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N.D. (AP) – A study by the American Medical Association concludes that North Dakota’s health insurance market is almost a monopoly.

The study says a concentration of health insurance among a handful of companies leads to less-generous benefits and higher premium costs.

Blue Cross Blue Shield is the state’s dominant health insurer.

Executives tell The Forum newspaper (http://bit.ly/YKFLav) that consumers are not being gouged – that other studies show employee contributions to health plans are on par with the national average and that health plans are ranked high in terms of benefit offerings.

State Insurance Commissioner Adam Hamm says the study confirms that a single health insurer dominates in North Dakota. But he says consumers are getting more choices, with companies introducing six new major medical coverage plans in the state last year.

Information from: The Forum