We are please to announce expanded access to our focused network- Sanford TRUE- coming in 2026!

Expansion counties in ND and SD are outlined below, with updated maps for easy identification. 

Member eligibility for group is based on the employee’s zip code and for individual it is based on the members county of residence. Reminder to check the updated TRUE Zip code listings.

TRUE Expansion & Mid-Year Adoption

As brokers and clients review the TRUE zip code expansion, a common question is whether groups can adopt TRUE if they are not on a 1/1/2026 calendar year renewal. The answer depends on group size. Large groups (51+) have the flexibility to add TRUE mid-year as a network-only change without impacting renewal cycles, while small groups (50 and under) can only adopt TRUE at their renewal. This ensures consistency in rates, benefits, and enrollment rules across both markets.

Large Group (51+)

• Mid-Year Adoption: Groups may adopt TRUE mid-year if newly eligible through zip code expansion.
• Renewal Dates/Rates: Their current renewal date and rating structure remain unchanged.
• Scope of Change: Mid-year adoption is treated as a network-only change. Deductibles, OOPM, and other benefit structures remain locked for the plan year.
• Employee Enrollment: No new open enrollment event is triggered. Employees cannot change deductibles or plan designs mid-year.
• Communication: Position this as an access expansion, not a benefit change.

Small Group (50 and under)

• Mid-Year Adoption: Not allowed due to complexities in ACA rates.
• Renewal Dates/Rates: They can add TRUE at their renewal or look to change their renewal date if they are interested.
• Scope of Change: Mid-year adoption is treated as a network-only change. Deductibles, OOPM, and other benefit structures remain locked for the plan year.
• Communication: Opportunity to add TRUE will be at renewal in 2026.

For small group employers, please note that TRUE can only be offered in rating regions where it is available. If an employer is located in a rating area where TRUE is not offered, it will not be an available option.

Additionally, TRUE must be positioned as a side-by-side plan with your Simplicity offering. This ensures both plans are available for employees to compare and select based on their needs.

If you have questions about availability by region or how to structure your offerings, please reach out to your Account Executive for support.

LARGE GROUP NORTH DAKOTA: 

Emmons, McLean, Mercer, McIntosh

LARGE GROUP SOUTH DAKOTA: 

Codington, Clay, Turner, Union

57201 - 57242 – 57243 – 57272 – 57235 – 57263 – 57265

SMALL GROUP NORTH DAKOTA:

Emmons, McLean, Mercer, McIntosh

SMALL GROUP SOUTH DAKOTA:

Clay, Turner, Union

INDIVIDUAL NORTH DAKOTA: 

Emmons, McLean, Mercer, McIntosh

INDIVIDUAL SOUTH DAKOTA:

Clay, Turner, Union