Ranked 7 of 17 states · median $725/mo · CMS PY2026
Prefer to talk? Call (713) 575-9904
Licensed Independent Agent · NPN #22052447 · 23 States
A 40-year-old general contractor in South Dakota pays a median $725/month for a Silver plan before subsidies — 7th of 17 on cost. The cheapest plan in the state is $512 from Avera in Lincoln. On highest out-of-pocket maximum, South Dakota ranks 12 of 17 for this occupation.
For work with real injury exposure the premium is the wrong headline number. What decides a bad year is the annual out-of-pocket maximum — the ceiling you stop paying at. A fall, a fracture, an imaging series and a course of physical therapy will reach that ceiling on any metal tier, so the states below are ordered by worst-case exposure.
Occupational context: Falls, struck-by injuries, and heavy-equipment exposure.
None of that changes your price. ACA plans in South Dakota are community rated — premium varies by age, ZIP code, tobacco use and household size only. Your occupation cannot be used to rate you, decline you, or exclude a condition. What it changes is which plan design is the right bet.
Premium is set by rating area, so a general contractor in one South Dakota county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Moody | $664 | Sanford | $6,000 | 3 |
| Day | $679 | Sanford | $6,000 | 3 |
| Kingsbury | $679 | Sanford | $6,000 | 3 |
| Aurora | $702 | Avera | $6,000 | 2 |
| Hand | $702 | Avera | $6,000 | 2 |
| Stanley | $702 | Avera | $6,000 | 2 |
The spread across just these six is $38/month — $461 a year for the same metal tier. Statewide the range runs $512 to $882. Coverage by County publishes all 66 South Dakota counties individually.
| South Dakota — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $7,200 |
| Highest annual out-of-pocket maximum | $10,600 |
| Cheapest Gold plan @40 | $559 — Sanford |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $512 — Avera |
| Cheapest Silver @50 | $715 |
For a general contractor, the gap between $7,200 and $10,600 in annual out-of-pocket maximum is worth more than any premium difference on this page. One serious injury reaches that ceiling regardless of which plan you picked.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 1,822 plan records across 66 South Dakota counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Alabama ($680), Wisconsin ($687), Michigan ($708). More expensive: Oklahoma ($731), Kansas ($765), Tennessee ($773).
Side-by-side: South Dakota vs Wisconsin · South Dakota vs Michigan · South Dakota vs Oklahoma · South Dakota vs Kansas
Read the comparison as context, not as a shopping list. Your county of residence determines what you can buy, and for a general contractor that is fixed unless you relocate. Where it is actionable is a move already in progress — that is a qualifying life event, and you have 60 days on either side of it.
Expense categories that typically apply to this trade: Tools, truck, liability insurance, bonding, licensing. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The BLS median wage for First-Line Supervisors of Construction Trades and Extraction Workers in South Dakota is $75,840 a year (May 2024). Starting pay — the 10th percentile — is about $59,610. The middle half earn $64,260 to $82,880, and the top 10% more than $98,810. BLS counts about 2,270 people doing this work for an employer in South Dakota. The self-employed are not in the BLS survey, so this is the going rate for the work, not your own number.
The cheapest Silver plan for a 40-year-old in South Dakota is $512 per month from Avera, with a state median of $725. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
Yes. Plan types filed for 2026: EPO, HMO, PPO.
South Dakota ranks 7 of 17 states covered here, at a median $725 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
Above the cliff. At this income a single-person household receives no premium tax credit for 2027 and pays the full premium.
This occupation sits above the cliff in 22 of the 23 states reported and below it in the other 1, so the answer changes with the state.
What this figure is. It is the median annual wage BLS reports for First-Line Supervisors of Construction Trades and Extraction Workers (SOC 47-1011) in South Dakota. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed general contractor. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2027 the 400% FPL limit applies again, so household income above $63,840 ends premium tax credit eligibility outright.
This page compares states. For South Dakota specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for General Contractors in South Dakota and a blog covering deductibles, subsidies and special enrollment.
South Dakota has 3 carriers filing across 66 counties right now. That list is rebuilt every year, so what you can choose from in November may not match what you see today — and for a general contractor buying your own cover, who stays matters more than the headline rate.
Nobody can tell you your 2027 South Dakota premium yet. Filings nationally cluster around a 15% median increase, with the full spread running −1% to 54% — and until this state signs off, a specific local number is invention.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in South Dakota and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
All 66 counties in South Dakota sell a PPO, which is unusual and useful. For a general contractor covering ground, it is the plan type that travels best.
Nothing about 2027 is urgent yet, which is exactly why it is worth ten minutes now. Come November you will be choosing between South Dakota’s carriers under a deadline; today you can do it without one.
Enter a ZIP and a licensed agent will tell you three things:
Rates for General Contractors in South Dakota are set by county, not by occupation. Start with your ZIP and a licensed agent will show you the plans actually filed where you live.
★★★★★
“I run my own business and my time is valuable. Daniel handled everything — compared the private options, explained what I was actually getting, and had me covered fast. Way better experience than trying to navigate it myself.”