Custom Design Benefits tailors its services to meet the needs of companies

There are few certainties in life, with death and taxes being the only ones, to quote Ben Franklin.

If Franklin had lived today, he might add rising health care costs to the short list of life’s certainties. It’s certainly one experienced by businesses, as large employers are expecting yet another increase in 2021 of more than 5%, according to the nonprofit Business Group on Health.

To help control health care costs, some employers turn to self-funding their health benefits. When they do that, they need a third-party administrator to design and administer their plans.

In Greater Cincinnati, Custom Design Benefits is the only privately held, locally owned third party administrator, says its CEO, Julie Mueller.

The company competes with the big, publicly traded insurance companies by focusing on service and acting as strategic partners with its clients, typically businesses with 100 or more employees, she says.

“We’re kind of like David and Goliath,” she says. “We’re very nimble, very focused on the employers.”

Custom Design Benefits will celebrate its 30th year in business in 2021, a year in which the health care business will continue to be heavily affected by the COVID-19 pandemic.

The firm responded in 2020 by expanding its telemedicine program, Call A Doctor Plus, to include behavioral health and EAP+Work/Life programs, Mueller says.

Its newest service offering is one to help to control the costs of specialty drugs. The company contracted with a vendor to help employees get access to affordable drugs through arrangements and program that can save money.

Nearly 10 years ago, the company was in the forefront of designing and marketing a cost-saving plan called reference-based pricing that has since grown. “We are the nationally recognized leader in reference-based pricing,” Mueller says.

Reference-based pricing is a cost-containment strategy in which health care providers are paid based on a certain benchmark, typically what Medicare reimburses for services. It’s sometimes called “Medicare plus” because it pays a percentage higher than Medicare, whose reimbursement is typically considered by health care providers to be too low.

“We make sure it’s a fair and equitable reimbursement,” Mueller says.

Custom Design’s reference-based pricing program is called TrueCost. “We’ve been doing that since 2012. We were on the cutting edge,” Mueller says.

The company also provides compliance services and administration of COBRA plans, flexible spending accounts, the Family and Medical Leave Act, short-term disability programs and other human resources programs.

“We keep our clients compliant,” Mueller says. “We have a whole compliance area.”

Mueller says Custom Design Benefits enjoys a 95% client retention rate and a recent client survey found that 97% rated its service “excellent.”

She attributed those scores to the company’s focus on service and its ability to adapt to client’s needs and changes in the industry.

“It’s a complicated industry,” she says. “You have to be quick, nimble and able to respond with solutions.”