A new era of health benefits: The rise of copay-based plans
Discover how copay-based plans like Surest are gaining adoption as clearer, more predictable options that support smarter decisions and better value.
In an era where health care costs continue to climb and benefit complexity frustrates both employees and employers, copay-based health plans are continuing to gain momentum in the employer-sponsored insurance market.
For decades, most plans have relied on familiar cost-management approaches, including deductibles, coinsurance and intricate coverage designs. While well intentioned, these designs have grown increasingly complex over time, often leaving employees uncertain about what their care will cost and when benefits apply. That uncertainty can lead to delayed care, avoidable health complications and an influx of cost-related questions for HR teams and their benefits advisors.
Employers are beginning to reassess how health care costs are structured, communicated and experienced across their workforce.
Moving beyond deductibles
Rather than depending primarily on deductibles and coinsurance, copay-based health plans are one approach employers are exploring to improve predictability at the point of care. According to the UnitedHealthcare 2026 Health Trends Report, one-third of large employers now offer copay-driven plan designs as a standalone or complementary option, up from just 10% in 2023.1
How does a copay-based health plan work? Copay-based plans replace deductibles and coinsurance with fixed payment amounts for specific health services, so employees know exactly what they will pay before receiving care. This approach stands in contrast to traditional models, where members often face unpredictable out-of-pocket costs and must first meet a deductible before their coverage begins. With coinsurance, employees pay a percentage of the cost after the deductible is met, which may lead to uncertainty at the point of service.
For employers, the fixed nature of copays makes budgeting and cost forecasting more accurate, helping organizations plan with greater confidence. Simplified benefit explanations reduce administrative burdens on HR teams, while greater clarity into cost and quality of care information can encourage employees to seek preventive care and make more informed health care choices, which works to improve utilization, support better health outcomes and lower overall spending. These efficiencies can support organizational objectives for cost management and employee retention.
For employees, copay-based plans can eliminate surprise medical bills and provide transparent pricing at the time of care. This clarity helps to reduce financial barriers, making it easier for employees and members to seek needed treatment without fear of unexpected costs. Predictable prescription copays also improve medication adherence, while the overall transparency and ease of use leads to higher member satisfaction.
As a result, both employers and employees can benefit from a health plan design that prioritizes value, simplicity and trust.
Enter Surest: A copay‑based model built for clarity and value
Surest® began with a simple question: What if health insurance worked more like other helpful consumer services, giving members clear care options and upfront costs? One of the first copay-based health plans to enter the market, Surest was founded as Bind Benefits in 2016 and later rebranded and joined UnitedHealthcare in 2022 to expand its reach but retained its consumer-centric approach and is the fastest-growing employer-sponsored UnitedHealthcare health plan.
Surest is a copay-only health plan, with no deductibles or coinsurance, allowing members to see what services will cost in advance through listed copayment amounts. This design gives members clearer cost information before receiving care and helps reduce uncertainty at the point of care.
Also available within the Surest app are Surest Care Ratings, which reflect a provider’s historical effectiveness and cost efficiency for a specific service. Plus, for services that have variable copays, providers with higher Surest Care Ratings are assigned lower copays. These ratings alongside the listed copays can help members compare care options and support more confident choices.
When members have clearer upfront information, engagement tends to follow. In fact, 89% of households with a claim registered on the Surest app, and 70% searched for care options before receiving treatment.2 Members averaged 9.6 app sessions per household, suggesting repeated engagement rather than one‑time use,3 and those who shopped for more than half of their care cost 23% less than members using the same services on a traditional plan.4
From a utilization perspective, Surest members also had 15% fewer surgeries and 8% fewer emergency room (ER) visits.5 And employers with 10% plan savings reduced member out-of-pocket costs by an average of 30%.6
Surest proves that, with clear information and simple tools, both employers and employees can see better results:
Thunderdome Restaurant Group, a Cincinnati-based restaurant company, turned to Surest for a broad national network, upfront pricing and a copay-only design that fit the needs of its workforce without raising costs. The result was strong digital engagement and 18% lower allowed medical costs per member per month.
A large medical tech company wanted a better health plan at a lower cost for both the business and employees. After offering Surest, the company saw 15% lower total cost of care, reduced employee out-of-pocket spending by 60% and saw strong satisfaction driven by simpler, more predictable benefits.
Dayton Children’s Hospital, based in Ohio, chose Surest to support its worry-free philosophy by giving employees immediate access to benefits without a deductible and clearer cost information up front. With strong support during rollout and easy price comparisons, employees embraced the plan, with 83% selecting some of the most cost-efficient care options.
ISG, an employee‑owned architecture and engineering firm, introduced the Surest health plan as a copay‑only option to complement its existing coverage and bring a more transparent, easy‑to‑use experience to employees. By prioritizing upfront cost clarity and simpler navigation, ISG aimed to improve access to care and support a more engaged, informed workforce.
Cumberland School District, based in northwestern Wisconsin, needed a better way to manage rising health plan costs without compromising benefits for staff. After moving its full workforce to the Surest plan, the district reduced projected medical costs by $700,000 — freeing up budget for priorities like staff pay and facility needs.
Surest, designed for what’s next
As demand for copay‑based plans continues to grow, solutions like Surest reflect a broader movement toward value‑driven, transparent benefit design. For employers navigating cost pressures and changing workforce expectations, plans that help improve predictability, guide care decisions and reward efficiency offer a path beyond short‑term cost containment.
Rather than replacing traditional offerings, copay‑based plans can complement an employer’s broader benefits strategy, giving organizations more flexibility to meet diverse workforce needs while supporting long‑term sustainability.
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