Wellmark Blue Cross Blue Shield members who use Sanford Health in South Dakota and northwest Iowa could face out-of-network costs from July 1, 2027, after Sanford sent Wellmark a notice that it will end their contract. Sanford reports that about 130,000 Wellmark members were its patients over the past 12 months, counting both individual and employer-plan members.
Nothing changes now. Sanford told patients that coverage and benefits stay the same while the two sides negotiate, that appointments continue as scheduled, and that it will keep treating Wellmark patients whatever the network status turns out to be. The risk sits in the second half of 2027, when members could owe more out of pocket or need to find new in-network providers if no deal is reached.
The question for anyone with Wellmark coverage is which kind of plan it is, because that decides when a choice can be made. Individual plans bought directly or through HealthCare.gov can be compared during open enrollment for 2027, while employer-sponsored plans depend on the employer’s own enrollment window, and members of either type who see Sanford doctors should watch for a settlement before July 1.
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Sanford’s notice and the July 1, 2027 date
Local reporting by Dakota News Now on Oct. 26 says Sanford is giving Wellmark until July 1, 2027 to reach a new contract agreement. If none is reached, members may have to pay more out of pocket or find new in-network providers. Sanford is a large system, with 57 hospitals and about 290 clinics across seven states, and the notice affects its South Dakota and northwest Iowa facilities.
The termination date is not entirely clear. Live Insurance News reports that the notice is effective July 1, 2027 but that the contract does not expire until June 30, 2027. For members, the practical date is the same: coverage at Sanford on a Wellmark card is secure through the first half of 2027 and uncertain after that unless the sides settle.
Wellmark had not responded publicly as of that report. That leaves Sanford’s description of the dispute as the only account on the record so far, and the dispute may look different once Wellmark describes its position.
What the two sides are arguing about
Sanford says the core issue is control over contract terms rather than a dispute over a single payment rate. Nick Olson, Sanford’s executive vice president and chief financial officer, told South Dakota Public Broadcasting that “Wellmark is insisting on having sole authority, exclusive control to change key contract terms.” Olson also said Sanford is “merely asking to enter into an agreement where care for our patients can stay close to home.”
According to Sanford, Wellmark wants sole authority to change key terms after the contract is signed, including terms that affect patient care and what Sanford is paid. Sanford says it is refusing that. Dakota News Now describes the disagreement as centering on who controls contract terms and how much Wellmark pays for care.
The difference between the two descriptions matters to patients less than the outcome. The notice period is the time the sides have to settle or let the contract end. Members cannot influence the result, but they can learn their own plan type now.
Individual plans and employer plans run on different clocks
Wellmark market share explains why the notice reaches so many households. Live Insurance News reports that Wellmark held 31% of South Dakota’s individual market in 2024, about 19,265 enrollees according to KFF. The 130,000 Sanford patients span individual and employer plans, and the employer-plan members cannot change coverage on their own.
For individual coverage, open enrollment for 2027 starts Nov. 1, and HealthCare.gov open enrollment closes Dec. 15, 2026, according to Live Insurance News. A buyer choosing a 2027 Wellmark plan in that window is choosing a plan whose Sanford access is only secure through June 30, 2027.
Employer-sponsored Wellmark plans cannot be switched on HealthCare.gov. Their timing depends on the employer’s enrollment window, so workers with a Wellmark card and a Sanford clinic should ask the benefits office what alternatives exist and when they can be chosen.
What members can do before July 1
The notice does not say whether a mid-year loss of Sanford would open a chance to change plans, and neither Sanford nor Wellmark has addressed it in the reporting available. The question is worth putting to Wellmark and to the employer or marketplace before relying on a switch later.
Members with scheduled surgery, a pregnancy or ongoing treatment at Sanford near or after July 1 are the ones with the most at stake. Asking Sanford billing and Wellmark member services how continuing care would be handled in a network exit, and getting the answer in writing, costs only a phone call.
A settlement before July 1 would make all of this moot. Until one is announced, members have no reason to leave Wellmark or Sanford today, but a reason to know their plan type, the open enrollment dates that apply to them and the name of the person at work who handles benefits.
Facing a bill that may go out of network?
A health system and an insurer failing to agree is one of the ways household money leaks without anyone making a mistake. For Wellmark members who see Sanford doctors, the possible leak starts July 1, 2027, and it arrives alongside the other costs that quietly drain a retirement: taxes, Medicare charges and the house.
The Keep-It Starter Bundle puts nine guides in one download, one per money leak. It covers how to cut the tax bill with the senior deduction, RMDs, QCDs and the Roth window, and how to cut Medicare costs by appealing the income surcharge and using the drug cap.
Another guide covers the house costs, with every senior property-tax break and the equity options. Each guide is built to be worked through in an afternoon, so a household facing a medical network change can tighten the other costs while waiting for a settlement.
Get the nine-guide download that tightens tax, Medicare and house costs →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
