We’re often told to read the fine print before we sign things, but how many of us actually do that?

From terms and conditions to user agreements, plenty of companies have us read their rules and requirements, but it’s unknown just how many people follow those guidelines.

It’s gotten to the point where our refusal to read the terms and conditions has been used for company jokes when April Fools rolls around — after an April Fools’ change to their shopping user agreements, 7,500 online shoppers sold their souls to internet retailer GameStation, according to Duffy & Duffy Law in New York.

But when it comes to health insurance, the consequences of failing to read the contracts can be far more serious than a joke.

In order to see just how many people know what their contracts say, Duffy & Duffy recently surveyed individuals across all of the U.S. to determine which states know the most and least about their health policies.

In the case of North Dakota, there were some aspects that we are more than familiar with: 80% of the state’s surveyed population knows the meaning of HMO (Health Maintenance Organization) and 63% understood the acronym POS (Point-Of-Service Plan). Despite the basic understanding, the survey discovered that overall, 52% of North Dakota residents surveyed cannot correctly identify common acronyms and terminology linked to health insurance.

When the details were spread across the United States, Wyoming was revealed to have the highest rate of insurance literacy, with 77% of residents understanding the fine print in their health insurance. In contrast, South Carolina came last in understanding with a score of 43%.

While reading the fine print can be a hassle, Duffy & Duffy says that it’s extremely important that North Dakotans, and any state, for that matter, fully read and understand what their health insurance entails, as this could be the key to avoiding costly mistakes in the future.

“It’s important to stay informed and up-to-date when it comes to terminology used in healthcare insurance,” said a spokesperson for Duffy & Duffy in a press release. “Always read the fine print when signing a new contract or looking up new information to do with your healthcare insurance. Regulations and guidelines often change over time, so make sure your resources are credible and updated in terms of validity for the best possible understanding.”

Duffy & Duffy have an interactive map charting each state’s score, which can be found on their website.