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BCBS PPO ACA

BCBS of TX PPO Members

Urgent ALL BCBS of TX PPO Members must read the following notification just released by BCBS of Texas.  This Notice affects all members who have an ACA (Affordable Care Act) PPO plan with Blue Cross Blue Shield of Texas.

As of December 31, 2015, BCBS of TX will no longer be offering their PPO insurance plans for the individual under 65 block of business going forward.  This means if you currently have one of the new ACA plans purchased after Jan 1, 2014, and it is a PPO, it will no longer be offered for 2016.   This means you must change plans for 2016!

According to BCBSTX, they have filed a new product that should give members a flexible choice.  Bottom line, their PPO network for new ACA plans is going away.  The 2016 plans are currently not available, but as soon as they are released, we will be contacting you.  You can count on us to make sure you see all options available to you, from All Insurers and that we will make this transition as smooth as possible for you.

According to BCBSTX, the reason for this is because for the past 2 years, they have been the only insurer offering individual PPO plans in all TX markets and due to anti-selection, they find the PPO product is unsustainable at an affordable price.  The will continue to offer other plan options in all 254 counties, on and off the Marketplace.

There are about 367,000 members who will have their PPO plan discontinued in 2016.  If this is you, click here.

There are about 148,000 members who are in a Grandfathered PPO plan who WILL NOT have their plan discontinued and will be able to continue to use the Blue Choice PPO network.

This does not affect Employer Group customers or Medicare members.

The Blue Advantage HMO Network will remain and BCBSTX is working to expand the number of providers in that Network.

According to BCBSTX, they paid out $400 million more in claims than it collected in premiums in 2014. Losses that high are unsustainable, and they must adjust offerings, as most of the other insurers have done also, in order to be sustainable in the new market reality.

As a Broker, who represents all the major Health Insurers, we are seeing many changes taking place in this entire market, which can have major effects on many consumers!  According to different Insurance News publications, it appears that Aetna is in the process of acquiring Humana and Anthem in the process of acquiring Cigna.  Acquisitions like this, mean less Insurers in the market, less competition, thereby creating less choices for our customers.  We realize this is not good for anyone, but we will help you find the best products that are available in the market.

Remember…A Broker works for YOU….not the Insurance Company!  It is ultimately our ONLY goal to make sure you have the plan that fits your needs best.  There are more things to take into consideration when choosing a plan, other than just the cost.  Many people found this out this year!

You will never pay more for your premium by working with a Broker, than you do by going direct with the Insurance company or by going direct to the Marketplace.

To shop for 2016 plans now, click here.