The broadest provider network in the area
The Wellmark Blue PPO℠ Network provides the broadest provider access in the market with an extensive statewide network and a national network through the BlueCard® PPO program. This gives your employees access to more than 2 million unique, in-network providers.
Wellmark blue ppo network
100% of hospitals and 95% of physicians in South Dakota, which equates to more than 6,000 South Dakota providers.
The national network covers 96% of hospitals and 95% of doctors.
International coverage through Blue Cross Blue Shield Global® Core.
Choose up to three plans
These Wellmark plans keep your employees healthier and more productive while reducing costly issues like missed workdays and employee turnover.
Premier Plan
Our richest plan with the lowest deductibles and out-of-pocket maximums.
Deductible
$2,000 Single / $4,000 Family
Out-of-Pocket Maximum
$6,500 Single / $13,000 Family
Coinsurance
50%
Doctor On Demand Copay
$10
Office Visit Copays
$50 Primary / $100 Specialist
Emergency Room Copay
$400
Pharmacy Copays - Blue Rx Value Plus
$20 / $40 / $80 / $200 / $250
Summary of Benefits & Coverage
Aug 2025-July 2026 / Aug 2026-July 2027
Traditional Plan
Our most popular plan offering the lowest copays for office visits and Rx.
Deductible
$3,500 Single / $7,000 Family
Out-of-Pocket Maximum
$7,200 Single / $14,400 Family
Coinsurance
40%
Doctor On Demand Copay
$10
Office Visit Copays
$35 Primary / $75 Specialist
Emergency Room Copay
Deductible / Coinsurance
Pharmacy Copays - Blue Rx Value Plus
$15 / $50 / $70 / Deductible & Coinsurance
Summary of Benefits & Coverage
Aug 2025-July 2026 / Aug 2026-July 2027
Global Plan
A competitive plan with higher deductibles and out-of-pocket maximums.
Deductible
$5,000 Single / $10,000 Family
Out-of-Pocket Maximum
$8,150 Single / $16,300 Family
Coinsurance
50%
Doctor On Demand Copay
$10
Office Visit Copays
$75 Primary / $125 Specialist
Emergency Room Copay
$400
Pharmacy Copays - Blue Rx Value Plus
$30 / $80 / $200 / $300 / $400
Summary of Benefits & Coverage
Aug 2025-July 2026 / Aug 2026-July 2027
HDHP One Plan
Our most popular high-deductible health plan.
Deductible
$6,900 Single / $13,800 Family
Out-of-Pocket Maximum
$6,900 Single / $13,800 Family
Coinsurance
0%
Doctor On Demand Copay
$10
Office Visit Copays
Deductible
Emergency Room Copay
Deductible
Pharmacy Copays - Blue Rx Value Plus
Deductible
Summary of Benefits & Coverage
Aug 2025-July 2026 / Aug 2026-July 2027
HDHP Two Plan
The lowest monthly premium plan with more up-front medical cost-share.
Deductible
$7,450 Single / $14,900 Family
Out-of-Pocket Maximum
$7,450 Single / $14,900 Family
Coinsurance
0%
Doctor On Demand Copay
$10
Office Visit Copays
Deductible
Emergency Room Copay
Deductible
Pharmacy Copays - Blue Rx Value Plus
Deductible
Summary of Benefits & Coverage
Aug 2025-July 2026 / Aug 2026-July 2027
*This is a general summary of coverage. Please reference the Summary of Benefits & Coverage and Coverage Manual for more detailed information.
wellness benefits included with all sdhba plans
Built-in tools, programs, and select services at no additional cost.
$10 Doctor On Demand®
Connect face-to-face with a board-certified doctor from virtually anywhere using a smartphone, tablet, or computer.
myWellmark® Benefits
Your personal account to access all your health insurance information anytime online.
Preventive Care
Routine health care services that prevent illness, disease, or other health problems before symptoms occur.
Blue365® Program
This program gives employees exclusive access to discounts and resources that help them live a healthier lifestyle.
Wellmark Connect powered by WebMD®
Personalized content on mental health, nutrition, exercise, and more.
BeWell 24/7®
Get connected to a real person 24/7 for answers to your health questions or concerns.
Identity Protection Services
With IDX Identity, your personal information remains secure with services including credit record monitoring.
Pregnancy Support
Get resources to help you have a healthy, stress-free pregnancy.
More doctors in sd than any other vision plan
Optilegra is accepted at over 150 in-network providers and is the only vision plan that gives employees the flexibility to choose the coverage that best fits their individual needs.
LASIK Discounts with South Dakota Ophthalmologists
Each plan offers a $600 discount on LASIK surgery at Vance Thompson Vision or Black Hills Regional Eye Institute, and post-op with any Optilegra provider.
Platinum 180 Plan
Frequency
Eye Exam Every Year / Glasses Every Year
Allowances
$180 Frame / $180 Contacts
Eye Exam Copay
$25
Glasses Copay
$25
Contact Lens Copay
$0
Gold 160 Plan
Frequency
Eye Exam Every Year / Glasses Every Year
Allowances
$160 Frame / $160 Contacts
Eye Exam Copay
$25
Glasses Copay
$25
Contact Lens Copay
$0
Silver 100 Plan
Frequency
Eye Exam Every Year / Glasses Every Two
Allowances
$100 Frame / $105 Contacts
Eye Exam Copay
$25
Glasses Copay
$25
Contact Lens Copay
$0
Design an entire benefits package for your employees
Work with your chapter agent to create or refine a comprehensive employee benefits package aimed at improving retention and attracting top talent.
-
Group life insurance provides affordable financial protection for employees’ families, boosts job satisfaction, and helps employers offer valuable benefits. It is also flexible, allowing employees to add optional coverage to fit their needs.
-
Group disability plans offer flexible coverage that can integrate with other benefits. They replace part of an employee’s income during illness or injury, providing financial stability.
-
Accidental injury, cancer, critical illness, and hospital indemnity plans provide added financial protection for unexpected health events. These benefits help offset out-of-pocket costs associated with injuries, serious diagnoses, or hospital stays by paying cash benefits directly to an employee.
-
Group dental plans make it easier and more affordable for employees to maintain oral health by covering preventive and major care. Dental coverage helps pay for routine preventive care, such as cleanings and exams, as well as more extensive procedures when needed.