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Nation's top health insurer to expand into three-state region in January

Headquarters in Minnetonka, Minn., of UnitedHealth Group, the parent company of UnitedHealthcare, the nation's largest health insurer, which will expand to North Dakota and South Dakota and areas of Minnesota near Fargo-Moorhead in January 2019.

FARGO — UnitedHealthcare, the nation's largest health insurer, has announced its plans to enter the small group market in the three-state region in a move North Dakota's insurance regulator said could increase competition.

The entry in January into South Dakota and new parts of Minnesota, too, will add a major player in the health insurance market.

In North Dakota, the market is now dominated by three companies: Blue Cross Blue Shield of North Dakota, the Sanford Plan and Medica.

UnitedHealthcare is part of UnitedHealth Group, based in Minnetonka, Minn., which last year had worldwide revenues exceeding $200 billion and served about 124 million people, including 50 million in the United States and South America.

Its expansion in the tri-state region is attractive because of its "very attractive, very growing" economy, Philip Kaufman, CEO of UnitedHealthcare Minnesota, North Dakota and South Dakota, said Thursday, Sept. 6.

Also, he added, large, multinational employers were asking the company to provide health insurance in the region. "It was a good opportunity."

The expansion in the three states means UnitedHealthcare's remaining service gaps will be in states like Montana, Wyoming and perhaps Idaho, Kaufman said.

"It is one of the very last gaps in the map," he said of expansion in Minnesota, North Dakota and South Dakota.

To prepare for its entry in the region, UnitedHealthcare representatives have been negotiating contracts with medical providers, including Sanford Health and Essentia Health, and meeting with insurance consultants, brokers and independent agents.

"The reception has been very positive," Kaufman said, referring to insurance brokers and agents, whom he said are pleased to have another option for their clients and customers.

So far, the health insurer has contracts with 30,000 physicians in Minnesota, North Dakota and South Dakota — part of the more than 1 million physicians in UnitedHealthcare's nationwide network.

Initially, UnitedHealthcare will focus on small employer groups, and over time will enter other markets, typically following with Medicare and Medicaid offerings, Kaufman said.

Jon Godfread, North Dakota insurance commissioner, welcomed the entry of UnitedHealthcare, which he predicts eventually will become a "full player in North Dakota.

"We're excited about that because that means more competition, which means more options for consumers," Godfread said. "This is a big deal for North Dakota. It's a big deal for consumers."

Eventually, he added, "It may have some impact on pricing, it may have an impact on product offerings. Time will tell."

Blue Cross Blue Shield of North Dakota has long been the state's dominant private insurer. It commands 91 percent of the small group market, 84 percent of the individual health insurance market and 51 percent of the large group market, according to a state report. Sanford Health Plan follows with 44 percent of the large group market, 8 percent of the small group market and 6 percent of the individual market.

UnitedHealthcare invests heavily on innovation, including ways to engage customers to be more active and more involved in their health and well-being, Kaufman said.

One initiative involves a device app called Motion, which logs physical activity and reminds users to move—and offers financial rewards for doing so. UnitedHealthcare also can work with employers to tailor programs that meet their needs, including wellness programs, he said.

As UnitedHealthcare's presence in North Dakota grows, it likely will add staff in the state. Initially, the market will be served by its headquarters in Minnesota, where the company has 18,000 employees, Kaufman said.

The health insurer's goal is to be a "competitive player" in the new markets, but will not try to "buy the business" by offering seductively low premiums initially, only to raise them significantly later, he said.

"That's just not how we operate," Kaufman added. "We're looking for sustainability and experience. We like long-term customers."

Patrick Springer

Patrick Springer first joined the reporting staff of The Forum in 1985. He can be reached by calling 701-241-5522. Have a comment to share about a story? Letters to the editor should include author’s name, address and phone number. Generally, letters should be no longer than 250 words. All letters are subject to editing. Send to

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