Avera eCare

What Avera eCare does

Avera Health Plans operates as the health insurance subsidiary of Avera Health, distributing Individual & Family Plans, Medicare Supplement Insurance, and Employer Group Plans across South Dakota, Iowa, and Nebraska. The company serves three primary customer segments: individuals and families (including Federal Marketplace enrollees), Original Medicare beneficiaries seeking supplemental coverage, and employer groups ranging from 2-person businesses to enterprises with 1001+ employees. Distribution is hybrid: a 642+ licensed insurance agent network across the Upper Midwest provides in-person and phone-based consultation, complemented by online quote tools, the Federal Health Insurance Marketplace, and self-service portals. Premium revenue is recurring on a monthly billing cadence; pricing is quote-based and not publicly disclosed.

The company's technology backbone is Epic, implemented in May 2026 to consolidate legacy patient and member systems into a unified platform. Three interconnected Epic-based portals anchor the digital surface: Avera MyChart serves as the combined member/patient portal (claims, coverage, digital ID cards, scheduling, messaging, virtual visits), Avera System Link provides the provider portal for claims, eligibility, and prior authorization, and Employer Link centralizes employer administration (enrollment, billing, eligibility, rosters). The pharmacy benefit integrates with a 56,000+ network pharmacy base plus Amazon Pharmacy and Mark Cuban Cost Plus Drug Company as cost-transparency options.

Commercially, Avera Health Plans leverages its parent system integration and a UnitedHealthcare Options PPO agreement to provide members access to 1.3 million providers and 6,500 hospitals nationwide. The company has served Midwest communities for more than 25 years and, as of 2026, expanded coverage into northwest Iowa and northeast Nebraska. Revenue, ownership transfer history, and external funding are not publicly disclosed in the source material beyond a 2018 $7.8M grant from The Leona M. and Harry B. Helmsley Charitable Trust. Deanna Larson is identified as Chief Executive Officer.

Name

Avera eCare

Legal name

Avera Health Plans

Website

https://www.averaecare.org/ecare/

Company type

Private

Founded year

1993

Operating status

Operating

Headcount range

101–250 employees

Short description

Avera Health Plans is a regional health insurance subsidiary of Avera Health offering Individual & Family Plans, Medicare Supplement insurance, and Employer Group Plans to residents and businesses in South Dakota, Iowa, and Nebraska through licensed agents, online portals, and the Federal Marketplace.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Insurance Carriers (5241)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)

akta.pro primary industry

ACA Marketplace (On-Exchange) Individual Plans (FSAIAEAA)

akta.pro secondary industries

Off-Exchange Individual & Family Plans (HLAEABAB), Off-Exchange Individual Major Medical Plans (FSAIAEAB), Ancillary & Supplemental Health Products (Accident/Critical Illness/Hospital Indemnity) (HLAEABAJ)

Keywords

• Health insurance plans
• Medicare supplement insurance
• Employer group coverage
• Individual family plans
• Pharmacy benefits management

Headquarters

HQ city

Sioux Falls

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Individual & Family Insurance Premiums: Monthly premium payments from individuals and families purchasing health insurance coverage. Premiums vary by plan type (bronze, silver, catastrophic), deductible levels, and coverage options. Revenue is recurring on a monthly or annual basis.
2. Medicare Supplement Premiums: Monthly premium payments from Medicare beneficiaries supplementing Original Medicare coverage. Plans include Standard and Select options with varying network restrictions.
3. Employer Group Premiums: Monthly premium payments from employer groups providing health insurance to employees. Employers typically deduct premiums through payroll. Coverage for groups ranging from 2 employees to 1001+ employees.

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels6 records

Core offering

Avera eCare, through its Avera Health Plans subsidiary, sells health insurance products including Individual & Family Plans, Medicare Supplement Insurance, and Employer Group Plans across South Dakota, Iowa, and Nebraska. Members access their coverage via the Epic-based Avera MyChart portal, providers use Avera System Link for claims and eligibility, and employers use Employer Link for enrollment and billing administration. The company also provides Avera Health Plans Rx pharmacy benefits integrated with national and online pharmacy networks.

Product overview

Avera Health Plans operates as the insurance subsidiary of Avera Health, offering a portfolio of health insurance products including Individual & Family Plans, Medicare Supplement Insurance, and Employer Group Plans across South Dakota, Iowa, and Nebraska. The company's digital ecosystem consists of three interconnected core platforms: Avera MyChart serves as the unified member and patient portal combining insurance benefits with health information; Avera System Link provides the provider portal for claims, authorizations, and eligibility; and Employer Link enables employer administration of enrollments and payments. The subsidiary's pharmacy benefits integrate with external pharmacies including Amazon Pharmacy and Mark Cuban Cost Plus Drug Company, while all portals transitioned to Epic's platform in May 2026.

Differentiator

Problem solved

Functional benefit

Products and services

• Individual & Family Plans

Quantifiable outcome

• Network of 1.3 million providers and 6,500 hospitals nationwide through UnitedHealthcare Options PPO
• +1 more outcomes

Segments3 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration7 records

Feature4 records

Partnerships

Two partnerships are on record, tiered core.

• Epic SystemscoreTechnology or Integration · 1 May 2026Epic provides the electronic health record (EHR) and health plan management systems powering Avera MyChart, Avera System Link, and Employer Link portals. The May 2026 transition unified patient health records with insurance member functions.
• UnitedHealthcarecoreTechnology or IntegrationUnitedHealthcare Options PPO provides Avera Health Plans members with national network access to 1.3 million providers and 6,500 hospitals. This partnership extends coverage for members traveling outside the Avera service area or with dependents living in other regions.

Scale indicators4 records

Recent moves10 records

Expansion highlights5 records

Direct peers

• Medica: Upper Midwest-focused health plan offering individual ACA, Medicare, and employer group coverage across Minnesota, Iowa, Nebraska, and the Dakotas — directly comparable multi-product regional carrier operating in Avera's footprint and adjacent markets.
• HealthPartners: Minnesota-based integrated payer-provider offering individual, Medicare, and employer group plans — comparable regional health plan with a vertically integrated care delivery model similar to Avera's Avera Health integration.
• Blue Cross and Blue Shield of Nebraska: Nebraska's dominant Blue Cross licensee selling individual, Medicare Supplement, and employer group plans — competes directly with Avera Health Plans in Nebraska with comparable products and a similar regional carrier profile.
• Sanford Health Plan: Regional health insurer owned by Sanford Health operating in the Dakotas and surrounding states, offering ACA individual, Medicare Supplement, and employer group plans — the closest head-to-head comparable to Avera Health Plans in geography, product mix, and vertically integrated payer-provider model.
• Wellmark Blue Cross Blue Shield: Iowa- and South Dakota-licensed Blue Cross Blue Shield carrier offering individual, group, and Medicare Supplement coverage — directly competes with Avera Health Plans in the same geographies with overlapping product lines and similar regional mid-market positioning.

Emerging players

• Oscar Health: ACA Marketplace-focused insurtech selling individual and small group plans with a technology-led member experience — competes for the same Individual & Family customers as Avera Health Plans, particularly in Iowa and Nebraska where Oscar has expanded exchange footprint.

Broad incumbents

• Humana: National health insurer and Medicare Advantage/Supplement leader — competes across Avera's individual and Medicare Supplement product lines at greater scale and broader geographic reach, exerting pricing and network pressure on regional carriers.
• Cigna: Global health services company offering individual, Medicare Supplement, and employer group plans — competes with Avera in the employer group and individual segments, with materially larger scale and broader network leverage.
• UnitedHealthcare: Largest U.S. health insurer and Avera's national-network partner via the Options PPO arrangement — sets competitive benchmarks across individual, Medicare, and group segments while also providing Avera's out-of-area network access.
• Elevance Health (Anthem): National Blue Cross Blue Shield-licensed carrier selling individual ACA, Medicare, and employer group products across most U.S. states — competes with Avera in overlapping geographies and benefits from significantly larger scale on PBM and provider contracting.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Facebookfacebook.com/AveraHealthPlans
• LinkedInlinkedin.com/company/avera-health
• YouTubeyoutube.com/user/AveraHealth

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Avera eCare