How a modernized health plan is lowering total cost of care and improving employee experience

Like any good startup, the copay-only Surest® health plan came from a group of innovators discontent with the status quo.

These veteran insurance innovators asked themselves, what if health insurance could work like other helpful consumer services? What if provider options and clear costs were available before members sought care so people could shop for health care like they shop for many other products?

In 2016, that concept became a reality. Shortly thereafter, the company that would later be rebranded as Surest, signed its first customers, and in 2022, it upscaled its business, joining with UnitedHealthcare.

How does the Surest plan work?

Surest is an employer-sponsored health plan available to Florida employers and is offered on a self-funded, fully insured, or level funded basis.

With employers of all sizes looking to combat rising health care costs, Surest remains the only product that can help curb rising health care costs without trimming benefits, narrowing networks or shifting costs onto employees.

What makes Surest different? It allows members to more easily compare cost and coverage options upfront and provides more convenient, better access. The Surest health plan makes it simpler for members to choose higher-value providers, which are proven to bring better outcomes and lower costs.

The Surest plan simplifies coverage and helps improve access by eliminating financial barriers like deductibles and coinsurance. Instead, with an easy-to-use app, members can see clear cost and care options upfront.

Within the app, members can compare care options (including virtual visits) and network providers and see actual costs in the form of a single copay — not costs estimates. Copays are lower for providers evaluated as higher-value, based on past effectiveness or cost efficiency data. Surest members chose high-value providers 17% more compared to traditional plans. (5)

Members pay the single copay offered upfront in the Surest app for the health services provided during the visit. In other words, there are no deductibles, no coinsurance and no surprise bills, and with Surest, members have access to the broad, national UnitedHealthcare and Optum Behavioral Health networks.

330 million unique, value-based copays for each unique service/location combination

This reimagined health plan is accessible, intuitive and affordable — and it's reducing costs for both employers and employees alike:

Up to 15% savings for employers (1)

50% average lower member out-of-pocket spend (2)

Year-over-year medical trend was less than 5% sustained across 4 years (3)

Why does Surest work?

This innovative model is resonating. Since 2022, Surest has grown from serving 1 in 9 of UnitedHealthcare's largest employer clients to 1 in 4 today.

But with numbers like that, it's no wonder that when employers are first introduced to the plan some react with: "It's too good to be true."

"Our broker explained the magic in the sauce is really through the decision-making of the employee," said Maria Freda, Chief Client Finance Officer for Horizon Media in New York City.

7.7% lower total spend in 2022 with Surest, when compared with control group

In other words, with its health plan design, Surest empowers its members to comparison shop for care. Putting members in the driver's seat of their health care has paid off: According to a third-party study, Surest medical and pharmacy spend was 7.5% lower in 2021 and 7.7% in 2022, compared to the control group. (4)

Surest uses visible Care Ratings within the digital experience and aims to improve member confidence in choice of providers by evaluating providers on services they offer, then assigning higher Care Ratings — and lower copays — for higher performing providers.

Surest can help reduce the utilization of potentially wasteful (and costly) treatments. For instance, compared to a control group, Surest members had: (5)

14% fewer emergency room visits

17% fewer surgeries

4% less complex imaging (MRI/CT)

At the same time, Surest members used more efficient services more often than the control group:

698% more virtual visits

584% more virtual mental health

8% more preventive visits

19% more physical therapy visits

With better, more convenient access to care and improved affordability, plus lower costs for employers, the Surest health plan can be a win-win.

www.surest.com/ 866-683-6440

(1) Surest actuarial results through 2024.

(2) Members who migrated from a non-Surest plan to a Surest plan in 2022, compared to those who stayed with a non-Surest plan.

(3) The Surest book-of-business demographic, adjusted compound annual growth rate from 2019 to 2023 was 4.6%.

(4) Aon's Cost Efficiency Measurement of Surest 2021-2022, March 2024.

(5) Study comparing Surest financial and utilization outcomes to a matched control group composed of non-Surest members from the same employers, using the same network. Members were matched on age, gender, geography, and chronic conditions.