E
Avera Health Plans Inc
Rating Date
January 2026
NAIC
Classification
Risk Adjusted
Capital Ratio #1
Risk Adjusted
Capital Ratio #2
Total
Assets
Capital
Health
Premiums
Net
Income
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Major Rating Factors: Weak profitability index (1.2 on a scale of 0 to 10) with operating losses during 2021 and 2022. Average return on equity over the last five years has been poor at -3.2%. Fair quality investment portfolio (4.5). Fair overall results on stability tests (4.3). Rating is influenced by the weak financial results of Avera Health.
Other Rating Factors: Good liquidity (6.3) with sufficient resources (cash flows and marketable investments) to handle a spike in claims. Excellent capitalization (7.0) based on excellent current risk-adjusted capital (severe loss scenario) reflecting significant improvement over results in 2021.
Principal Lines of Business: --
Licensed in: IA, NE, SD
Principal Enrollment Breakdown: --
Other Highlights
Medical Loss Ratio
Medical Expense
Per Member Per Month ($)
466
Provider Compensation ($000)
Capitation Pay
0
Fee For Service
Contractual Pay
Salary
0
Bonus
0
Other
--
Member Physicians
Enrollment
Total Patient Encounters
Physician
Non-Physician
Corporate Info
Group Affiliation
None
Investment Rating
--
Company Address
5300 South Broadband Lane
Sioux Falls, SD 57108
Phone Number
(605) 322-4500
NAIC Number
95839
Largest Affiliates
No affiliate information available.