Signature Series Plan
See what the Signature Series Plan can do for you.
Sanford Health Plan would like to take this opportunity to introduce you to our integrated system of care. Due to ongoing circumstances requiring social distancing, we wanted to customize a virtual experience for you. You’ll get a better understanding of who we are, what we have to offer and a simplified way to engage with our team. We truly appreciate the opportunity to earn your business. Have a question not answered on this page? Submit here.
Our employee decision guide makes it easy to choose the right health plan. It puts all the information you need to know about Sanford Health Plan in one place. The guide includes three simple steps to help you choose a plan that fits your needs, lifestyle and budget.
Download the Guide
At Sanford Health Plan, we want to match you to the prescription drugs that are most beneficial to your health. See a list of all the drugs we cover. The formulary includes information about which benefit tier would cover a particular medication.
Use our OptumRX pricing tool to compare the costs of different prescription drugs. This tool will help you estimate what you would pay for your prescriptions if you choose a High Deductible Health Plan.
Try the Drug Pricing Tool
Sanford Health Plan members have access to 24/7 online care. We offer three virtual care options, so you can see a provider from the comfort of home or without leaving work. Learn about e-visits, video visits and virtual exams at the link below.
View Virtual Care Options
At Sanford Health Plan, we’re dedicated to the health and safety of our members. That’s why all preventive care and screening services are 100% covered under our plans if you’re using an in-network provider. Follow our preventive health guidelines to take advantage of these services.
Download the Guidelines
Not necessarily. We offer a variety of plan options and provider networks for members to choose from. With the provider networks Hawley Public Schools has chosen, you have the flexibility to see not only Sanford Health providers and facilities at an in-network level, but you also have access to a comprehensive network of independent providers and facilities at a regional and national level.
Broad Network: This network consists of over 25,000 providers within the Dakotas, Minnesota and Iowa in addition to a national network. To search for in-network providers, click here. Select the Through My Employer dropdown. Choose the Signature Series (Broad Network) option. Then, enter the city, state and mile radius you'd like to search.
Tiered Network: This network consists of over 25,000 providers within the Dakotas, Minnesota and Iowa in addition to a national network. It is split into two tiers of in-network providers. Learn more about the tiers below. To search for in-network providers, click here. Select the Through My Employer dropdown. Choose the Sanford PLUS (Tiered Network) option. Then, enter the city, state and mile radius you'd like to search.
Our Signature Series Plan uses the Broad Network for in-network provider access. The Signature Series plan options have both in-network and out-of-network coverage. For full plan details, reference the Summary of Benefit and Coverage (SBC) documents near the top of this page. These plans give you the flexibility to see any provider, either in-network or out-of-network, without a referral. For example, if you want to see a cardiologist, which is classified as a specialty provider, you can do so without a referral.
Our Sanford PLUS Plans use the Tiered Network for in-network provider access. The Sanford PLUS Plan options have both in-network and out-of-network coverage. The difference between these plans is you would have two levels (Tier 1 and Tier 2) of in-network providers to choose between to access your care. If you choose a provider from Tier 1, your costs, such as copay, deductible, co-insurance and out-of-pocket maximum, will be lower. For full plan details, refer to the Summary of Benefit and Coverage (SBC) documents on this page. These plans give you the flexibility to see any provider in either the in-network tier (Tier 1 or Tier 2) or from out-of-network without a referral. For example, if you want to see a cardiologist, which is classified as a specialty provider, you can do so without a referral.
Signature Series Plan considerations:
Sanford PLUS Plan considerations:
On both of these plans, urgent and emergency services are covered at the in-network benefit level. Since the Sanford PLUS Plan has both Tier 1 and Tier 2 in-network coverage, urgent and emergency situations will always fall under the lowest cost-share for our members, the Tier 1 benefit level.
Sanford Health Plan does have a contract with the Mayo Clinic Health System. In order for our members to access the Mayo Clinic Health System at an in-network level, they must receive prior authorization from the Sanford Health Plan. On our Sanford PLUS plans, if you receive prior authorization for services at the Mayo Clinic Health System, services will be applicable to the Tier 2 in-network cost-share amounts.
Sanford Health Plan recognizes the importance of a relationship between a patient and a provider. As a new member seeking treatment, you may complete a Transition of Care Request Form. This form must be submitted to Sanford Health Plan within 30 days of the employer group’s initial effective date. The form is to be used by an individual member to request continuing care currently being received for a specific medical condition, such as planned surgery, current cancer care, late pregnancy care, etc. with a provider (hospital, physician or any other health care professional) that does not participate with Sanford Health Plan. Completing this form does not guarantee authorization and it is not intended for a member who wants to continue with a provider who does not participate with us for yearly physicals or routine medical care.
High cost for medications should not keep you from taking prescriptions essential to your health. The IRS allows certain drugs to be available at a low cost without having to meet your deductible on a High Deductible Health Plan. These medications include many that treat common conditions and diseases such as high blood pressure, high cholesterol, depression, COPD, asthma, cancer, irritable bowel syndrome and many more. Medications that are both considered preventive and on our list of covered drugs only cost $5 for each 30-day fill at an in-network pharmacy. To find out if your prescriptions are covered as part of this benefit, use our Drug Pricing Tool. Enter your pharmacy, its location and the name of your prescriptions for an estimate of the cost if you were to choose a High Deductible Health Plan. You may find many of your medications are covered as part of the preventive medication benefit. If they do not fall into the preventive category, you will see an estimate of the retail cost of the medication that would be applied to your deductible if you choose a High Deductible Health Plan. Many of our members choose a High Deductible Health Plan specifically because this benefit lowers their prescription drug costs significantly compared to a traditional co-pay plan.
Sanford Health Plan has provided a link to the Formulary, which is a list of all the medications that are covered by the plan and at what applicable tier. We also provide a robust network of pharmacies our members can access both locally and nationally. The main pharmacy that does not participate in our network at this time is Walgreen’s.
This is a unique coverage option that so many of our members appreciate, especially families. This benefit incorporates basic lab and X-ray services (metabolic panel, strep culture, X-rays, certain minor surgical procedures, etc.) done in an office visit setting on the same date of service as the office visit to all be covered under what we call an ‘all-inclusive copay’ scenario.
This can work two different ways:
No. Sanford Health Plan will receive two data files from your current insurance company so we can credit you all applicable cost-share amounts you have already incurred in 2020 before your new policy with Sanford Health Plan begins.
Virtual care is offered on all of our plans. Every member has convenient access 24-hours a day, 7 days a week, with holidays included. Members on our copay plan options can access both our e-visit and video visit services with a $0 copay, while those members on our High Deductible Health Plan options have cost-share for these services anywhere between a $20-49 (depending on the plan chosen). Learn more here.
This is an additional value-added benefit you will receive once you become a member of Sanford Health Plan. You will receive this discount card in the mail. It gives you access to discounts on various health care services, including dental, vision, hearing and weight loss.
Your health is important to us. We encourage our members to regularly visit a gym that participates with our fitness program through the National Independent Health Club Association (search for participating fitness centers by visiting nihca.org). A member and their covered spouse can each receive up to $20 a month for visiting a participating fitness center a minimum of 12 days per month. Once you become a member, we will provide you with the tools to set up this value-added benefit.