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Author: Admin | 2025-04-28
To specific situations & questions (which is important since formal guidance is usually lacking or on formative stage). This allows SPBA to spread the word to other members about changes in government strategy or interpretations (which the government usually fails to announce, though the changes have legally binding implications). SPBA members and their client plans are not the only winners from this government relations strategy. Many of the government regulators get frustrated that they get so little immediate reliably candid real-world feedback and input about the impact and implication of new rules and changes they are considering imposing. Thus, the government authorities often call the SPBA office to ask "what would happen if ...?" or "How is this done now?" In all cases, SPBA promises discretion and/or anonymity to both TPAs and government officials.What's the future for employee benefits TPAs? Dozens of times, TPAs and/or employee benefits have been predicted to die. However, each time, TPAs and their market have blossomed even more. So, the future for TPAs is bright. Their flexibility, adaptability, compact management, low overhead, and entrepreneur-like spirit mean that they can roll with the punches (and usually prosper from them). TPAs are also perfectly positioned to maximize the rise in new innovations of health plans, which are usually very eager to have cost-effective administrative expertise. The 1,000 new laws, regulations, interpretations, and major court decisions government generates each year has solidified the need and specialty of TPAs. Increasing moves towards value driven “transparency” also increase the role for TPAs. The analogy has been made that TPAs are like an agile sports car amid the limousines of the insurance business. It seems we are constantly bemoaning some new horribly complicated imposition on plans and employers...and each year that imposition becomes a new reason why new clients seek out TPAs and a new profit center or service for TPAs. (This does not in any way mean that we welcome the new horrible impositions. We fight them vociferously. It is merely that it is not the stunning blow to TPAs that it could be to other benefit entities.) Government compliance is quickly becoming a dominant benefits duty. All is not rosy. Like every industry, TPAs could conceivably be crippled or wake up to a different market by the flick of the legislative pen. On the other hand, responsible politicians see that “single-payer” programs such as VA, Medicare & Medicaid and
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