Joe's insights: regulatoryjoe.com

In this episode of Regulatory Joe, Penstock’s Joe Boyle outlines how health plans can make smart, scalable ACA investments now to capture market share in 2026, 2027 and beyond.

Whether you're a new issuer or optimizing your current ACA portfolio, this playbook covers the three most critical pillars:

Joe also discusses non-financial investments that are often overlooked, including codified business processes, SERFF expertise, and interdepartmental coordination—all essential for regulatory success and long-term growth.

📌 Key Topics Covered:

ACA marketplace growth trends and issuer opportunity

Financial vs. non-financial investment strategies

What a smart "build vs. buy" analysis looks like

How competitive intel should shape your plan design

Timing, staffing, and infrastructure tips for entering new markets

Don’t fall behind on ACA strategy. Get clear, actionable insights from someone who’s helped dozens of health plans grow their QHP footprint.