Highlights
- Benefits advisors can help clients reduce healthcare spending by up to 34% with Roundstone’s preferred bundle solution.
- The preferred bundle combines Bywater TPA, Cigna network, and select PBMs to maximize cost control.
- Recent internal data shows Roundstone groups consistently outperform industry benchmarks while maintaining gold-level coverage.
- Advisors gain a competitive edge by offering solutions that deliver measurable cost advantages.
Healthcare costs can feel like an uphill battle for businesses. In 2023, employers spent an average of $16,464 per employee on healthcare.
Small and mid-size companies need better options for controlling healthcare costs. Recent analysis of Roundstone’s group captive performance data shows our Preferred Bundle Solution delivers exceptional results, with participating groups spending 34% less than the industry average while maintaining comprehensive coverage.
Our Preferred Bundle includes a combination of Bywater as the third-party administrator (TPA), Cigna as the network provider, and either True Rx, Serve You Rx, or Cigna as the pharmacy benefit manager (PBM).
This strategic arrangement consistently delivers lower per-employee-per-year (PEPY) costs, averaging $1,700 less annually compared to non-preferred bundles—18% less than the $23,154 average for other arrangements—without sacrificing quality of care.
These savings are driven by integrating three critical components: claims administration (TPA), provider networks, and pharmacy benefits management.
The Numbers Tell the Story
The 2023 Mercer’s National Survey of Employer-Sponsored Health Plans reports average healthcare costs of $16,464 per employee for companies with 50-499 employees. Even without our preferred bundle, Roundstone captive members average just $12,385 per employee—a 24% reduction.
Groups using our preferred bundle reduce costs even further to $10,810 per employee, representing a 34% savings versus the industry benchmark.
This means your clients save $5,654 per employee annually by choosing Roundstone’s preferred bundle solution. For a company with 100 employees, that represents over half a million dollars in annual savings.
Our Methodology
Aggregate PEPY data reflects the average cost of the Roundstone health plan for the whole book, and the average cost of Roundstone’s preferred bundle. The calculations don’t include dental and vision claims, point solution fees or PBM/TPA fees above base or admin fees.
Understanding the Preferred Bundle
Our preferred bundle combines three essential components:
- Bywater TPA. Our in-house third-party administrator specializes in self-funded plan management, delivering seamless administration and superior service.
- Cigna network. Access to Cigna’s comprehensive provider network ensures employees maintain choice and quality care.
- Select PBMs. Partnerships with True Rx, Serve You Rx, or Cigna provide transparent pharmacy benefit management and maximize rebate potential.
Companies using this strategic combination spend $1,700 less PEPY compared to those using other arrangements, while maintaining high-quality coverage.
Bywater + Cigna = Network Advantage
Self-funded health plans work best when their components work together seamlessly. That’s why our preferred bundle pairs Bywater’s administration with Cigna’s network capabilities. Here’s what this integration means for your business:
- Streamlined claims processing. When the TPA and network carrier work as one unit, claims move efficiently from provider to payment, reducing administrative complexity.
- Consistent provider communication. A unified TPA-network relationship means providers have clear channels for verification, authorization, and claims submission.
- Simplified implementation. Working with aligned partners eliminates duplicate setup processes and reduces implementation time.
- Single point of contact. Your clients get direct access to Bywater’s expert service team for both administrative and network questions, streamlining issue resolution.
- Data alignment. Integrated systems mean better data flow between network and administrator, leading to more accurate reporting and faster issue identification.
Pharmacy Benefits That Work Harder
Our preferred PBM partnerships show clear advantages in controlling prescription drug spending:
- Lower administrative costs. Preferred PBM administration fees average $75 per employee annually—23% less than non-preferred arrangements.
- Better net pharmacy costs. Despite variations in rebate structures, our preferred PBMs deliver total pharmacy claim costs that are $210 less per employee annually.
- Integrated approach. The combination of competitive pricing, efficient administration, and strategic partnerships helps control one of the fastest-growing healthcare expenses.
The Rest of the Story: Data-Driven Cost Containment
The preferred bundle’s savings extend beyond initial discounts through strategic cost containment. By combining Bywater’s administration with transparent data access and Roundstone’s Cost Savings Investigators (CSI team), employers can:
- Track spending patterns. The CSI Dashboard provides real-time insights into healthcare spending, helping identify opportunities for additional savings beyond the bundle’s baseline advantages.
- Make informed decisions. Regular data analysis reveals which cost containment strategies work best for your specific employee population.
- Monitor results. Track the impact of cost containment measures through detailed claims data, ensuring your savings continue growing over time.
This data-driven approach helps explain why our preferred bundle groups consistently outperform both non-preferred arrangements and industry benchmarks.
Quality Remains Priority One
Cost savings mean little without quality coverage. Roundstone plans maintain an actuarial value of 81.04%, qualifying as gold-level coverage. This means employers cover approximately 81% of healthcare costs, providing substantial support for employees while controlling spending.
Groups of all sizes benefit from our model, with larger groups seeing additional advantages through higher specific deductibles. The data shows consistent performance across our book of business, with the preferred bundle delivering optimal results.
The key takeaway? With the flexibility of our preferred bundle, organizations across the size spectrum can achieve meaningful savings while tailoring their healthcare strategies to meet specific needs.
The Roundstone Preferred Bundle: Your Path to Healthcare Cost Optimization
At Roundstone, we don’t just talk about savings, quality, and efficiency—we deliver them:
Our preferred healthcare bundle brings together the best in claims administration, provider networks, and pharmacy benefits management to give you a competitive advantage and transform how you provide value in a complex market.
- Differentiate your practice: Offer a data-driven approach that delivers tangible savings.
- Build client trust: Demonstrate your commitment to cost-effective, high-quality healthcare solutions.
- Increase client retention: Become the advisor who consistently delivers bottom-line results.
Your Next Step
Give your clients the advantage of proven cost control without sacrificing coverage quality. Contact Roundstone today to learn how our group captive and preferred bundle can reduce their healthcare spending.
To learn more about self-funding employer health insurance through Roundstone’s group captive, download your free Advisor’s Guide today.
Source: 2024 Roundstone Internal Data Report, “PEPY Performance Analysis”, November 2024.