There is a pattern in this market that is easy to miss. The biggest buyers do not have to stretch, because they already win plenty of deals. Smaller buyers who are still building a book often do have to stretch, because losing a policy costs them more.
That does not mean a small buyer always pays more. It means the spread between offers is real and it is not predictable from the outside. Two providers looking at the same medical file and the same premium schedule will land in different places often enough that guessing is a bad strategy.