A SaaS Platform Health Plans & Teams Love

On average it takes a filer 1,500 hours per year to execute pre and post submission filing work

Clearfile reduces work implementation efforts by 50%, leaving an extra 750 hours per year to allocate to other projects

From regional health plans aiming to expand their reach to large carriers needing help to stay updated, ClearFile is your go-to solution. We also cater to various roles within hospital health plans, non-profit or for-profit health plans, and divisions of insurance. Our platform is also perfect for professionals working in State-Based Marketplaces (SBEs), Federally Facilitated Marketplaces (FFM), and National Accounts. Furthermore, ClearFile is a versatile platform that can benefit health plans of all sizes, from small to medium and large, as well as consultants and subcontractors operating in the healthcare sector. 

If you are involved in any capacity with ACA compliance, regulatory filing, or strategic planning within the healthcare industry, ClearFile has something to offer you. Our technology is here to ensure you navigate the complex landscape of healthcare regulation with ease and efficiency.

ClearFile takes the stress out of keeping up with constantly changing legal requirements. From clear deadlines to simplified filing directions, everything you need for success is available within the platform. ClearFile also provides measurable analytics, enabling our clients to track their progress and make data-driven decisions. This comprehensive approach ensures that our clients achieve filing success, keeping them compliant, informed and ready for any regulatory challenge that comes their way.

Our software integrates directly with the official system where state rules are issued throughout the year, so you never miss an update. We also keep tabs on the major federal rules to ensure our partners’ compliance. If you’re overwhelmed by the sheer volume of legislation to review, we’ve got you covered. Our process can condense around 100 pages of legislation from various sources into an average of just a single page. This includes everything needed for your health plan, whether it operates on a State-Based Exchange (SBE), Federal Marketplace (FFM), or off the exchange. All this crucial information, including important due dates, instructions, and supporting documents for each state, is stored in our software platform. This serves as our main distribution channel, making it easy for every user to access the resources they need to stay compliant and informed.

Start by exploring our demo and meeting our team to understand how we’re elevating regulatory filing. Our comprehensive resource library and user guide, along with a dedicated Client Success Manager, make onboarding smooth. The setup is quick and tailored to your needs, ensuring your filing success story starts off strong.

Penstock offers stellar customer service with guaranteed response times for support inquiries through our dedicated Help Desk. From 8am – 8pm EST, our experts are ready to provide timely assistance. Our implementation and ongoing support offerings range from a technology-focused SaaS solution to a flexible hybrid model and even a full-scale outsourcing service. We’re committed to flexibility, ensuring our involvement aligns with your needs.

At ClearFile, we prioritize data protection, and our SOC 2 Type 2 Report affirms our commitment to data security. Our systems undergo yearly HIPAA-HITECH IT Security Risk Analysis to maintain compliance with health information regulations. Additionally, our data is stored securely across multiple ISO/IEC 27001:2013 and NIST SP 800-53 certified locations. We use advanced encryption methods, adhere to OWASP Web Security Testing Standards, and support SSO and MFA for added security layers. And we meet all CMS and State DOI healthcare regulatory and compliance certifications.

Standardized reviews of an Issuers Good Standing are a key part of vetting new clients to ensure they are an active Life and Health, commercial product carrier authorized by states they participate in, and by CMS to transact fully insured health insurance to members and persons of a given geography. This includes robust evaluation of quality ratings, any conservator/receivership, and health and wellness of the Qualified Health Plan product to ensure there are no risks to be mitigated up front.

ClearFile proactively seeks out, addresses, and implements improved processes throughout each year. We perform robust lessons learned exercises during Q3 and Q4 of each year post-certification with each individual stakeholder business area (and collectively) to align on what went well, opportunities for improvement, and execution to the following year’s implementation and project plans. This is a critical exercise that we have proven to be incredibly successful with clients. From reducing change controls, objections, filing re-openings, to also modifying the product to be more competitive (e.g. implementing new VBID programs, QHP marketing AEP campaigns, evaluating new metrics and analytics, and more).

We’re active members of many health plan associations and we attend standing weekly CMS QHP Webinars, as a part of the REGTAP listening series. We also attend industry-wide calls to collect, disseminate, and distribute real-time updates to our client and carrier partners. Data is benchmarked year-over-year to assess changes and are cascaded down to stakeholders. This is inclusive, but not limited to real-time, door-to-door delivery of all state filing guidance and timeline updates via the SERFF system as binders are configured each year using our proprietary ClearFile Software integration with the NAIC’s open APIs attached to the SERFF system.

ClearFile supports filing for Qualified Health Plans as well as the following:

• Medicare Advantage Filings
• RxDC
• Standalone Dental Filings
• Integrated Dental/Vision Filings
• Network Filings (All Products) – Contracting
• Large Group (Defined as 51+ lives)
• Mental Health Parity Certification Filings
• Accreditation, Re-accreditation Filings
• Certificate of Authority License
• NCQA Multicultural Distinction

And other supplemental filing & submission