2026 Rate Changes - South Dakota: +5.3% (unweighted), but up to ~54,000 enrollees are still likely looking at MASSIVE rate hikes

Overall preliminary rate changes via SERFF database, South Dakota Insurance Dept. and/or the federal Rate Review database.

Avera Health Plans:

(Unfortunately, Avera hasn't provided a justification summary and has almost completely redacted their actuarial memo, making it impossible for me to know what their current enrollment is; see below)

Sanford Health Plans:

(Unfortunately, Avera hasn't provided a justification summary and has almost completely redacted their actuarial memo, making it impossible for me to know what their current enrollment is; see below)

Wellmark BCBS:

(Unfortunately, Avera hasn't provided a justification summary and has almost completely redacted their actuarial memo, making it impossible for me to know what their current enrollment is; see below)

(sigh) This is the first state I've run into where I'm unable to find either the actual current enrollment or even make an educated guess as to what it is for any of the carriers on the individual market. All three of them have heavily redacted their memos, and none of them have provided a rate justification summary (which usually includes the current enrollment figure).

In addition, while I know that total on-exchange enrollment is around 54,000, I can't really guess at off-exchange since even the 2024 CMS liability risk score report doesn't include off-exchange member months for South Dakota.

As a result, I can only provide the unweighted average increase, which is a relatively modest 5.3%. The carriers range between 1.2% - 8.9%, so the weighted average has to fall somewhere within that range.

HOWEVER, It's important to remember that this is for unsubsidized enrollees only; for subsidized enrollees, ACTUAL net rate hikes will likely be MUCH HIGHER for most enrollees due to the expiration of the improved ACA subsidies & the Trump CMS "Affordability & Integrity" rule changes.

I also have no enrollment data for the small group carriers; the unweighted average 2026 rate hike for them is a similarly modest 5.7%, ranging between 1.8% - 11.2%.