FARGO — Noridian Mutual Insurance Company, which does business as Blue Cross Blue Shield of North Dakota (BCBSND), received an A-minus rating with a "stable" outlook from Standard & Poor's for the fourth year in a row.

In its rating, S&P noted that BCBSND's expense ratio of 8.2 percent is well below its peer group average of 14.1 percent and added that the company continues to improve efficiency and reduce costs. The company's medical loss ratio of 89.2 percent also beats the industry average of 87 percent. Medical loss ratio measures the percentage of member premiums used to pay medical claims.

"BCBSND continues its commitment to remain good stewards of our members' premiums while investing in programs and services that help us continue to cut costs and deliver affordable products to those we serve," said Paul von Ebers, president and CEO of BCBSND.

S&P said the rating reflects BCBSND's "dominance of the North Dakota health insurance market, strong capital position, and improving product diversity."

"We are very pleased to maintain our A- stable rating," said Dave Breuer, senior vice president and chief financial officer of BCBSND. "The rating is a reflection of what the company is doing right in our mission to deliver affordable solutions to improve the care and health of our members. As we continue to diversify and grow non-insurance business, we look forward to further strengthen our rating."

S&P is an internationally recognized authority on the claims-paying ability of nearly all insurance companies.

About Blue Cross Blue Shield of North Dakota
BCBSND is a member-owned, not-for-profit independent licensee of the Blue Cross and Blue Shield Association. As North Dakota's largest provider of health care coverage, BCBSND is taking BOLD steps to collaborate with doctors, hospitals, clinics and members to ensure affordable access to quality health care in the state. To learn more about BCBSND, visit www.BCBSND.com.