Medical Loss Ratio · South Dakota · 2024 reporting year · Wellmark Group
Wellmark Blue Cross and Blue Shield of South Dakota
In South Dakota, over the three-year window through 2024, Wellmark Blue Cross and Blue Shield of South Dakota spent 94.8% of individual premiums on care, 87.4% of small group premiums on care, and 91.2% of large group premiums on care (its Medical Loss Ratio). It met the 80/20-rule floor in every market, so no rebate was owed.
Where each premium dollar went
The filled bar is the share of premiums spent on medical care + quality improvement — the three-year Medical Loss Ratio. The marker is the legal floor for that market (80% individual & small group, 85% large group). Below the floor, the insurer rebates the shortfall (floor − MLR), applied to that year's premium.
See what Wellmark Blue Cross and Blue Shield of South Dakotasells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all South Dakota marketplace plans. Complaint counts and loss ratios for Wellmark Blue Cross and Blue Shield of South Dakota (NAIC 60128) are on its carrier quality profile.
RECORDED — the Medical Loss Ratio, the 80/85% standard, premium earned, and the rebate owed are CMS-published figures (the 2024 MLR reporting year, a three-year window through 2024; rebates are paid the following year). DERIVED — rebate as a share of premium, and the rebate per enrollee (rebate ÷ member-years).
Machine-readable: JSON-LD · Markdown · Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year
What this is — and is not
This is how Wellmark Blue Cross and Blue Shield of South Dakota spent premium dollars across its entire South Dakota book in each market — it is not a measure of a specific plan's quality, your denial odds, or whether the insurer is right for you, and it is not advice. A rebate, if owed, is a rule-based payment to policyholders (a check or premium credit) the following year. To compare plans, check eligibility, and enroll, go to HealthCare.gov.