Customer Success

From Dormant to Market-Ready How ClearFile Built a Regional Health Plan’s ACA Filing Operation From Scratch & Saved $425k 

The Challenge  A regional health plan with existing state operations decided to re-enter the individual marketplace for plan year 2027. Unlike a first-time market entrant, the plan had an issuer entity still technically active under a doing-business-as (DBA) structure—but an active license and a functioning ACA operation are two very different things.  Effectively, the organization was building a […]

From Dormant to Market-Ready How ClearFile Built a Regional Health Plan’s ACA Filing Operation From Scratch & Saved $425k  Read More »

Untangling Multi-Entity TPA Licensure Risk After Leadership Turnover 

The Challenge  Following a leadership transition, a national TPA initiated a deeper review of its regulatory posture and uncovered significant inconsistencies in state licensure management.  The organization operated under multiple DBAs (Doing Business As entities), each tied to different tax IDs and regulatory obligations. Over time, licensure responsibilities had become fragmented across entities and external advisors, resulting in outdated records,

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Compliance at a Crossroads: How ClearFile Stepped In to Save a PBM from Losing Licensure

After falling behind on required filings in a key state, one PBM faced a formal notice from the state—including a fine and the looming threat of license revocation. Internally, there was confusion around whether they needed to file as a PBM, a TPA, or both—compounded by the fact that no one had clear ownership of

Compliance at a Crossroads: How ClearFile Stepped In to Save a PBM from Losing Licensure Read More »

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