Editor’s Note: This appears to be a classic case of decision making based on PPO discounts with little or no regard to fixed costs. As our three readers know, we have developed extensive information on PPO discounts and have written numerous articles on the subject. Few “expert” insurance consultants understand the matter completely, and often base their analysis using faulty premises. A challenge to the board’s decision may prove fruitful to the incumbent, however in the past that has not been the case. An incumbent must always “sell” themselves continuously to keep their clients informed and knowledgeable throughout the course of the contract. An ignorant and ill-informed customer often falls prey to vendor machinations.