(KNOX) – Insurance Commissioner Jon Godfread has announced the health insurance rate changes for individual and small group plans for 2025 that comply with the Affordable Care Act (ACA), citing the rise in healthcare costs in recent years as the driving force in rate changes.
Insurance companies submit premium rate requests to the insurance commissioner. State law gives the commissioner the authority to approve or adjust premium rates requested by companies. The commissioner is tasked with balancing consumers’ interests in keeping premiums affordable while also ensuring companies remain financially sound.
For the 2025 plan year, Godfread approved the following average changes for the small group market:
- UnitedHealthcare Insurance Company: 9.54%
- Blue Cross Blue Shield of North Dakota: 15.3%
- Sanford Health Plan: 10.51%
- Medica Health Plan: 6.38%
- HealthPartners withdrew from the market for 2025
The following average changes were approved for individual health plans for 2025:
- Blue Cross Blue Shield of North Dakota: 15.94%
- Sanford Health Plan: 16.5%
- Medica Health Plan: 4.6%
“Insurance is a pool of funds that needs to be filled at a faster pace than what is being released. Because of the pace in costs imposed by healthcare providers and facilities, the pool is being drained at an unsustainable pace,” Godfread said. “This is the first time in my nearly eight years as insurance commissioner that all health insurance plans purchased on the market will see increased premiums. High costs impact those who purchase their health insurance, and it affects businesses in the state who offer health insurance as an employee benefit.”
In 2023, on average, health insurance companies in North Dakota kept less than $0.01 for each dollar received in premiums for individual health plans. Since the onset of the COVID-19 pandemic, health insurance companies have, on average, retained one to two cents for every dollar collected in premiums.
“The insurance industry has several safeguards in place to protect consumers. My office carefully reviews the finances, products, and rates of every insurance company operating in the state. These laws ensure that both my office and the public can hold insurance companies accountable,” said Godfread. “However, when it comes to the costs and prices set by healthcare providers and facilities, there are fewer mechanisms in place to ensure similar oversight. Ultimately, these costs are passed on to insurance companies and, in turn, to consumers.”
This graph illustrates the change in premiums collected in North Dakota, which were approved by the insurance commissioner (blue), the change in premiums that would have been collected if insurance companies’ requested rates were approved (gray) and the change in healthcare spending (red), taking into account the total number of individuals covered by each plan in the individual market.
More than 50,000 North Dakotans were insured through the individual market in 2023.
Open enrollment for plans under the ACA will be from Nov. 1 to Jan. 15. Enroll by Dec. 15 for coverage to begin Jan. 1. Consumers can review plans and purchase plans through Healthcare.gov or a licensed agent.


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