On October 9th, 1975, a meeting was held at the O'Hare Hilton in Chicago in order to discuss the formation of an association solely for independent Third Party Administrators. There had been previous discussions and previous coalitions on special issues. However, this meeting was to create a permanent ongoing organization for TPAs. SPBA's first name was the American Society of Professional Administrators. However, since that ASPA acronym was too close to that of the pension actuaries, the SPBA name was chosen in 1977.
The official founding goals and purposes set forth for the TPA association were as follows:
- Defeat National Health Insurance
- Understand and help shape the then-new ERISA law.
- Improve the image of TPAs among other benefits professionals and with the general public.
- Foster the availability of Errors & Omissions coverage for TPAs.
- Fight the unfair advantages of HMOs, such as grants & mandate.
- Provide advice to TPAs to help members better serve clients & plans.
- Enhance the financial security of TPAs within the limits of the anti-trust laws.
You can immediately see that we have achieved those goals. All of those priorities continue, and SPBA has also expanded to many other roles, and services never envisioned 19 years ago. However, SPBA diligently stays very true to the founding concepts.
Most of SPBA's success is attributable to something intangible which those founders brought to that meeting. They brought a spirit of sharing, professionalism, and selflessness. The TPA business has always been extremely competitive...but the founders of SPBA felt that if the goals were to be accomplished, the Society should not waste its time and effort on petty rivalries or ego trips for the leaders. SPBA carefully maintains that philosophy of openness and sharing, and it has proved very successful for everyone. SPBA's leaders have also fostered a strong spirit of equality, avoiding any cliques or special treatment for themselves.
Two decades ago, TPAs were viewed by many attorneys, consultants, insurance companies, accountants, and government policy makers as mere paper-pushers or "go-fers" who had no expertise or insights on how benefits policy and implementation should evolve. That's why one of the founding goals was to make TPAs full players. Today, by banding together to share professionalism and insights, SPBA members have become the most respected consistent source of information & predictions. Now it is the lawyers, CPAs, insurance companies, consultants, and government who often come to TPAs for advice!
Each year, SPBA shares information on about 1,500 new laws, regulations, rulings, interpretations, and major court cases. Some members even report that local IRS, DOL, or HHS offices call the TPAs to learn the latest news from their own government agencies. Meanwhile, in Washington D.C., government policy makers from the White House to regulatory agencies, to Capitol Hill...and even foreign government leaders...have come to rely on SPBA and its members for behind-the-scenes candid insight and feedback about pending policy decisions. We can't say SPBA's candid common sense is always heeded...but it is always respected.
SPBA members can take special pride in this leadership role, because 19 years ago, the founders assumed that information SPBA disseminated would need to come from attorneys or some other outside source. Instead, by sharing experiences and insights among ourselves, SPBA members have created the best source of knowledge in the benefits business...especially as government compliance has evolved into a guessing game in the absence of official guidance.
At the conclusion of the founding meeting 19 years ago, the founders tried to imagine how many firms might ever be eligible to join the new association for TPAs. They came up with the outrageously optimistic estimate of 60 firms. Today there are nearly 440 SPBA member firms (not including about 70 firms which have merged into other member firms) , with about 35 new members per year (and about 200 applicants each year who are turned away as ineligible). About 95% of firms known to be eligible for SPBA have joined.
SPBA's 1000% growth in the past 10 years is mostly growth of the market for TPAs, with new business and new clients turning to the concept of TPA-administered plans. It is estimated that 40% of all U.S. workers, dependents, & retirees are covered by plans administered by SPBA members. That's over 60 million people!
SPBA membership eligibility criteria has remained unchanged since the founding...though the explosion of forms and format of TPAs since 1975 has brought variations never envisioned by SPBA's founding fathers. SPBA still requires that at least 50% of the income of the member entity be derived from TPA services. Also, the member TPA must be an independent corporate entity, with its own Board. The variations of TPA structure & ownership today make the interpretation of eligibility an ever-greater challenge. However, as SPBA membership has become an increasingly valuable business asset for TPAs, SPBA's vulnerability to the very tight anti-trust laws for association eligibility have also risen.
Not long after SPBA's founding, the private health benefits system was on the verge of extinction due to the growing call for National Health Insurance. Even in its infancy, SPBA played a strategic role via educating government staffers and other groups in defeating nationalized medicine. That was the first time that Uncle Sam learned that TPAs are unique because they have first-hand knowledge of all aspects of benefits: participants, sponsors, costs, & coverage.
In 1975, TPAs who sought E&O insurance got either a blank stare or warmed-over form designed for some drastically different business. SPBA assisted in designing and launching the first true TPA E&O policy in 1980, and has remained active (not as a formal endorsement or sponsor) in maximizing the E&O and bonding options for SPBA members.
HMOs were an especially fiery topic for TPAs in the 1970s. There was strong resentment that HMOs were given monetary grants from the government as well as the power to force themselves upon employers to skim the best risks at guaranteed prices. SPBA was the lead player in having Congress and HCFA remove grants and terminate the HMO mandate authority.
Thus, SPBA has worked hard to achieve its stated goals and remain true to its founding precepts. SPBA's history is not old and dusty. All of the founding member firms (or their corporate derivative) are still members. Many of the founders and first member firms are still active. A few have never missed a meeting. These are the true historians and leading lights of SPBA. They are strongly encouraged to share the history, customs, and insights of SPBA with newer members in order to keep SPBA's successful spirit alive.