Big-firm leverage. Zero conflicts of interest.
You're weighing the national consulting firms and the PE-backed brokers. We go up against them every day — and we win. Because we bring the buying power of a giant with the independence, transparency, and hands-on service of a partner who actuall`.
No commission on any employer-paid benefit. Ever. Just transparent, flat fees.
Average in-network discount by carrier in your markets — illustrative
We start here, not with the renewal letter. The right network in your geography can swing total cost more than any plan-design tweak.
Owned by the people who answer your calls.
Custom Benefit Consultants, Inc. was founded in Las Vegas in 1997 and is still privately held and founder-led. We're licensed in all 50 states, and we've spent 25+ years in one place: large-group, self-funded employee benefits.
Being owned by the people who run your account is the whole point. No quotas pushed down from above, no carrier we're quietly obligated to favor — we answer to our clients. And we built a firm that puts consulting and benefits-administration technology under one roof, staffed remote-first across every U.S. time zone.
Consulting + technology
Two firms in one: senior benefits strategists and an in-house technology team that builds and runs the platform.
A team that stays
Senior leadership is accessible, and each team member carries roughly three large accounts — not three hundred.
Deep large-group bench
Years of experience running plans for 1,000-, 5,000-, and 10,000+-life employers across every region.
What we run on
Family. Integrity. Community. Contribution. The values our clients feel in every interaction.
A health insurance marketplace built for Costco Business members.
Through the CBC Health Insurance Marketplace, your company gets access to proprietary contracts you simply can't buy on the open market — negotiated third-party administration, network access, and stop-loss reinsurance, bundled and priced for the buying power of the Costco membership base.
It's the kind of leverage the national firms reserve for their Fortune 500 book. We make it available to mid-market and large employers — and most of our clients had no idea it existed until we showed them the numbers.
Exclusive Available to Costco Business members. Not a member? We'll walk you through it.
Proprietary TPA
Pre-negotiated third-party administration with auditing software, EDI to every carrier, and service levels we hold vendors to.
Network access
Direct access to the deepest-discount national networks — without the markup layered on by most brokers.
Stop-loss
Group-leveraged reinsurance with competitive attachment points and rate guarantees that protect the plan from outlier claims.
Net-cost Rx
A transparent, pass-through pharmacy contract inside the same marketplace — no spread, full rebate pass-through.
We build the plan around where your people actually get care.
Anyone can shop your renewal. Real savings come from sequencing the strategy correctly — and it almost always starts with the network, not the premium.
Map the network
Where do your employees actually access care? We analyze claims by geography and ask the real question: who has the deepest discount in your markets — BCBS, Cigna, UHC, or Aetna?
Engineer the funding
Self-funded, level-funded, or captive — we model contributions, stop-loss attachment, and IBNP so the funding arrangement fits your risk tolerance and cash flow.
Attack unit cost
Reference-based pricing and direct provider contracting where they make sense — paying a fair, transparent multiple of Medicare instead of an opaque "discount" off an inflated charge.
Steer to value
Direct primary care, centers of excellence, and member steerage that lowers total cost and improves the experience. Cheaper and better aren't opposites.
Reference-Based Pricing (RBP)
Instead of accepting a mystery discount off a hospital's chargemaster, RBP anchors reimbursement to a defensible, transparent benchmark — typically a fair multiple of Medicare. Paired with a national network wrap for consistent physician access, a member concierge to coordinate provider acceptance, and full balance-bill legal defense, a value-based RBP design can project 20–30% plan savings — without leaving your people exposed.
Direct Contracting
For your highest-volume and highest-cost services, we negotiate directly with health systems, surgical centers, and specialists. Bundled case rates and direct relationships remove the middle layers — and the margin that comes with them.
We plan with you — not just for you.
Cost engineering wins the year. A written plan wins the decade. We sit down with your leadership, build a multi-year benefits strategy, and measure against it every quarter — so benefits stop being a fire drill and start being a roadmap.
Listen
We interview leadership to surface success drivers — what "winning" actually looks like for your people and your P&L.
Define
We co-write a benefits mission and the design principles every future decision gets measured against.
Measure
Clear goals, owners, and metrics tied to each success driver — so progress is visible, not anecdotal.
Review
Quarterly review of tactical solutions against the plan through a standing Benefits Advisory Group — and we adjust.
What you walk away with
A real strategy you can hand to your board — not a pile of renewal options. Every engagement produces durable artifacts your leadership can act on and your CFO can defend.
Put a doctor on your team — not a deductible.
Direct Primary Care (DPC) flips the model: a flat monthly fee for unlimited primary care, same-day visits, and a physician who actually knows your employees. No claims, no copays for the front door of healthcare.
We're experts at standing up onsite clinics for concentrated workforces and shared nearsite clinics for distributed ones — handling vendor selection, build-out strategy, member adoption, and the integration with your plan so DPC actually moves utilization upstream.
Fewer ER & urgent-care claims
When the front door is free and easy, members use it — and expensive downstream claims fall. DPC consistently bends the cost curve where it starts.
Better chronic-condition outcomes
Longer visits and real relationships mean diabetes, hypertension, and behavioral health get managed proactively instead of in a hospital bed.
A recruiting & retention edge
"See a doctor today, no copay" is a benefit employees actually feel. It's one of the most visible ways to show your team you've invested in them.
Meet members where they are.
The cheapest claim is the one a member avoids because someone helped them make a better choice. We wrap the plan in a member-experience layer that's actually easy to use — the "irresistible experience" your people remember at renewal.
Navigation & concierge
One app and a human team to find in-network care, book appointments, and answer "is this covered?" before the bill shows up — with measurable ROI.
Virtual care & telehealth
24/7 virtual visits that keep routine issues out of the ER and urgent care, and meet a distributed workforce wherever they live.
Bill review & advocacy
We review medical bills for errors and overcharges and advocate on the member's behalf — protecting both their wallet and the plan.
Decision support
Plan-comparison and cost tools, plus awareness campaigns for mental health and preventive care, so members choose the right plan and the right site of care.
We only do transparent, net-cost-plus pharmacy.
Pharmacy is the fastest-rising line on your plan and the most rigged. The traditional PBM model profits from spread pricing and retained rebates — the more your plan spends, the more they make. We refuse to play that game.
The GLP-1 question — answered two ways.
GLP-1s are the single fastest-growing line on most plans. We don't ban them, and we don't write a blank check. We give your CFO a defensible, auditable policy — and let you decide how far to go.
On formulary — clinically gated
Formulary access is limited to Type II diabetics — the on-label, clinically indicated use. We audit monthly to confirm every member on a GLP-1 is also adherent to their other diabetes medications. You cover the drug for the people who need it, and you have the audit trail to prove it.
For weight management — at cash price
For employers who choose to offer GLP-1s for weight loss, we run dedicated programs and can source the drug at cash price — frequently cheaper than running it through the plan's formulary. You decide the benefit; we make it affordable.
A handful of members drive half your spend. We manage that handful.
On a self-funded plan, catastrophic claims are where you win or lose the year. We stratify your population through the data warehouse and wrap a dedicated clinical team around the members who drive the cost — protecting your plan and taking better care of your people.
Your Anchor Nurse
A URAC-accredited registered nurse assigned to your population — building relationships, navigating members across the continuum of care, managing complex and chronic conditions, and addressing the social barriers that drive avoidable cost. She's also the single clinical quarterback for any point solution you add — diabetes, GLP-1, MSK, dialysis, specialty Rx, maternity — so nothing falls through the cracks.
Carve-outs & point solutions
Dialysis carve-out, infusion therapy, specialty and J-code management, musculoskeletal, and targeted disease management — moving high-cost categories off the plan whenever the math works.
Cell & gene therapy
Million-dollar therapies need a plan before they hit. Pipeline reports with projected PMPM impact, coverage-language development, and programs of excellence with negotiated CAR-T and gene-therapy rates.
COBRA avoidance
At termination or FMLA exhaustion, specialists reach the member to compare individual-market, Medicare, and Medicaid options against COBRA — actively removing adverse risk from your plan.
Stop-loss alignment
We align your plan document to your stop-loss policy, watch prior-authorization timing, and design programs to move risk off-plan before it becomes a six-figure claim.
Risk stratification
The data warehouse flags rising-risk members early, so intervention happens upstream — not after the claim lands. Every clinical decision is tied to its financial impact.
Automate it. Outsource it. Stop carrying it on your team.
We work on any platform — keep your Workday, ADP, UKG, or Paychex with SSO and API integration, or move to DataSource, our proprietary platform built and maintained by our own in-house programmers. Either way, our sister company Control Source handles the heavy TPA work, AI and process automation do the repetitive work, and our dedicated, year-round contact center does the human work.
Dedicated contact center
A toll-free number that's truly yours — IVR and call routing to every vendor, plus chat, text, email, and multilingual support.
- Year-round member support
- Benefits, eligibility & enrollment questions
- Qualifying-life-event administration
Enrollment, done for you
Self-service, telephonic, and on-site bilingual enrollment for open enrollment, new hires, and voluntary lines.
- Eligible-not-enrolled outreach campaigns
- Private-labeled, branded member website
- 80+ branded email & SMS touchpoints
Eligibility & EDI
EDI feeds to payroll, carriers, and vendors with discrepancy management, so the data is right everywhere.
- Variable-hour eligibility determination
- Payroll deduction & arrears reconciliation
- Post-enrollment auditing
Dependent verification
Initial dependent audits and ongoing verification that routinely remove ineligible dependents from the plan — pure savings.
- Document upload & secure storage
- Age 26 / Age 65 notifications
- QMCSO administration
Compliance, handled
The alphabet soup that keeps HR up at night — tracked, filed, and documented with a full audit trail.
- ACA tracking, 1094/1095-C, letter 226-J support
- 5500s, PCORI, SAR, RxDC, gag-clause attestation
- Nondiscrimination & creditable-coverage testing
Leave, COBRA, FSA/HSA
Third-party administration for the programs you'd rather not run, fully integrated with eligibility and billing.
- Leave & disability claim management
- COBRA & consolidated billing
- FSA, HSA & commuter accounts
Custom reporting that tells you what to do next.
The national firms will hand you a polished benchmarking deck. We give you a live, custom data warehouse — your claims, eligibility, pharmacy, and vendor feeds in one place — with reporting built around your questions, not a template.
Monthly data feeds power a plan-performance dashboard your CFO can actually use: budget vs. actual, large-claim tracking, network and discount analysis, medical and Rx utilization trends, and the financial impact of every plan-design decision before you make it. We aggregate every source — carriers, TPA, PBM, labs, wellness vendors — into one warehouse. The principle is simple: map it, own it, use it — your plan owns the data, and we put it to work with predictive and prescriptive analytics, condition-management tools, and provider channeling.
See a sample dashboardPlan performance dashboard
Real-time budget variance, enrollment, and cost-PEPM trends.
Claims & utilization
Quarterly medical & Rx deep-dives with large-claimant tracking and IBNP.
Network & discount analysis
Provider access and disruption modeling by geography and carrier.
Predictive analytics
Plan-cost forecasting, contribution modeling, and predictive & prescriptive risk models.
You own your data
One warehouse aggregating carriers, TPA, PBM, labs & wellness — owned by the plan sponsor, not the broker.
SLA & vendor scorecards
We hold every vendor to documented service-level agreements.
Your employees' data, protected to enterprise standard.
We protect the confidentiality, integrity, and availability of every record we touch — and we keep your plan on the right side of a regulatory landscape that changes every year. This is the part procurement, IT, and legal care about, and it's where small brokers fall short.
Security & privacy
Our program is built in conformity with ISO 27001 and the NIST Cybersecurity Framework, plus HIPAA. We provide SOC 1 and SOC 2 reporting, run organization-wide risk assessments daily across every asset, support SSO with your systems, and record calls for compliance.
Compliance, handled
CAA and No Surprises Act, annual gag-clause attestation, RxDC, PCORI (F720), Form 5500 & Schedule A, nondiscrimination testing, the full ACA lifecycle (1094/1095-C, Letter 226-J), and DOL-compliant plan-document delivery — tracked, filed, and documented.
Self-serve compliance suite
Beyond the filings, your HR team gets a full toolkit: legislative alerts and seminars, a health-plan compliance calendar, poster and notice builders, an FMLA advisor, OSHA logs, an employee-handbook builder, and e-learning.
We don't hand you a checklist. We run the calendar.
Every plan-year deadline is tracked, filed or distributed on time, and reported to you every month — all backed by ERISA counsel. Here's a 2026 plan-year snapshot of what we manage on your behalf.
Q1 · Jan–Mar
- Contribution affordability confirmation (Jan 1)
- ACA 1094/1095-C to IRS & employees (Feb–Mar)
- Medicare Part D disclosure to CMS (Mar 1)
Q2 · Apr–Jun
- SPD distribution (new participants / plan changes)
- §105(h) self-insured nondiscrimination testing (May)
- RxDC prescription-drug reporting (Jun 1)
Q3 · Jul–Sep
- Form 5500 filing (Jul 31)
- PCORI fee via Form 720 (Jul 31)
- SAR distribution & MLR rebate handling (Sep 30)
Q4 · Oct–Dec
- ACA health-plan mandate notice (Oct 1)
- Medicare Part D notice (Oct 15)
- §125 / FSA nondiscrimination testing (Dec 31)
- Gag-clause attestation (Dec 31)
Ongoing notices
- SBC within 7 days; COBRA & HIPAA (incl. annual training)
- CHIP, MHPAEA parity, WHCRA, SMM, marketplace notice
- FMLA general-notice posting & handbook inclusion
State filings
- California, New Jersey, Rhode Island (1094/1095-B/C)
- Massachusetts (1099-HC)
- District of Columbia
2026 dates shown and subject to change with IRS and DOL guidance. Custom Benefit Consultants, Inc. and CBC Benefit & Insurance Services is not a law firm; this calendar is a general guide for plan sponsors and is not intended to replace the advice of legal counsel.
You'll always know exactly what we make, and how.
The fastest way to know whose side a broker is on? Ask how they get paid. Here's our answer, in writing, every year.
Every dollar we pull out of benefits drops to EBITDA.
Benefits are one of the largest controllable line items in the P&L — and one of the most overlooked margin levers. For sponsors and operators focused on EBITDA, we turn benefits from a cost center into a value-creation play.
The EBITDA math
Net-cost pharmacy, network re-pricing, high-cost-claimant management, and conflict-free vendor sourcing pull hard dollars out of spend. Those dollars don't just lower a budget line — they flow straight to EBITDA and get multiplied at exit.
Cut benefit spend
A double-digit reduction on a multi-million-dollar plan is routine for us.
Straight to the bottom line
Recurring savings drop dollar-for-dollar into EBITDA.
Multiplied at exit
At a typical EBITDA multiple, that recurring savings becomes real enterprise value.
Due diligence
Claim-liability projection, discrimination & ACA analysis, reserve and stop-loss re-rating, and full vendor disruption analysis before the deal closes.
Integration
Plan consolidation, deductible-credit coordination, and day-one communications — run varied plans, eligibility, and vendors by business segment on one platform.
No legacy systems
Preserve or run a legacy plan in parallel for continuity — without being held hostage to the seller's legacy administration system.
Stop-loss re-rating
We update your stop-loss carrier at diligence and at close to confirm insurability and protect your existing rates as the group grows.
The difference Transparent fees and no competing agenda — the savings we find are real, and they show up in your numbers. And whether it's one company or a whole family of companies, we harmonize benefits across the portfolio and enable talent mobility between them.
The strategy works. Here are the receipts.
A sample of what this approach has delivered for large, multi-state employers — across retail, staffing, healthcare, manufacturing, gaming, and aviation — including multi-year partnerships where we drove medical trend negative while the rest of the market ran double digits.
Spiraling claims, no controls
Network access, transparent PBM, reinsurance, dependent audit, and full TPA.
$6.0M saved, year oneYears of over-budget renewals
Vendor RFP, network & formulary review, TPA change, automation, telehealth.
$5.4M + $1.5M moreUnderused, undervalued plan
Utilization analysis, outsourced admin, and outreach to every eligible employee.
$1.6M saved, 33% leaner staffUncompetitive vs. the union
Ancillary redesign, bilingual enrollment, leave management, contact center.
$500K + $450K admin savedTrend driven negative
Self-funding, out-of-network RBP, dialysis & specialty carve-outs, biosimilars, COBRA avoidance, onsite clinic.
$8M+ saved · −4% medical trendThe complete scope of services.
Depth is the price of entry. Here's the full stack we run for large-group clients, from C-suite strategy to the day-to-day administration your team never has to touch again.
Strategy
- Strategic plan linked to business objectives
- Design & cost benchmarking
- Plan-cost forecasting
- Executive / board summary reporting
- Ongoing stewardship & renewal meetings
Financial Management
- Budget projections & contribution modeling
- Funding & COBRA rate development
- Stop-loss deductible & attachment analysis
- Alternate-funding analysis
- IBNP calculation & budget variance monitoring
- Medical / Rx utilization analysis
- Data warehouse & monthly reporting
Renewal & Marketing
- Pre-renewal projections & marketing
- Market selection, negotiation & finalist meetings
- Network discount & provider disruption analysis
- Carrier / vendor performance & financial ratings
- Full disclosure of proposals & compensation
- National vendor liaison & issue resolution
Compliance
- Annual compliance check-up
- Wrap plan document & SPD drafting
- Form 5500 & Summary Annual Report
- PCORI, MLR, RxDC & ACA notices
- Nondiscrimination & creditable-coverage testing
- ERISA & HIPAA consulting, HR hotline
Benefit Administration
- Dedicated toll-free contact center
- DataSource platform (or your platform)
- Private-labeled member website & self-service
- 80+ branded email / SMS communications
- Telephonic & multilingual enrollment
- EDI & discrepancy management
Administrative Processes
- Payroll deduction & arrears reporting
- Dependent verification audit & ongoing management
- QLE & QMCSO administration
- Age 26 / Age 65 & age-bracket notifications
- Onboarding & eligible-not-enrolled management
- Life & disability claim management
Subject-Matter Experts
- Pharmacists & pharmacy consultants
- Actuaries & financial consultants
- Underwriters & clinical consultants
- Legal, absence & leave consultants
- Wellbeing & voluntary-benefit specialists
- Pharmacy purchasing coalition assessment
Add-On Services
- Full ACA 1095-C management
- Consolidated billing
- COBRA administration
- FSA, HSA & commuter benefits
- Leave management
Scope is tailored to each client. Certain services carry additional fees and are scoped transparently up front.
Pressure-test your benefits program.
Hand us 24 months of data, your current contracts, and your pain points. One of two things happens next — and both are wins. Either we validate that your costs and vendors are already best-in-class, or we show you exactly where the money is. There is no version of this where you walk away worse off.
$200,000 value The same deep-dive analysis our largest clients pay for — yours at no cost.
You hand over the data. 24 months of claims and enrollment, your current vendor contracts, and the pain points you actually want fixed. We sign an NDA first.
We run the full pressure test. Network re-pricing, pharmacy audit, high-cost-claimant review, funding model, and a marketplace eligibility check.
You get the verdict. Either "your program is solid — here's the proof," or "here's what your incumbent left on the table." Then you decide.
Sponsor or operator? Ask us to model the EBITDA impact — the number your investment committee actually cares about.
Start your pressure test
A senior consultant reviews every request personally — usually within one business day.
Start your pressure test
A senior consultant reviews every request personally — usually within one business day.