Codington County Reviews 23% Health Insurance Increase, Considers Sanford True Network to Lower Employee Premiums
Northeast Radio SD News – Watertown, SD - Codington County Commissioners spent more than an hour Tuesday morning reviewing projected 2027 employee health insurance costs, receiving what one presenter bluntly described as “not good news” regarding next year’s premium increases. Representatives from Kranz Insurance, Sanford Health Plan, and Graber & Associates outlined a 23 percent renewal increase driven by rising claims and several high‑cost cases.
The discussion brought four representatives to the table: Ray Kranz and Jamie Riley of Kranz Insurance; Julia Andresen and Joe Weber of Sanford Health Plan; and Stephen Brua of Graber & Associates. Chair Troy VanDusen opened the item by asking presenters to identify themselves and activate microphones.
Kranz began with a three‑year claims history that set the tone for the conversation.
“If you look there, the first column, there’s $1.4 million worth of claims… the second year from ’24 to ’25, $1.3 million… and the third year, which is this year, we’ve got about $1.44 million worth of claims again,” Kranz said. “We’re bringing in about projected about for next year, about $1.2 million. They feel like they have to… a 23% rate increase for next year.”
Kranz told commissioners that while the increase is significant, the county does have a potential cost‑saving option: the Sanford True network, a narrower provider network that became more viable locally after Sanford acquired Prairie Lakes Hospital last year.
Sanford True Network Could Reduce Employee Premiums
Kranz explained that employees would have a choice between staying on the current Sanford Signature plans or switching to the Sanford True network. The True option restricts care to Sanford facilities and participating providers, but offers substantially lower premiums.
“If an employee decides they want to take the True option… instead of 1444, the single rate would be 1158.62,” Kranz said. “Family rate would be 2896… it’s almost a 23 to 24 percent decrease by taking the True.”
Sanford’s representatives confirmed that prescription coverage and formularies remain identical between Signature and True.
“It’s pretty much going to be all the same pharmacies, all the same medications,” Andresen said. “It’s just a more narrow provider directory.”
However, the True network does not include out‑of‑network coverage except for emergencies.
“There’s no out‑of‑network benefits,” Andresen said. “If they travel or if they’re seeking care at Mayo… they’re going to have to pay those claims out of network.”
Commissioners asked how often Sanford approves referrals to outside specialists.
“If Sanford feels that we don’t have the specialty or a facility that can cover it, they will refer approval,” Andresen said. “On the True network, it’s pretty low.”
Chiropractor Coverage Was a Concern — But Providers Are Joining
One early drawback of the True network was the absence of chiropractors. Riley told commissioners that Kranz Insurance has already begun working with local providers to expand participation.
“The downfall of this network was there’s no chiropractors,” Riley said. “I reached out… and she goes, ‘Yep, we’re effective 10/1.’ We’ll probably just make our rounds to the chiropractors and let them know that this network is starting to grow.”
Riley noted that other Watertown employers — including First Premier and Sharp Automotive — have already adopted the True network, prompting more providers to join.
County’s Long‑Standing Subsidy Formula Still Applies
Commissioner Lee Gabel asked for clarification on how the county’s HSA subsidy calculations work under the new rates. Kranz walked commissioners through the county’s established formula, which applies a 5 percent employer contribution toward annual increases.
“You’ve always agreed… to pay 5% of the increase every year,” Kranz said. “5% of the 23 is equal to 21.74%. The new single premium minus the current premium is an increase of $270… your new subsidy is 1134.”
Kranz emphasized that the county’s subsidy structure remains intact regardless of whether employees choose Signature or True.
Commissioners Want Employee Input Before Making a Decision
Commissioners agreed no action would be taken Tuesday. Chair VanDusen said the board needs time to review the information and gather feedback.
“We don’t have to… but soon,” VanDusen said.
Commissioner Myron Johnson noted that employees should have an opportunity to weigh in.
“It’d be kind of nice if we could have some input from our employees too,” Johnson said. “See how they feel and what their thoughts are.”
Kranz encouraged commissioners to make a decision before November 1, giving employees time to review provider directories, consider HSA contributions, and receive new ID cards if they switch networks.
“The sooner you decide, the sooner they can make a decision,” Kranz said. “That helps Brenda a lot.”
No Action Taken; Further Discussion Expected
“We do appreciate you digging into it and finding out what you can do for us,” VanDusen said.
The board is expected to revisit the issue later this fall as part of its 2027 budget and benefits planning.
