Let’s get straight to the point.
Surest, a UnitedHealthcare company, is an ACA-compliant employer-sponsored health plan—offered on a fully insured and self-funded basis. In fact, the Surest health plan is disrupting the health insurance marketplace with its comprehensive medical plan. Surest is changing how employees use their health insurance—giving them more control over where they go and how much they pay for care. To understand how the Surest health plan is different, it’s important to know how most medical plans work versus what a point solution offers.
How does a health insurance plan work?
An employer-sponsored health plan offers a broad range of care options and services to employees. It covers things like preventive care, hospital stays, surgeries, specialty care, and more. The employer pays a premium and the employee typically pays for health care through paycheck deductions and fees to a provider or facility after coinsurance has been calculated and a deductible has been met. There are a variety of plan types, with the majority falling into one of three categories—a high-deductible plan, health maintenance organization (HMO), and preferred provider organization (PPO). These health plans provide the same basic coverage, but premiums, out-of-pocket costs, and provider networks vary.
Along came Surest—a no-deductible, copay health plan.
The Surest health plan provides all the medical coverage you’d expect with a traditional health insurance plan, but has deliberate differences in how it works, primarily around member experience and price.
Surest is designed to provide information like price (copay), provider ratings, what’s included in a visit, and treatment options that members can see in advance to help them decide how to get care. Through an intuitive digital experience (via the Surest app or website), members can easily search for and compare care options and then decide how to get care based on their health needs and budget.
A few highlights of the Surest health plan include:
- No deductible or coinsurance so members know the price for care on day one, no calculations required
- Upfront prices (not estimates) for care to help reduce financial barriers to seeking care
- Value-based copays where lower prices are often assigned to providers evaluated as higher value
- Alternative treatment options presented alongside a member’s original search to help them decide how to get care
The plan also uses the broad UnitedHealthcare provider network—one of the largest in the country—so members can find doctors, hospitals, and clinics near home, on vacation, or from their sofa via virtual care.
The Surest health plan is designed with the premise that clinical excellence is the best path forward and uses that methodology to assign prices to providers and facilities. Those evaluated as higher value, based on quality, efficiency, and overall effectiveness of care, are often assigned a lower copay. This way, members can easily identify quality care. When employees choose quality care, employers may save, too.
When members search for care in the Surest app or website, they also see alternative treatment options like physical therapy or virtual care to consider. One of the ways Surest is able to provide a variety of care options is by partnering with point solution vendors. Employers can “plug in” point solutions to their plan to offer employees a more personalized benefit.
What is a point solution?
A point solution focuses on addressing specific health-related needs or challenges and offers targeted services or features to support them. This can include things like weight management programs, prescription management, wellness programs, or chronic condition management tools.
While the broad coverage of a comprehensive plan ensures all-around health management, point solutions supplement this by providing focused strategies for specific health issues. Employers can add one or more point solutions to enhance their benefits package. The integration of point solutions into a health plan like Surest is seamless and helps enhance overall member experience. Surest is designed to present these tailored options within the search experience to provide a more custom approach to members’ unique needs. Members have the opportunity to view the offering and register with the vendor or select other care options from the results screen.
As employers look to keep pace with the changing needs of employee health, Surest can help by offering comprehensive coverage with additional layers of care built in that align with employer needs. The Surest plan not only allows employers to offer a rich benefit without cost shifting, but also allows employees to take ownership of their health by giving them options—who to see, how much to pay, and what type of care to get—so they can become active participants in how they get better, feel better.
