Sanford Health Plan
Sanford Health Plan is a private regional health insurer offering individual, employer, and Medicare Advantage plans across Iowa, Minnesota, North Dakota, and South Dakota, affiliated with the Sanford Health integrated delivery network and leveraging OptumRx, Delta Dental, and licensed agent distribution.
- Company typePrivate
- Founded1997
- HeadquartersSioux Falls, United States
- Headcount101–250
- GTM typeB2B and B2C
- OfferingServices
What Sanford Health Plan does
Sanford Health Plan is a private, for-profit regional health insurance company headquartered in Sioux Falls, South Dakota, founded in 1997 and operating with 101–250 employees. The company offers individual and family ACA-compliant plans, small and large employer group plans including ICHRA arrangements, and Medicare Advantage plans under the Align brand (ChoiceElite HMO, ChoicePlus HMO, and the DUALPartnership D-SNP) in select counties across Iowa, Minnesota, North Dakota, and South Dakota. It is organizationally affiliated with the Sanford Health integrated delivery network and operates as part of a HIPAA-organized healthcare arrangement alongside Security Health Plan, Marshfield Clinic Health System, and The Evangelical Lutheran Good Samaritan Society.
The company's technology stack includes the My Sanford Health Plan member portal, mobile applications with Apple HealthKit and Google Fit integrations, telehealth video visits at $0 cost-share, and CMS-compliant FHIR interoperability APIs (Provider Directory, Patient Access, and Medicare Advantage Formulary). Distribution combines licensed insurance agents, a direct-to-consumer website, healthcare marketplace enrollment, in-person and virtual Medicare seminars, and an agent portal for quoting and enrollment support. Pharmacy benefits are managed through OptumRx, providing access to over 60,000 network pharmacies including preferred partners Lewis Drug, CVS, and Thrifty White.
Revenue is generated primarily through recurring subscription premiums from Medicare Advantage (Parts C and D), ACA marketplace and off-exchange individual/family plans, and fully insured employer group contracts. The company layers additional benefits such as the Healthy Benefits+ Flex Card (OTC, dental, hearing, vision allowances), Delta Dental network access, Silver&Fit fitness benefits, and the Healthy Pathways nurse care coordination program. The go-to-market model spans B2C (direct, agent-assisted, and marketplace), B2B (small and large employer sales), and senior-focused acquisition (Medicare Advantage seminars and licensed agent outreach). No external venture funding, public listing, or M&A activity is evidenced in the source data, and ownership commentary indicates the entity operates within the broader Sanford Health nonprofit health system.
Sanford Health Plan firmographics
Firmographics- Name
- Sanford Health Plan
- Legal name
- Sanford Health Plan
- Website
- https://sanfordhealthplan.com
- Company type
- Private
- Founded year
- 1997
- Operating status
- Operating
- Headcount range
- 101–250 employees
- Short description
- Sanford Health Plan is a private regional health insurer offering individual, employer, and Medicare Advantage plans across Iowa, Minnesota, North Dakota, and South Dakota, affiliated with the Sanford Health integrated delivery network and leveraging OptumRx, Delta Dental, and licensed agent distribution.
- Ownership category
- akta.pro rank
Sanford Health Plan industry classification
Industry- Product category
- Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114)
- SIC
- Accident & Health Insurance (6321)
- akta.pro primary industry
- MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)
- akta.pro secondary industries
- Small Group Health Insurance (2–50/100) (FSAIAFAD), Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE), Off-Exchange Individual & Family Plans (HLAEABAB)
Keywords
Where Sanford Health Plan is headquartered
LocationHeadquarters
- HQ city
- Sioux Falls
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Sanford Health Plan business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Personnel, Operations, Marketing or Sales, Technology or R&D, Infrastructure
Revenue model
- Medicare Advantage Premiums: Revenue from Medicare Advantage (Part C) plan premiums paid by beneficiaries and Medicare, including Part D prescription drug coverage integrated into MA plans
- Individual and Family Health Insurance: Affordable Care Act (ACA) compliant health insurance plans for individuals and families, with coverage options available through healthcare marketplaces and direct purchase
- Employer-Sponsored Health Insurance: Small and large business health insurance plans including ICHRA (Individual Coverage HRA) options for employers to provide health benefits to employees
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Medicare Advantage Plans - $0 preventive care and virtual care |
Go-to-market motion2 records
Distribution channels4 records
Marketing channels5 records
Sanford Health Plan product offering
Product offeringCore offering
Sanford Health Plan is a private regional health insurance company that underwrites and distributes Individual & Family health plans, Small and Large Business group health plans (including ICHRA arrangements), and Medicare Advantage plans (ChoiceElite, ChoicePlus, and Align DUALPartnership D-SNP) in select counties across Iowa, Minnesota, North Dakota, and South Dakota. Members access benefits through digital platforms (member portal and iOS/Android apps with Apple HealthKit and Google Fit integrations), receive $0 preventive care and telehealth visits, and obtain prescriptions through the OptumRx-managed network of 60,000+ pharmacies including home delivery.
Product overview
Sanford Health Plan is a health insurance company offering a comprehensive portfolio of products across individual/family plans, employer group plans (including ICHRA), and Medicare Advantage plans. The core Medicare Advantage offerings include ChoiceElite, ChoicePlus, and the DUALPartnership D-SNP plans, available in select counties across Iowa, Minnesota, North Dakota, and South Dakota. Members access services through digital platforms including the My Sanford Health Plan member portal, mobile apps (with Apple HealthKit and Google Fit integrations), virtual care/telehealth, and the Healthy Benefits+ Flex Card for OTC and dental/hearing/vision expenses. Pharmacy benefits are managed through OptumRx with home delivery options and access to over 60,000 network pharmacies. Care coordination is supported through the Healthy Pathways nurse care management program. Additional digital services include provider and agent portals.
Differentiator
Problem solved
Functional benefit
Products and services
- Individual & Family Health Insurance Health insurance plans for individuals and families in IA, MN, ND, and SD, offering affordable monthly premiums, $0 preventive and virtual care, and discounts on vision services and retail partners. Plans are available direct and through healthcare marketplaces, including options for those eligible for ACA premium tax credits.
- Small & Large Business Health Insurance Group health insurance plans for small and large employers that integrate coverage, care, and service expertise to simplify health insurance administration and provide members with comprehensive coverage and care experiences.
- ICHRA (Individual Coverage Health Reimbursement Arrangement) Health reimbursement arrangement allowing employers to reimburse employees for individual health insurance coverage, enabling more flexible benefits delivery for small and large employer groups.
- ChoiceElite Medicare Advantage Plan Medicare Advantage plan offered in select counties across Iowa, Minnesota, North Dakota, and South Dakota, providing comprehensive all-in-one coverage combining Medicare Parts A, B, and D, including $0 preventive care and virtual care and the Healthy Benefits+ Flex Card.
- ChoicePlus Medicare Advantage Plan Medicare Advantage plan offered in select counties across Iowa, Minnesota, North Dakota, and South Dakota, providing comprehensive all-in-one coverage combining Medicare Parts A, B, and D with $0 preventive care and virtual care and the Healthy Benefits+ Flex Card.
- Align DUALPartnership Plan (HMO D-SNP) Dual Special Needs Plan (HMO D-SNP) for individuals eligible for both Medicare and Medicaid, offering additional benefits at no extra cost and is available in select North Dakota counties.
- Virtual Care / Telehealth 24-hour, 365-day online care access offering $0 virtual care visits for members and their families, allowing members to connect with providers from home for health assessments and consultations.
- OptumRx Pharmacy Benefits Pharmacy benefit management service providing prescription coverage, home delivery pharmacy services, and access to over 60,000 regional and national pharmacies for Sanford Health Plan members.
- Dental Coverage Dental insurance integrated into Medicare Advantage plans, providing access to the Delta Dental nationwide network of dental providers with coverage for routine dental care, cleanings, exams, and X-rays.
- My Sanford Health Plan Member Portal Secure online member portal for viewing benefits, checking claim status, accessing personal health information, and managing insurance accounts.
Quantifiable outcome
- $0 preventive care and virtual care visits available on Medicare Advantage plans
- +1 more outcomes
Companies that use Sanford Health Plan
Customer profileNamed customers1 record
Segments5 records
Ideal customer profiles4 records
Sanford Health Plan technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration2 records
Feature4 records
Sanford Health Plan partnerships and signals
Strategic signalPartnerships
Five partnerships are on record, tiered core.
- OptumRxcorePharmacy benefit management partner providing prescription drug coverage, home delivery pharmacy services, and pharmacy network management for Sanford Health Plan Medicare Advantage members
- Delta DentalcoreDental benefit provider offering access to the largest network of dental providers in the U.S. for Medicare Advantage members, covering routine dental care, cleanings, exams, and X-rays
- Lewis DrugcorePreferred pharmacy network partner offering prescription coverage at lowest cost-share amounts for Medicare Advantage members in the Upper Midwest
- CVS PharmacycorePreferred pharmacy network partner providing prescription coverage at preferred cost-share rates for Medicare Advantage members
- Thrifty White PharmacycoreRegional preferred pharmacy partner serving Medicare Advantage members with prescription coverage at preferred rates
Scale indicators2 records
Recent moves6 records
Expansion highlights5 records
Sanford Health Plan competitors and assessment
Company assessmentBroad incumbents
- Humana: One of the largest U.S. Medicare Advantage insurers with a national footprint that competes directly with Sanford Health Plan for senior enrollees in Iowa, Minnesota, North Dakota, and South Dakota; comparable as a competing MA-PD carrier in the same service regions.
- SelectHealth: Intermountain Healthcare-affiliated regional health plan in Utah, Idaho, and Nevada offering individual, employer, Medicare, and Medicaid coverage; comparable to Sanford Health Plan as a provider-sponsored regional carrier of similar scale and integrated-delivery model.
Regional players
- Dean Health Plan: Wisconsin-based regional health plan affiliated with SSM Health offering HMO and PPO products in the upper Midwest; comparable to Sanford Health Plan as a provider-affiliated regional carrier operating neighboring geography.
- Quartz Health Solutions: Wisconsin, Illinois, Iowa, and Minnesota regional health plan operated by Gundersen Health System and UnityPoint Health; comparable to Sanford Health Plan as a provider-affiliated regional carrier in the Upper Midwest offering employer and individual plans.
Direct peers
- HealthPartners: Minnesota-based integrated health plan and care system offering individual, family, employer, Medicare, and Medicaid plans across the Upper Midwest; comparable to Sanford Health Plan as a regional, provider-affiliated carrier with overlapping Minnesota service area.
- Blue Cross Blue Shield of Minnesota: Minnesota's largest health insurer offering individual, employer, Medicare, and Medicaid plans statewide; directly comparable to Sanford Health Plan on product breadth and Minnesota service area overlap.
- Blue Cross Blue Shield of North Dakota: North Dakota's largest health insurer offering individual, group, and Medicare plans throughout the state; directly comparable to Sanford Health Plan as a regional Blue plan operating in one of Sanford's core states.
- Medica: Regional not-for-profit health plan headquartered in Minnesota offering individual, group, Medicare Advantage, and Medicaid plans across the Upper Midwest; directly comparable to Sanford Health Plan on product mix, geography, and provider-affiliated positioning.
- Avera Health Plans: South Dakota-based health insurer affiliated with the Avera Health system offering individual, group, and Medicare Advantage plans in the Upper Midwest; directly comparable as a regional, provider-affiliated peer sharing the Dakota service area.
- Security Health Plan: Wisconsin-based regional health plan affiliated with Marshfield Clinic Health System offering individual, employer, and Medicare Advantage coverage; explicitly named in Sanford Health Plan's source data as part of the same HIPAA-organized healthcare arrangement, making it a uniquely direct peer for product, governance, and affiliation model.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat4 records
Key risks5 records
Key highlights6 records
Customer concentration
Sanford Health Plan social profiles
Digital presenceSanford Health Plan compliance and trust
Trust signalCompliance4 records
Sanford Health Plan financial estimates
Financial estimateRevenue estimate
Valuation estimate
Sanford Health Plan leadership team
Management profileNumber of profiles
Profiles2 records
Sanford Health Plan funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Sanford Health Plan M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Sanford Health Plan
What does Sanford Health Plan do?
Sanford Health Plan is a private regional health insurance company that underwrites and distributes Individual & Family health plans, Small and Large Business group health plans (including ICHRA arrangements), and Medicare Advantage plans (ChoiceElite, ChoicePlus, and Align DUALPartnership D-SNP) in select counties across Iowa, Minnesota, North Dakota, and South Dakota. Members access benefits through digital platforms (member portal and iOS/Android apps with Apple HealthKit and Google Fit integrations), receive $0 preventive care and telehealth visits, and obtain prescriptions through the OptumRx-managed network of 60,000+ pharmacies including home delivery.
Is Sanford Health Plan a public or private company?
Sanford Health Plan is a private company. It is classified as corporate owned and is currently operating.
When was Sanford Health Plan founded?
Sanford Health Plan was founded in 1997. It employs 101 to 250 people.
Where is Sanford Health Plan based?
Sanford Health Plan is headquartered in Sioux Falls, United States, in the North America region.
How does Sanford Health Plan make money?
Three revenue lines are on record. Medicare Advantage Premiums are the primary driver. The others are individual and Family Health Insurance and employer-Sponsored Health Insurance.
Who are Sanford Health Plan's main competitors?
Broad incumbents on record are Humana and SelectHealth. Regional players are Dean Health Plan and Quartz Health Solutions. Direct peers are HealthPartners, Blue Cross Blue Shield of Minnesota, Blue Cross Blue Shield of North Dakota, Medica, Avera Health Plans and Security Health Plan.
Does Sanford Health Plan have an API?
Yes. Sanford Health Plan offers Medicare Advantage APIs for interoperability compliance. Three APIs are available: (1) Provider Directory API containing provider directory information, (2) Patient Access API for secure sharing of processed claims, encounters and clinical data, and (3) Medicare Advantage Formulary API for drug formulary data enabling members to see covered medications. Subscription key required for API access. Developer documentation is at fhir.align.sanfordhealthplan.com/hspd/r4.
What industry is Sanford Health Plan in?
Sanford Health Plan's product category is Health Insurance. Its primary akta.pro industry code is FSAIAGAG, MA-PD Plans (Medicare Advantage with Prescription Drug Coverage), with a secondary code of FSAIAFAD, Small Group Health Insurance (2–50/100). Its NAICS code is 524114 and its SIC code is 6321.