Medical/Rx Benefits

South Dakota Medical/Rx Benefits Benchmarks

Real plan data from verified employers in your state

Verified Data
165Employers
514Plans
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Source-verified plan dataReal plans, not surveysRefreshed monthly
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Employee Benefits in South Dakota

Medical plan benchmarks from verified employer data

Verified Data

Medical benefits typically represent the largest share of employer benefit spending and are a key factor in employee recruitment and retention.

Our database includes 165 employers in South Dakota offering 514 verified benefit plans. PPO plans are the most common (46% of employers), followed by HDHP (42%). Funding approaches are mixed, with self-insured (51%) and fully-insured (41%) both common. Most employers offer three or more plan options to employees (57%).

Medical plan benchmarks include deductibles, copays, coinsurance, out-of-pocket maximums, and employer contribution rates.

165 employers514 verified plansUpdated September 2026
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South Dakota plan design & cost benchmarks

In-Network Cost Sharing — sample layout
In-Network Benefits
LimitedBalancedRobust
Your Plan
Individual Deductible
$544
$1,375
$2,616
$1,37552Bal
Family Deductible
$1,968
$3,278
$5,416
$3,27852Bal
Individual OOP Max
$3,698
$5,552
$6,629
$5,55252Bal
Family OOP Max
$7,165
$9,126
$12,426
$9,12652Bal
Coinsurance
13%
21%
29%
21%52Bal
Primary Care
$20
$35
$50
$3552Bal
Specialist
$35
$49
$67
$4952Bal
Emergency Room
$217
$371
$470
$37152Bal
Urgent Care
$55
$78
$90
$7852Bal

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Real plan-design and cost benchmarks for south dakota, with percentile rankings and exportable data.

What's inside the full report
In-Network Cost Sharing

Deductibles, copays, coinsurance & out-of-pocket maximums

Employee Contributions

Monthly employee premium contributions by tier

Gross Premium Rates

Total monthly premium costs by coverage tier

Prescription Drug Coverage

Rx copays, deductibles & mail-order options

Percentile rankings (25th / 50th / 75th)
Live, real-time data (this preview refreshes monthly)
Exportable to PDF & CSV

Plan Type Mix

% of employers offering each

VERIFIED
PPO46%
HDHP42%
HMO4%
POS4%

Plan Funding

% of employers by funding

VERIFIED
Self-Insured51%
Fully-Insured41%
Level-Funded8%

Plans Offered

% of employers by plan count

VERIFIED
Three or More Plans57%
Two Plans34%
One Plan9%
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See What You'll Discover

Our reports reveal exactly where your plan stands, and why. Preview using sample South Dakota data.

72
Balanced
Sample Report
Sample PPO Gold 1500
Blue Cross Blue Shield · PPO

This plan aligns well with common market practices. Benefits and costs are competitive, providing reliable value that meets typical employer offerings in your segment.

Based on 847 comparable plans
Core Scoring Drivers
In-Network Cost Sharing78Robust

Deductibles and copays rank above market median, offering strong value to employees.

Employee Contributions65Balanced

Contribution levels are competitive with peer employers in your industry.

Premium Rates71Balanced

Gross premiums align with market expectations for comparable coverage.

Plan Types
PPO
42%
HDHP
31%
HMO
18%
POS
9%

% of employers

Plans Offered
2 Plans
38%
3 Plans
29%
1 Plan
22%
4+ Plans
11%

% of employers

Funding Types
Fully Insured: 58%
Self-Funded: 34%
Level-Funded: 8%
Top Performers

Features in top 25% of peers

Individual Deductible82Robust
In-Network Cost Sharing
Primary Care Copay79Robust
In-Network Cost Sharing
Generic Rx Copay77Robust
Prescription Drugs
Individual OOP Max76Robust
In-Network Cost Sharing
Under Performers

Features in bottom 25% of peers

Family Premium18Low
Gross Premium Rates
EE+Spouse Contribution21Low
Employee Contributions
Specialist Copay24Low
In-Network Cost Sharing
Actionable Insight

Family Premium ranks in the 18th percentile. Adjusting employer contribution strategy could improve retention without significant cost increases.

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