Many consumers choose to get coverage through PPO plans because they allow more freedom for picking doctors or hospitals. But approximately 367,000 Texans will see that disappear next year when BlueCross BlueShield of Texas (BCBS-TX) drops their Blue Choice PPO plan. Check out the full story here or read my summary and thoughts on the matter below:
In 2014, BCBS-TX paid out $400 million more in claims than they collected in premiums for their Blue Choice PPO plan. As a result, the company decided to drop the product in 2016, as they think it’s no longer viable.
This type of change will have a big impact on Texas’ health insurance market. Without this PPO, HMO plans are likely to dominate. Since HMOs are usually pricier and more restrictive than PPO plans, the size and quality of plan networks will become the key to sales. Agents who utilize efficient enrollment solutions with quote engine plan data, such as our own eBroker Software, will have the upper hand when selling products in Texas.
The change will not affect consumers covered by BCBS-TX PPO group plans through their employers or consumers whose PPO plans were grandfathered in 2010. It also won’t affect consumers’ coverage until this year’s end.