Surest

A health plan you can read

Open the Surest app before a knee scan or a pediatric visit, and something strange happens for American health care: a number appears. Not a coinsurance percentage, not a deductible you will hit sometime in October, not an estimate with seven asterisks. A copay. The price you will pay, in dollars, before you walk in the door.

That is the whole pitch, and it sounds almost too plain to be a billion-dollar business. Yet Surest - the UnitedHealthcare employer plan formerly known as Bind - has grown into the fastest-growing plan in UnitedHealthcare's book, with close to a million members and employers that range from family shops to the Fortune 100. The radical idea, it turns out, was telling people what things cost.

The deductible was never a feature

For decades, the standard employer plan asked you to spend thousands of your own dollars before coverage really kicked in, then taxed every visit with a coinsurance percentage you could not calculate in advance. People delayed care. They guessed. They opened bills like scratch tickets, hoping. The system called this "skin in the game." Patients called it homework with a penalty.

The founders of Surest looked at that arrangement and asked a question that should have been obvious: why is the one thing you cannot see in health care the price? Every other service in modern life shows you the cost before you commit. Health insurance, somehow, had made opacity a selling point.

Built in the Twin Cities, on a hunch

Surest began in 2016 as Bind, launched out of Lemhi Ventures, the Minneapolis venture fund run by serial entrepreneur Tony Miller. Miller was not new to this fight - he had earlier built Definity Health, a consumer-directed health plan that UnitedHealth's parent acquired for $300 million in 2004. He had spent a career arguing that insurance could behave less like a bureaucracy and more like a useful product.

The bet was that employers, exhausted by the annual ritual of cost-shifting onto employees, would pay for a plan that simply worked better. Investors agreed. Bind raised a $105 million round in 2020 with backing from Ascension Ventures and UnitedHealth Group, the latter an early believer essentially from launch. Total funding climbed past a quarter of a billion dollars before the relationship deepened into ownership.

One app, no surprises

Surest is, mechanically, an ACA-compliant employer medical plan offered on self-funded, fully insured, and level-funded terms, riding UnitedHealthcare's national provider network. But the part members touch is the app. Search a provider. Compare treatment options by cost and by quality rating. Check coverage in real time. See the copay. Pay it. There is no math at the pharmacy counter because there is no coinsurance to compute.

What disappears is the friction. Virtual visit usage jumped tenfold versus prior offerings. Emergency department visits dropped. None of it required a wellness lecture - just the quiet nudge of a visible price.

The receipts, such as they are

Skeptics are right to poke at a plan that promises lower costs for everyone. So here is the third-party version: a 2024 study by Aon, the benefits consultancy, found Surest lowered claim costs and saved members more than $400 a year. UnitedHealth Group's own reporting in 2023 pointed to more preventive care and member satisfaction running well above industry benchmarks.

The growth is its own argument. Hundreds of employers covering a combined workforce of more than 4.4 million people offered Surest for 2024, including roughly one in six of UnitedHealthcare's national accounts. A plan that did not work would not spread through HR departments, the most risk-averse buyers on earth.

Power, handed back

Surest describes its mission as giving people power over their health care experience. Stripped of the slide-deck gloss, that means a member should be able to make a decision the way they make most decisions - with the price in hand and the trade-offs visible. The plan does not promise to make you healthier through willpower. It promises to stop hiding the ball.

The price, finally, in the open

Health care pricing is slowly being dragged into daylight by regulation and by patience running out. Surest got there early and built the whole product around the assumption. If the next decade of insurance is a fight over who can make coverage legible, the company that has been pricing 490 services up front since the 2010s starts with a head start and a million people who already expect to see the number.

So return to that app screen, the one with the copay glowing where a question mark used to be. It is a small thing. It is also the entire point. For a million members, opening a health plan no longer feels like opening a bill you cannot read - it feels like checking a price before you buy. In American health care, that still counts as a revolution.