Who is leaving, what's left in your county, and what to do before the deadline. Last checked October 5, 2026.
No major insurer is leaving the South Dakota marketplace for 2027.
In 2026, 3 companies sold South Dakota marketplace plans: Avera Health Plans, Sanford Health Plan and Wellmark of South Dakota, Inc..
Hi, I'm Sam Jaber, a licensed broker, and South Dakota is one of the 36 states I hold a license in. Here's the short version for South Dakota: I found no insurance company leaving the marketplace for 2027.
I didn't take that on faith. South Dakota's marketplace has three companies, Avera, Sanford and Wellmark, and I looked for a 2027 individual rate filing from each one on the federal rate review site. All three filed. None of the 2026 exits I track touched South Dakota either, so nobody here is carrying a forced move over from last year.
That doesn't mean your plan comes back unchanged. A company that stays can still retire a specific plan, trim a network, or redraw where it sells. When a plan goes away but the company stays, the federal rule says the marketplace will move you into another plan from that same company, if state law allows. That new plan may not match your old one, so the letter you get by November 1 deserves a real read.
Choice in South Dakota is thin to begin with. In 2026, 24 counties had only 2 marketplace companies, and that list includes Minnehaha and Lincoln, which is Sioux Falls and its suburbs, plus Pierre, Aberdeen, Mitchell and Yankton. Rapid City's Pennington County had all 3. With so few names on the list, any shift in a network carries extra weight.
Think about a rancher outside Pierre whose clinic is in Hughes County and whose specialist is in Sioux Falls. If either of those offices changes which plans it takes for 2027, the rancher has one other company to try, not five. The time to ask both offices is late October, when the 2027 plan list publishes, not the week before December 15.
On PPOs, South Dakota is in decent shape. Avera and Sanford both sold marketplace PPO plans in every county in 2026. If you're healthy and over the tax credit line, a nationwide private PPO through me is still worth pricing next to them.
No South Dakota county loses a marketplace insurer for 2027 from what I checked.
On the marketplace, PPO plans were sold in 66 of South Dakota's 66 counties in 2026. They come from Avera Health Plans and Sanford Health Plan.
When an insurance company leaves, your plan doesn't stop overnight. It runs through December 31, 2026, and the company has to tell you in writing first. Federal rules require at least 90 calendar days notice when a company drops a plan, and at least 180 calendar days when it leaves a state's individual market entirely. If your company is leaving and you haven't seen that letter, call the company and ask for it.
What happens next is the part people get wrong. If no plan from your company is left on the marketplace, the federal rule (45 CFR 155.335) says the marketplace may move you to a plan from a different company. It doesn't say it will. The move has to fit state law, it follows the state regulator's direction, and without that direction the marketplace picks a "similar" plan. Nothing in that rule checks your doctors or your prescriptions.
If you bought your plan straight from the company, off the marketplace, the marketplace's re-enrollment rule doesn't reach you at all. You need to pick a new plan yourself.
Open enrollment on HealthCare.gov starts November 1. By then you should get 2 letters: one from your current company and one from the marketplace. The marketplace letter tells you which plan, if any, you'll be moved into if you do nothing by December 15. HealthCare.gov is plain that in some cases you won't be automatically re-enrolled.
Pick by December 15 and your new plan starts January 1. Pick between December 16 and January 15 and it starts February 1, which leaves January uncovered if your old plan ended December 31.
Miss open enrollment and you may still have a way in. Losing a plan because it's discontinued is on HealthCare.gov's list of qualifying events, and the federal rule gives you 60 days before and 60 days after the day your old coverage ends to pick a new plan. Don't build your plan around that window. Confirm you qualify before you count on it.
Here's how I'd think about it, depending on where you are. Each path ends the same way: a call with me before the deadline.
If you earn too much for the credit, you're paying the full marketplace price, and now you're paying it for whatever is left in your county. You have another option. Private plans with medical underwriting run on nationwide PPO networks and are priced on your health, which is how the price for a healthy person can come in under the marketplace's full rate. They ask health questions up front, and the company can decline you or leave out a past condition, so we go through the details together before you choose.
Next step: Call me and I'll price a nationwide PPO for your household next to the South Dakota marketplace plans in your county.
Whatever the marketplace looks like in your county, you can still get a nationwide PPO in South Dakota through me. On the marketplace, PPO plans were sold in 66 of South Dakota's 66 counties in 2026. They come from Avera Health Plans and Sanford Health Plan.
Private PPO plans with medical underwriting use networks that work across the country, and for a healthy person who pays full price on the marketplace, they're often worth pricing. I'm licensed in 36 states, and South Dakota is one of them.
Straight answers, no sales pitch.
No major insurer is leaving the South Dakota marketplace for 2027. Every company that sold South Dakota marketplace plans in 2026 has a 2027 rate filing on the federal rate review site.
Maybe, but don't count on it. The federal rule says the marketplace may move you to a similar plan from a different company, as state law and your state regulator allow. HealthCare.gov says that in some cases you won't be automatically re-enrolled, and if you bought off the marketplace, nobody moves you. Pick your own plan.
On HealthCare.gov, pick by December 15 for coverage that starts January 1. Open enrollment runs to January 15, but a plan picked after December 15 starts February 1.
Yes. You can still get a nationwide PPO in South Dakota through me. On the marketplace, PPO plans were sold in 66 of South Dakota's 66 counties in 2026. They come from Avera Health Plans and Sanford Health Plan.
Last checked October 5, 2026. I update this page when the 2027 plan list publishes in late October.
Tell me your county, who's on your plan and what your letter says. I'll show you what's left on the South Dakota marketplace, price a nationwide PPO next to it, and help you pick before the deadline. I'm licensed in 36 states and work by phone.
Every state on the list, and guides for South Dakota