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You are here: Home . hmo . mcqa . networkadqwaivr

List of Insurers Requesting a EPBP or PPBP Waiver

Information Relevant To the Grant of a Waiver

If a Texas Life/Health insurer’s Preferred Provider Benefit Plan (PPBP) network or Exclusive Provider Benefit Plan (EPBP) network does not meet the network adequacy requirements of 28 TAC §3.3704 in a portion of the state that the insurer wishes to include in its service area, the insurer may apply for a waiver from one or more of those network adequacy requirements.  The commissioner may grant the waiver if the commissioner believes there is good cause.

If the commissioner grants a waiver under 28 TAC §3.3707, TDI will post information relevant to the grant of the waiver on TDI's website, including:

  • the insurer offering the PPBP;
  • the name of the Preferred Provider Benefit Plan (PPBP) for which the request is granted;
  • the affected service area.

For detailed information about deficiencies, please visit the insurer's website.

PPBP Network Adequacy Waiver List

Insurer: Aetna Life Insurance Company

Plans:

Insurer: Blue Cross and Blue Shield of Texas, A division of Health Care Service Corporation, an Independent Licensee of the Blue Cross and Blue Shield Association

Plans:

Insurer: Memorial Hermann Health Insurance Company

Plans:

Insurer: Unimerica Insurance Company

Plans:

Insurer: UnitedHealthcare Insurance Company

Plans:

EPBP Network Adequacy Waiver List

Insurer: Aetna Life Insurance Company

Plans:

Insurer: Cigna Health and Life Insurance Company

Plans:

Insurer: Humana Insurance Company

Plans:

Insurer: United Healthcare Insurance Company

Plans:



For more information, contact:

Last updated: 11/17/2016

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