State employees will now have to travel to Sioux Falls and other eastern cities for the most affordable specialty services.
Changes to state benefits took effect Tuesday that put more of the burden on the insured and relieve pressure on the state.
Deductibles have increased by $250 in two of the state's three insurance plans. Out-of-pocket payments increased for all plans.
State officials took bids from health providers to give more affordable care for cardiac and other needs. For non-priority providers, people will be charged up to an additional $2,075.
The governor's administration has become more involved with updates to the state benefits in recent years.
Eric Ollila is the executive director of the South Dakota Employees Organization. He says employees should have been consulted in the process.