Codington County Renews Sanford Health Plan for Employees Despite 23% Standard Rate Increase

Northeast Radio SD News – Watertown, SD - After postponing a vote for one week to gather employee union feedback and compare competing insurance proposals, the Codington County Board of Commissioners voted unanimously Tuesday, Oct. 27, 2026, to remain with Sanford Health Plan for county employee health insurance.

The approved renewal retains both the Sanford Standard and Sanford True health insurance plans, which together provide county employees with six different coverage options. At the board’s Oct. 20 meeting, commissioners initially considered a motion to stay with Sanford before Commissioner Lee Gabel moved a substitute motion, seconded by Commissioner Myron Johnson, to delay the final decision until Oct. 27.

Codington County Chairman Troy VanDusen noted Tuesday that the one-week delay allowed the county’s employee unions to review the proposals and submit input through Human Resources Representative Natalie Remund.

“We did receive some feedback from the different unions on this, so we did give them time to offer their feedback to us through the Human Resources Department,” VanDusen said.

Gabel, who condensed Remund’s comparison spreadsheet by deductible level and single-versus-family coverage for the board’s review, said the Sanford proposal continued to offer the broadest range of choices for county staff. While the Sanford Standard plan carries a price increase, the Sanford True plan offers a lower-cost alternative without out-of-network coverage.

"So what to me it looks like still at this point, the most options would probably be the Sanford offer, which includes both the Sanford Standard with the concerning price increase, and then the Sanford True that doesn’t have the out-of-network option,” Gabel said.

Gabel also compared the Sanford renewal against competing quotes, including an Avera plan submitted through insurance broker Bulldog and options involving a supplemental gap plan. He noted that the Avera broad-network option was the most expensive proposal without a gap plan, and said the county was not yet in a position to implement a gap-plan structure.

"Actually, the most expensive one was that one of the insurance brokers, Bulldog, had the Avera one—that's an Avera plan that covers, it's kind of like a Blue Cross thing, it would work everywhere—that turned out to be the most expensive one, so that's without the gap plan," Gabel said. "I personally don't think we should wade—we're not ready to deal with the gap plan yet because that's a more complicated kind of setup as far as I can tell."

23% Standard Rate Increase, High-Deductible HSA Options and Wellmark Contract Notice

Gabel moved to approve the Sanford plan, encompassing both Sanford Standard and Sanford True, and Commissioner Tyler McElhany seconded.

During discussion of the motion, Gabel noted that while rates for the Sanford Standard plans rose about 23% from last year, the high-deductible health plan (HDHP) options paired with a Health Savings Account (HSA) remain competitive at the $4,000 single and $8,000 family deductible tiers.

"So you see the Sanford, you know, the standard rates did go up—I think we're told that's about a 23% increase from last year, so that's a little bit concerning," Gabel said. "However, the high-deductible plan, which would include the ability to have an HSA, that's competitive. So that's on the family side, that's with the $8,000 deductible, and on the single employee side, that's with the $4,000 deductible. So I think we've done as much diligence as we can."

Gabel also pointed out another factor weighing against switching to a Blue Cross Blue Shield plan this cycle: a notice on Sanford’s website stating that the network agreement between Wellmark Blue Cross and Blue Shield and Sanford is currently scheduled to terminate July 1, 2027.

"The other thing I would note is that Blue Cross and Blue Shield—so it's on Sanford's website—that agreement between Wellmark Blue Cross and Sanford is scheduled to terminate the first of July next year, so less than a year from now," Gabel said. "I think that still can turn out differently, but at this point we don't know."

With no further discussion, the commission voted unanimously to approve the Sanford health insurance proposal.