Society of Professional Benefit Administrators

 

Welcome to the SPBA Public website.
 
SPBA is the national association of Third Party Administration (TPA) firms who provide comprehensive ongoing administrative services to client employee benefit plans.  SPBA also has a Stop-Loss Service Partner category for carriers, MGUs, and re-insurers of self-funded health plans.  Our members are firms, not individuals who are employed within a firm to handle employee benefits and human resources. 
 
This page is designed for two audiences: those seeking membership and researchers of the TPA industry.
 
1.  What can membership in SPBA offer you and is your firm eligible?
 
SPBA’s goal is to be your most profitable business investment each year.
 
2.  Are you seeking background and explanations of the TPA industry and market?
 
1.  Membership Value and Eligibility
 
Insights ¨ Network with Peers ¨ Analysis ¨ Education
 
Goal and Role:  SPBA is unique.  Our goal is to make SPBA members brilliant and give them the perspective and respect of having a nationwide and even international base of insight and support.  While SPBA certainly keeps members alert and up to date on emerging legislative issues and trends, the main day-to-day work is providing mostly regulatory government compliance insight and guidance.  This is where the rubber meets the road, with hundreds of new laws, regulations, interpretations, and court cases per year which may apply to TPAs, plans, and/or sponsoringemployers.  Government compliance is the biggest cost and liability in employee benefits.
 
SPBA and the regulators who implement how laws will be applied and enforced have a win-win relationship.  SPBA’s membership represents the largest and most diverse perspective on every type and size of plan in every format of employment and every region.  SPBA offers the regulators this breadth of invaluable real-world insights, which helps them shape the regulations and enforcement to meet that reality.  These discussions also give SPBA members the invaluable perspective of understanding what the government officials are thinking and what they see as the goal and end-result of the law.
 
The SPBA office receives about 200 calls and e-mails per week from members asking or brainstorming on a wide array of questions on real-world situations they or clients are facing that day.  SPBA does not give legal advice or official guidance, but we can often report the answers we or others have gotten from the hands-on government officials.  Sometimes, if it is a new question, we connect the SPBA member with the government official, which is much-appreciated by the officials, since it often points out holes or unexpected ramifications in their regulations or interpretations.  Needless to say, this kind of interaction with the people writing and enforcing the rules allows SPBA members to obey the law and avoid the costly delays and second-guessing the legislative and regulatory system brings.  It is hard to put a dollar figure on this SPBA approach, but we are often told by members that any one of these events is worth the year’s dues all by itself.
 
SPBA holds two conventions a year, which are also unique, because the agenda is determined by what members are indicating is important to them, not what some meeting planner wants.  These SPBA meetings are off-the-record; only members are allowed to attend; lots of audience participation; and there is no commercialism.  The reason is that the TPA business can seem insular, and SPBA meetings are a chance for totally candid exchange and sharing among peers, and many also include sessions with the government officials.  The officials tell us that nothing is as convincing as a room full of informed TPAs with penetrating comments.  Many an issue has been eased or withdrawn thanks to discussions officials have had at SPBA meetings.
 
Members also have access to a Member-only website which has well over 1,000 entries to help members 24/7 on background and explanation of issues, other applicable issues, and sample language or solutions.  This is not legal or official advice.  It is a resource to help SPBA members solve situations in an informed expeditious manner.
 
SPBA realizes that the term “TPA” is sometimes applied to a variety of functions and settings.  We try to be candid if SPBA would not be a good fit for your firm.  SPBA’s services are geared to comprehensive administration (more or less one-stop-shopping source for the client) of employee benefit plans, mainly self-funded health coverage.  However, some new non-plan markets are also approaching TPAs, such as state and local jail systems for inmate health services and native tribes.  So, we are open to new markets, but if you are a TPA who only does Workers Comp or some specialty, SPBA is probably not a worthwhile membership for you.  We will be happy to suggest other associations which might fit your needs.  SPBA is a firm believer that you should be in the best association for your needs.
 
SPBA members have a long tradition against commercialism in any way related to SPBA.  If your firm does a very small amount of TPA work, but primarily is interested in selling a product or service to TPAs, membership in SPBA may actually hurt your relationship with potential customers.  Here’s why:  SPBA members have a strong sense of identity, so when an entity joins SPBA it identifies them as a TPA, but that also means that they are a potential competitor.  TPAs usually turn off to hiring or buying things from “competitors” out of fear that once the other TPA gets to know the clients, they may someday steal the client.  Joining SPBA to sell to other TPAs becomes psychologically counter-productive.
 
SPBA does not provide opportunities for exhibits, advertising, or other ways to reach the members.  The “Everything You Wanted To Know” piece (below) gives some proven techniques for selling to and reaching TPAs.  Note:  Be aware that TPAs have heard every sales pitch before, so be sure you understand the industry to which you are selling, and that your product or service truly does what it claims.     
 
2.  If you are looking for data and information on TPAs and the market for TPA services, SPBA strives to give you an accurate picture.  Caution: Statistics are plentiful, but virtually all are apples and oranges, which will give you a misleading number or perception.   SPBA’s most valuable advice is:  Every number or statistic about TPAs, insurance, health costs, etc. has a built-in 1,000% distortion factor.  That is not because anyone is trying to lie.  It is because even the simplest vocabulary terms used to collect data have vastly different meanings to the questioners, to the entity that answers, to the people who process the responses, and to the many people who subsequently use (and misuse) the data.  For example, the seemingly simple term “per-life” means one individual…but too many other people can mean the worker + spouse + many children.  Obviously the cost and headcount statistics would be vastly different depending on that vocabulary term.  
 
Even the most prestigious data sources are subject to the 1,000% distortion.  A few years ago, an SPBA President was appointed to be a judge of the US Government’s panel of experts.  It was the 20 or so top statistical agencies, such as GAO, BLS, CMS, White House Office of Economic Policy, Congressional Research Service, etc.  About 25 of the same questions were inserted into the studies of each.  When these prestigious entities reported their findings, they were tens of millions of people and tens of billions of dollars apart in what should have been the same answers (even to such basic numbers of how many people are employed and how many have health coverage).  The culprit was different vocabulary that had been casually applied or assumed.  The moral of this story is that even data from very prestigious sources can be a virus that destroys the validity of the end statistic you are seeking.  Seat-of-the-pants and using percentages instead of hard numbers are usually more accurate in the goal to understand the trend orconcept.   For the sake of your credibility, avoid getting bogged down in specific (suspect) numbers.
 
This public website has several informational pieces to help you understand the many ways in which TPAs operate and their relationship with clients.  Please read the pieces carefully.  The answers are there candidly, and, yes, they mean what they say.
 
Here are some of the key points to note in your reading:
 
(a).  The key to success in the TPA market is personalization, personalization, personalization.  The client plan and every TPA service is customized.   Textbook “good management” has tended to be poison, because the efficiencies of corporate management tend to detract from the personalization that keeps customer loyalty.  A TPA firm can go from successful to no clients remaining within a year or two, despite the well-intentioned “management” changes.  If you are thinking of buying a TPA, love it for how it operates today.  Changes can spook clients very quickly.
 
(b).  The “best TPA” is not a contest of who can be biggest.  The winners (most successful) are those who maximize personalization, personalization, personalization.  It is very hard to be huge and yet make every client feel the intimate personalization they expect and demand.  So, “who are the biggest” is usually not the most productive question.
 
(c).  TPAs tend to subdivide themselves by their primary types of clients.  For example, TPAs who manage Taft-Hartley collectively-bargained plans, TPAs who serve single-employers, TPAs who serve state and local government employee plans, and TPAs who serve the employees of religious entities, such as a diocese.
 
(d).  Almost all TPAs administer self-funded plans, which works under a totally different legal and regulatory basis than insurance.  Be sure to carefully read and understand all of the ERISA and fiduciary pieces on this website.
 
(e).  Marketing to TPAs is best if clearly geared to them.  TPAs get flooded by marketing, much of which clearly does not understand what TPAs do.  That is a waste.  Because of government compliance rules and the unique TPA/client relationship, the best technique is to select a focus group of a few TPAs (such as from the TPA Directory - available for sale) representing a variety of types of client plans.  Present the product, but listen more than talk.  TPAs like to think that they thought of how to apply the service, and they will also give you important factors of laws, regs or customs that could help or kill the usefulness of the product.  The focus group approach not only lets the marketer fine-tune the product, but the grape vine works well within SPBA when there is a good or bad product on the market.
 
(f).  The TPA Directory.