St. Louis has seen plenty of things go over the years. Trans World Airlines. The Rams. And now, one of America’s largest insurers.

According to KTVI-TV, Anthem — one of only two insurance companies serving the St. Louis metro-area — will no longer offer individual health insurance plans in the Gateway City, as well as 16 other counties in Missouri.

As the St. Louis Post-Dispatch notes, that means that Cigna is the only individual plan supplier left on the market in Missouri’s health insurance exchange.

Residents of other Missouri cities — including Columbia, Joplin and Springfield — will also no longer be able to obtain insurance from Anthem.

While Anthem will continue to offer individual plans in 68 Missouri counties, those who can still get it should prepare for to pay a hefty fee; double-digit premium increases are likely in store for residents of the Show-Me State.

“This has been an extremely challenging year for the health insurance market in our state and across the country,” Chlora Lindley-Myers, director of Missouri’s insurance department, said.

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