Custom Design Benefits

What Custom Design Benefits does

Custom Design Benefits (CDB) is a privately held, WBENC-certified women-owned Third Party Administrator (TPA) headquartered in Cincinnati, Ohio, founded in 1991. CDB administers self-funded medical, dental, and vision benefit plans for employers across the Ohio, Indiana, and Kentucky tri-state market and supports its plans with PPO access through Cigna, Cofinity, First Health Network, and Medical Mutual of Ohio. The company complements plan administration with a stack of consumer-driven account services (FSA, HRA, HSA, Lifestyle Spending Accounts under the Custom Flex brand), compliance administration (COBRA, FMLA, leave management), population health management, Employee Assistance Programs (SupportLinc via CuraLinc), and the Hybrid Insurance Plan, which blends self-funded and fully insured designs.

The technological centerpiece is TrueCost, a proprietary Reference-Based Pricing (RBP) plan that uses a copay-only design to eliminate coinsurance and deductibles and negotiates payments closer to actual provider costs; TrueCost Rx layers pharmacy benefit management and independent specialty drug prior authorization on top of that foundation. Underlying infrastructure includes the Executive Analytics dashboard powered by Cedar Gate Technologies for integrated medical and pharmacy reporting, a member/employer portal on VBA Gateway, the Custom Flex portal from Lighthouse1, and the TrueCost Connect cost transparency tool. Other proprietary programs include Innovate 360 integrated patient advocacy and Custom Care Population Health Management, which uses in-house utilization and case management to proactively manage chronic and high-risk members.

CDB generates revenue through per-participant and per-plan administration fees on multi-year contracts, distributed primarily via direct sales to self-funded employers and through a broker/consultant channel that is supported by Continuing Education courses, RFP support, and a formal Partnership Pledge. Distribution is regional rather than national, with no public revenue disclosed and no external equity or funding activity. Julie D. Mueller has led the company as President & CEO since 2003, and senior leadership was expanded in 2025 with a Chief Strategy Officer and a new Chief Operating Officer implementing the Entrepreneurial Operating System.

Name

Custom Design Benefits

Legal name

Custom Design Benefits

Website

https://customdesignbenefits.com

Company type

Private

Founded year

1991

Operating status

Operating

Headcount range

101–250 employees

Short description

Custom Design Benefits (CDB) is a Cincinnati-based, privately held Third Party Administrator that administers self-funded medical, dental, and vision benefit plans for employers across Ohio, Indiana, and Kentucky. Its proprietary TrueCost Reference-Based Pricing copay-only design eliminates coinsurance and deductibles to deliver cost transparency and pharmacy savings.

Ownership category

akta.pro rank

Product category

Third Party Administration of Self-Funded Health Benefit Plans

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Insurance Agents, Brokers & Service (6411)

akta.pro primary industry

Eligibility, Enrollment & Benefits Administration (HLAEALAH)

Keywords

• Self-funded health plans
• Third party administration
• Reference-based pricing
• Employee benefits administration
• Pharmacy benefit management

Headquarters

HQ city

Cincinnati

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure, Others

Revenue model

1. Third Party Administrator (TPA) Services: CDB generates revenue as a Third Party Administrator providing administration of self-funded health benefit plans, including medical, dental, and vision plan administration, pharmacy benefit management integration, and compliance services. Fees are likely charged as a per-participant or per-plan administration fee typical of TPAs serving self-funded employers.
2. Cost Containment Solutions: Revenue is derived from proprietary cost containment solutions including TrueCost (reference-based pricing) and TrueCost Rx (pharmacy benefit management). These solutions generate savings for employer clients while creating value through differentiated plan administration.
3. Consumer-Driven Account Administration: Fees for administering Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), Lifestyle Spending Accounts, COBRA, FMLA, and short-term disability — typically billed per participant or per service.

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels9 records

Core offering

Custom Design Benefits is a Third Party Administrator that administers self-funded employer health benefit plans, primarily for employers in the Ohio, Indiana, and Kentucky tri-state market. Core services include medical/dental/vision plan administration, the proprietary TrueCost Reference-Based Pricing plan with a copay-only design, TrueCost Rx pharmacy benefit management, Custom Care population health management, Custom Flex consumer-driven accounts (FSA/HRA/HSA/Lifestyle Spending Accounts), FMLA/COBRA/Leave compliance administration, advanced data analytics, and SupportLinc EAP services.

Product overview

Custom Design Benefits (CDB) offers a comprehensive, modular portfolio of self-funded employee benefits administration products and services built around its core Third Party Administrator (TPA) platform. The flagship product is TrueCost, a nationally recognized Reference-Based Pricing plan with a unique copay-only design that eliminates deductibles and coinsurance. This core offering is augmented by TrueCost Rx (prescription benefit management), Custom Care Population Health Management, and Advanced Data Analytics (Executive Analytics) for plan performance insights. CDB also provides a suite of consumer-driven account services under Custom Flex (FSAs, HSAs, Lifestyle Spending Accounts), compliance administration tools (COBRA, FMLA, Leave Management), the Hybrid Insurance Plan (HIP), Dental and Vision plans, and the SupportLinc Employee Assistance Program. All products are designed to work as integrated modules within CDB's self-funded platform, enabling employers to mix and match cost containment, analytics, and administrative services tailored to their workforce.

Differentiator

Problem solved

Functional benefit

Brands

• TrueCost: Nationally recognized Reference-Based Pricing plan with unique copay-only plan design.
• TrueCost Rx
• TrueCost Connect
• Custom Flex
• SupportLinc
• Hybrid Insurance Plan (HIP)

Products and services

• Self-Funded Health Plans Complete administration of self-funded medical plans with Pharmacy Benefit Manager integration, enabling employers to take control of benefit costs and create plans uniquely designed for their workforce. Sold to self-funded employers via direct sales and broker channel in the Ohio, Indiana, and Kentucky region.
• TrueCost Reference-Based Pricing Nationally recognized Reference-Based Pricing (RBP) plan with a unique copay-only plan design that eliminates coinsurance and deductibles while controlling costs through direct hospital and provider negotiations for greater price transparency. Sold to self-funded employer clients of CDB.
• TrueCost Rx Prescription benefit management solution providing savings over traditional PBM models through member education, medical management, and reference-based pricing on pharmacy with independent specialty drug prior authorizations to eliminate conflicts of interest. Sold to self-funded employer clients using CDB plans.
• Custom Care Population Health Management In-house population health management program with concierge member advocacy and early intervention for chronic and high-risk conditions, identifying health issues early to keep members healthy and reduce long-term healthcare costs. Delivered to CDB-administered health plan members and their employer clients.
• Custom Flex Services Consumer-driven account services complementing health plans, including Flexible Spending Accounts (Medical, Dependent Child Care, Adoption, Transportation), Health Savings Accounts, Health Reimbursement Arrangements, and Lifestyle Spending Accounts via the Custom Flex Portal (Lighthouse1). Sold to employers who administer consumer-driven benefits alongside CDB's medical plans.
• COBRA Administration COBRA administration services helping employers avoid compliance pitfalls when managing continuation coverage for employees and dependents. Sold to employer clients of CDB, including via the broker channel.
• FMLA & Leave Management Leave administration tools and management services helping employers improve record-keeping and stay in compliance with FMLA and other leave-related regulations. Sold to employer clients.
• Advanced Data Analytics (Executive Analytics) User-friendly analytics and reporting platform powered by Cedar Gate Technologies, providing executive dashboards, integrated medical and prescription data, and on-demand reporting to visualize plan performance and savings strategies. Sold to employer clients and broker partners.
• Hybrid Insurance Plan (HIP) Hybrid plan combining self-funded insurance and traditional insurance elements to offset rising premiums and avoid cost-shifting to employees, with potential employer savings of 25-50%. Sold to employer clients seeking alternatives to fully insured or fully self-funded models.
• Dental and Vision Plans Dental and vision benefit plan administration offered as part of the self-funded plan portfolio for CDB employer clients.
• Lifestyle Spending Accounts Fully customizable post-tax lifestyle spending accounts that employers can use to promote healthy habits and overall well-being, covering expenses such as childcare, student loans, gym memberships, and pet insurance without requiring multiple vendors. Sold to employer clients.
• SupportLinc Employee Assistance Program (EAP) Employee Assistance Program managed by CuraLinc Healthcare, providing personalized mental health support, counseling services, and resources accessible through the CDB member portal for employees of CDB-administered plans.
• Cost Containment Solutions Suite Suite of innovative cost-control tools bundling TrueCost Reference-Based Pricing, bundled payments with Centers of Excellence, telemedicine with behavioral health and EAP, Innovate 360 integrated patient advocacy, and Direct Primary Care arrangements. Sold as a holistic package to self-funded employer clients.
• Medical and Pharmacy Risk Management Services Comprehensive risk management including TrueCost Rx reference-based pricing on pharmacy, independent specialty drug prior authorizations, specialty drug copay assistance and alternative funding solutions, and in-house utilization and case management. Sold to employer clients.

Quantifiable outcome

• Employers saved up to 47% on benefits costs (Holland Roofing Group case study)
• +7 more outcomes

Named customers5 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration10 records

AI capability5 records

Feature6 records

Partnerships

23 partnerships are on record, tiered core and minor.

• QuantifycoreStrategic or Co-development Partner · 10 September 2025Quantify presented at CDB's 18th Annual Customer Conference (September 2025) on specialty infusion therapy. Their patient-first infusion platform helps employers control costs while improving patient outcomes using independent outpatient therapy centers and at-home therapy services.
• RxResultscoreTechnology or Integration · 10 September 2025RxResults presented at CDB's 18th Annual Customer Conference on data-driven prescription cost control strategies, including managing high-cost therapies, biosimilars adoption, and evidence-based prior authorization for GLP-1 medications. RxResults is a key partner in CDB's TrueCost Rx pharmacy risk management solution.
• ScriptSourcing, LLCcoreTechnology or Integration · 10 September 2025ScriptSourcing, LLC presented at CDB's 2025 Customer Conference on international sourcing for brand and specialty medications as a strategy for prescription cost control. Bob Pfeiffer from ScriptSourcing explained how international sourcing offers relief from unsustainable medication pricing trends for both members and employers.
• The Phia GroupcoreStrategic or Co-development Partner · 10 September 2025The Phia Group, led by Ron Peck (Chief Legal Officer), presented at CDB's Customer Conference on the psychology behind healthcare decisions, the No Surprises Act, and compliance topics. The Phia Group provides legal and compliance expertise, plan document support, and the PACE (Plan Appointed Claim Evaluator) program referenced in CDB's newsletter.
• CuraLinc HealthcarecoreTechnology or Integration · 10 September 2025CuraLinc Healthcare manages CDB's SupportLinc Employee Assistance Program (EAP), providing personalized mental health and employee assistance services. Representatives Catherine Caldwell and Hannah Harnack have presented at CDB's Customer Conference on mental health utilization trends and EAP program outcomes.
• People Working CooperativelyminorOthers · 10 September 2025People Working Cooperatively is a nonprofit receiving donations from CDB's 18th Annual Customer Conference silent auction in September 2025. It provides home repair and modification services to help people remain safely in their homes.
• Talbert HouseminorOthers · 24 February 2025Talbert House is a nonprofit client of CDB that receives donations from CDB's annual Customer Conference silent auction. Talbert House serves children, adults, and families in Southwest Ohio with prevention, assessment, treatment, and reintegration services across addiction, mental health, housing, and primary care.
• Ohio Valley GoodwillminorOthers · 24 February 2025Ohio Valley Goodwill is a nonprofit client receiving donations from CDB's annual silent auction. Goodwill enhances quality of life by strengthening communities, eliminating barriers to opportunity, and empowering individuals through the power of work, diverting more than 44 million pounds of donated product from area landfills annually.
• CHNK Behavioral Health (OneQuest Health)minorOthers · 24 February 2025CHNK Behavioral Health (now known as OneQuest Health) is a nonprofit client receiving donations from CDB's silent auction. It provides behavioral health and substance use treatment services for children, teens, and adults in an inclusive, innovative environment.
• PaydhealthcoreTechnology or Integration · 1 February 2025Paydhealth provides alternative funding solutions for specialty medications, helping employers manage the high cost of specialty drugs. David Galardi from Paydhealth has presented at multiple CDB Customer Conferences on prescription drug advocacy and alternative funding strategies.
• Cedar Gate TechnologiescoreTechnology or Integration · 1 February 2025Cedar Gate Technologies provides CDB's Executive Analytics platform — the data analytics and reporting dashboard used by CDB employer clients and brokers to visualize plan performance, integrated medical and pharmacy data, and savings strategies.
• Health Care Administrators Association (HCAA)coreStrategic or Co-development Partner · 1 February 2025HCAA is a trade association for the self-funding industry that recently launched HCAA University, an educational platform for self-funding professionals. Julie Mueller, CDB's President & CEO, serves on HCAA's Board of Directors, positioning CDB at the forefront of industry education and advocacy.
• Emerging Therapy Solutions (ETS)coreTechnology or Integration · 8 April 2024CDB announced a strategic partnership with Emerging Therapy Solutions (ETS) in April 2024 to help employers manage the high costs associated with treatments for rare genetic and complex diseases. As cell and gene therapies can cost up to $3.5 million per dose, ETS provides specialized management and cost containment for these emerging treatments.
• Learning Care GroupminorStrategic or Co-development Partner · 23 August 2022Learning Care Group partnered with CDB to offer employer-sponsored child care through LCG Open Access, a program making high-quality early childhood education accessible to employees of partner companies.
• CignacoreChannel Partner/ Reseller/ DistributorCigna is one of CDB's PPO network partners. CDB plans can integrate with Cigna's provider network to offer members access to discounted healthcare services through a traditional PPO arrangement alongside or in combination with CDB's reference-based pricing options.
• CofinitycoreChannel Partner/ Reseller/ DistributorCofinity is a PPO network partner providing CDB members access to a provider network for medical services, complementing CDB's reference-based pricing and other plan options.
• First Health NetworkcoreChannel Partner/ Reseller/ DistributorFirst Health Network is a PPO network partner providing CDB members with access to a national provider network, supporting CDB's out-of-area member coverage needs.
• Medical Mutual of OhiocoreChannel Partner/ Reseller/ DistributorMedical Mutual of Ohio is a PPO network partner integrated with CDB's plan administration, providing provider network access for CDB employer clients, particularly those in the Ohio market. CDB publishes a Machine Readable File for Medical Mutual on its resources page.
• Kroger Prescription Plans (KPP)coreTechnology or IntegrationKroger Prescription Plans provides a specialty alternative funding solution through CDB that delivers up to 58% savings on specialty medications for CDB employer clients.
• GallagherminorGTM or Marketing PartnerGallagher (Arthur J. Gallagher & Co.) is a global insurance brokerage and risk management firm referenced as a vendor partner donating to CDB's conference silent auction and as a strategic partner in the benefits ecosystem.
• USIminorGTM or Marketing PartnerUSI Insurance Services is referenced as a vendor partner donating to CDB's annual Customer Conference silent auction, indicating an ongoing benefits ecosystem relationship.
• VBA (VBATPA)coreTechnology or IntegrationVBA (VBATPA) provides CDB's member portal platform for Medical/Dental/Vision access, enabling members to manage benefits, view claims, and access plan information through the VBA Gateway portal.
• Lighthouse1coreTechnology or IntegrationLighthouse1 provides CDB's Custom Flex Portal for FSA/HRA/HSA administration, giving employer clients and members a unified platform to manage consumer-driven benefit accounts.

Scale indicators15 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• HealthEZ: Independent third-party administrator specializing in self-funded health plans with reference-based pricing and integrated cost containment. Directly comparable to CDB in product mix (medical admin, RBP, pharmacy, compliance) and mid-market employer target, though HealthEZ operates on a broader multi-state basis.
• Lucent Health: National independent TPA offering self-funded plan administration, reference-based pricing, and stop-loss capabilities. Comparable to CDB across RBP, integrated medical/pharmacy risk management, and broker distribution, with a larger geographic footprint.
• WebTPA: Large independent TPA administering self-funded medical, dental, vision, and consumer-driven accounts for employers nationwide. Closely comparable to CDB in core TPA functionality and self-funded focus, with significantly greater scale and national reach.
• MedCost: Regional independent TPA administering self-funded health plans primarily in the Carolinas and Southeast. Closely comparable to CDB in scale, regional independent positioning, and self-funded employer focus, and serves as a useful regional TPA benchmark.
• Surency: Independent third-party administrator offering self-funded health plan administration, consumer-driven accounts (FSA/HSA/HRA), and COBRA services. Highly comparable to CDB in product mix and target customer (mid-market employers), with national distribution.

Broad incumbents

• CoreSource (Cigna Group): Cigna's TPA arm providing administrative services for self-funded employer health plans, including integrated stop-loss and PPO networks. Competes with CDB on mid-market and large employer accounts where Cigna-branded network access and capital scale are decision drivers.
• Elevance Health (Anthem Blue Cross Blue Shield): Major national health insurer with TPA capabilities through its Anthem Blue Cross plans and affiliated services. Competes with CDB in the Ohio market specifically (Anthem is a major Ohio carrier) and on large/multi-state self-funded accounts where brand and network scale dominate.

Emerging players

• RBG Health (Reference Based Group): Specialist RBP administrator focused on reference-based pricing for self-funded employers. Comparable to CDB's TrueCost product line, with a more focused product set and broker-driven distribution model.
• Paydhealth: Specialty drug alternative-funding and copay-assistance platform serving self-funded employer plans. Directly comparable to CDB's specialty drug management offering and listed as a CDB partner; a logical competitive alternative for brokers evaluating specialty pharmacy solutions.
• Aither Health: Independent TPA focused on self-funded employer health plans with cost-containment and RBP-adjacent strategies. Comparable to CDB in target market (mid-market self-funded employers) and product architecture, though typically serving smaller employers on a national basis.

Market position

Strengths4 records

Weaknesses5 records

Competitive moat4 records

Key risks7 records

Key highlights7 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Custom Design Benefits