BCBS of Texas found the cost of the individual PPO plan was no longer sustainable since the Affordable Care Act came into effect. On BCBS of Texas’ website, the insurer said, “By dropping the PPO, we can still offer our other plans at reasonable rates.”
“It’s important for any market offering to be sustainable long-term, so when the cost of healthcare delivery outpaces the premiums that are charged for that product, it results in a loss,” said Dan McCoy, BCBS of Texas divisional senior vice president and CMO.
Last year the insurer paid out $400 million more in claims than it collected in premiums for the individual PPO plan. The change doesn’t affect customers who have a group PPO plan through their employer or those who were grandfathered in 2010.
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