South Dakota employer health plans: what they cost and who gets paid
Updated plan year 2024, the most recent complete year
164 South Dakota employers filed health plans with 100 or more participants for plan year 2024, covering 68,188 participants. They reported $185M in insurance premiums and $8.3M in broker commissions and fees. The median broker rate on commission-paying, fully insured medical plans was 1.6% of premium, 2.1 points below the national median of 3.8%.
Largest brokers
Reported commissions and fees, with the number of employer plans naming each.
Largest medical carriers
Medical premium written.
Cities in South Dakota
Every South Dakota city where 15 or more employers filed a health plan, by the sponsor's mailing address. Each page lists the city's largest plans, brokers and carriers.
| City | Employer plans | Premiums |
|---|---|---|
| Sioux Falls | 68 | $19M |
| Rapid City | 20 | $109M |
Largest employer plans
By health plan participants.
| Employer | City | Participants |
|---|---|---|
| Monument Health, Inc. | Rapid City | 4,494 |
| The Trustees of the South Dakota Bankers Benefit Plan | Pierre | 3,636 |
| Black Hills Corporation | Rapid City | 2,982 |
| Poet, LLC | Sioux Falls | 2,305 |
| Daktronics, Inc. | Brookings | 2,185 |
| Midland National Life Insurance Company | Sioux Falls | 1,988 |
| Poet Holding Company, LLC | Sioux Falls | 1,898 |
| First Premier Bank | Sioux Falls | 1,848 |
| C & B Operations, LLC | Sioux Falls | 1,247 |
| Pathward, National Association | Sioux Falls | 1,192 |
| Primrose Retirement Communities, LLC | Aberdeen | 1,078 |
| Empirical Technology, Inc. | Dakota Dunes | 1,060 |
| Regency Inns Management, Inc. | Sioux Falls | 1,027 |
| Furniture Mart USA, Inc. | Sioux Falls | 869 |
| Medical Facilities (USA) Holdings, Inc. | Sioux Falls | 827 |
| Dakota Turkey Growers, LLC | Huron | 827 |
| Billion Motors, Inc. | Sioux Falls | 773 |
| Coca-Cola Bottling Company High Country | Rapid City | 734 |
| Gpac, LLC | Sioux Falls | 632 |
| Sonifi Solutions, Inc. | Sioux Falls | 621 |
| New Angus, LLC | Aberdeen | 620 |
| Showplace Wood Products, Inc | Harrisburg | 618 |
| Lifescape | Sioux Falls | 606 |
| Dacotah Banks, Inc. | Aberdeen | 606 |
| Performance Bankers, Inc. | Pierre | 600 |
Highest broker pay
Employers reporting the most broker commissions and fees.
Highest commission rates
Fully insured medical plans with at least $500,000 in premium, ranked by broker compensation as a share of premium.
Source: DOL Form 5500 and Schedule A, plan year 2024; built October 24, 2026. Methodology.
What do South Dakota employers pay health insurance brokers?
Across 19 fully insured medical plans in plan year 2024, among commission-paying fully insured medical plans, the median broker compensation for South Dakota employers was 1.6% of premium (middle half 1.3% to 2.3%), against a national median of 3.8%. In dollars, the median employer that disclosed broker pay reported $35,673.
Which South Dakota employers paid the most in broker commissions?
First Premier Bank reported the most in 2024, $426,687, followed by Bankwest, Inc. ($334,062) and Rosenbauer Motors ($317,457).
Which brokers and carriers dominate South Dakota?
By reported compensation, the largest brokers are Marsh McLennan Agency, USI Insurance Services, Lori Lewison. By medical premium, the largest carriers are Wellmark Blue Cross and Blue Shield of South Dakota, Avera Health Plans, Inc., Wellmark Blue Cross and Blue Shield of SD.
Which South Dakota cities have the most employer health plans?
Sioux Falls (68 employer plans, $19M in premiums); Rapid City (20 employer plans, $109M in premiums). 2 South Dakota cities with 15 or more employer plans have their own page listing the largest plans, brokers and carriers.
Is your company on this page? Get its Form 5500 read next to the South Dakota medians.
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