I talk with plenty of Clearwater residents who've recently left salaried company positions to build businesses of their own. Once they make that move, the question I hear first is usually about replacing the health insurance they had through work.
Hi, I'm Sam Jaber, and I'm a licensed health insurance broker helping people find coverage they purchase themselves. My office is in Tampa, just across the Courtney Campbell from Clearwater. Since Clearwater serves as the county seat of Pinellas, residents choose insurance from the plans available throughout Pinellas County.
A large share of my Clearwater conversations involve people making the transition out of traditional employment. I've spoken with the kinds of people who leave marketing management for freelance work, dental hygiene for a mobile business, or IT management for consulting. I work through phone and video appointments, both locally and in the 36 states where I hold licenses. My Tampa page covers the broader bay area.
If you had a PPO through your employer, you might assume that leaving means giving up that kind of provider access. Pinellas has one marketplace PPO available, but its premium is more than twice the cost of the other choices. I can also help you find a private PPO with a nationwide network outside the marketplace. For someone healthy who pays the full premium, it can often provide coverage much closer to the employer plan they're accustomed to.
There are three timelines to watch. First is when your employer ends your current health coverage. Next comes COBRA, which gives you a way to stay on that same plan temporarily, but you'll have to cover the entire cost yourself. Finally, there's your special enrollment period, usually 60 days from when your job-based coverage ends, when you can sign up for a marketplace plan.
According to the Pinellas County plan data, 6 insurers offer 149 medical plans, including just 14 PPO options. For silver coverage at age 40, the marketplace PPO with the lowest premium is still priced 138% higher than the least expensive silver plan using another network type. That's a substantial difference, and it's why I like to compare PPO pricing separately.
Imagine an operations manager, age 48, who's just resigned from a company around the Gulf to Bay corridor. He's planning to provide consulting services for two former clients, and his wife also works for herself. They've stayed with their physicians for years, including a cardiologist connected to Morton Plant Hospital, a Clearwater institution that's been serving patients since 1916.
For that couple, I'd compare three routes: continuing their employer coverage through COBRA, enrolling through the marketplace, or seeking a private PPO. If both are healthy and consulting income puts them above the tax credit limit, I'd start by comparing private PPO premiums with COBRA. Private coverage involves medical underwriting, so approval depends on their health information. If approved, its nationwide network may provide an experience much closer to the insurance they're used to.
Next step: Reach out before you leave your job, and we'll review private PPO coverage, marketplace plans and COBRA together while making sure the enrollment dates work.
During its first year, a new business may generate very little income for its owner. If your earnings qualify for premium tax credits, marketplace insurance is generally your lowest-cost route, and COBRA usually can't match the price. We'd enroll within your 60-day special enrollment period and look for coverage that allows you to continue seeing your doctors.
Next step: Come to me with an honest estimate of your first year's earnings, and we'll choose suitable insurance while your enrollment opportunity is still open.
When you or your spouse is already receiving treatment, keeping medical care consistent usually takes priority. Sometimes that means continuing the existing insurance through COBRA until treatment finishes. Other times, changing to a plan that covers the same physicians makes sense. The right decision depends on your specific care and providers. Explain your treatment situation to me, and I'll compare COBRA, marketplace coverage and private insurance together.
Next step: Let me know which doctors you're seeing and when your treatments are scheduled. I'll help identify the insurance choice that lets your care continue without interruption.
Straight answers, no sales pitch.
It can be. COBRA lets you continue the same insurance you already have, although you're responsible for its entire cost. I'd compare that premium with private PPO and marketplace coverage before committing.
When employer health insurance ends, you generally have a 60-day special enrollment period to get marketplace coverage. Private insurance isn't tied to that enrollment window, although underwriting and approval require some lead time.
Yes, you have alternatives. COBRA can extend your previous employer plan temporarily, while healthy applicants paying full premiums may qualify for a private PPO offering nationwide coverage.
No. My commission is paid by the insurance company, so you won't receive any bill from me.
Give me your final day at work, the price you've been quoted for COBRA, everyone who needs insurance and your projected earnings from the new business this year. I'll compare the available choices and explain the important enrollment deadlines for each.
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