Even with Florida marketplace premiums rising sharply this year, nationwide PPO coverage remains an option. Let me show you how general contractors, home builders and remodelers are finding ways to spend less on their health plans.
Hi, I'm Sam Jaber. I'm a Tampa-based health insurance broker, licensed across 36 states, and I handle my work by phone. Florida certainly gives contractors plenty to do. Between new homes being built statewide, renovations throughout established neighborhoods, and hurricane rebuilding that can keep schedules packed for months into the following year, there's no shortage of construction activity.
Builders often ask me why insurance has become so difficult to afford when their companies are doing well. There are two pieces to that answer. One is the way premium subsidies are calculated. The other is this year's substantial increase in Florida marketplace premiums for people paying full price. Here's how I'd approach both situations.
Nationwide PPO insurance hasn't disappeared from Florida. If you're a healthy contractor, it can often make the difference in keeping your coverage budget manageable.
It's understandable that builders think otherwise. Florida's marketplace has just one insurer offering a PPO, although that coverage is sold statewide. Compare its premium with the least expensive plan using a different network type in each county, and the PPO's median price difference is 110%. In 43 out of 67 Florida counties, the PPO is at least twice as expensive. Faced with those numbers, most shoppers choose an HMO.
You aren't limited to marketplace coverage, though. Private plans using medical underwriting can provide nationwide PPO networks, with premiums determined by your health rather than marketplace pricing.
Florida residents use HealthCare.gov for marketplace coverage. Its premium tax credit depends on annual household income. If you own a contracting business, we're looking at net profit after paying for materials, subcontractors, trucks, insurance, bonds and other business costs. Two companies with identical revenue can therefore produce very different subsidy results.
That income cutoff matters especially this year. According to Florida's Office of Insurance Regulation, approved individual-plan rate changes for 2026 averaged 34.1% before subsidies, weighted according to enrollment. Qualifying for the credit can offset much of that increase. Without it, you're responsible for the higher premium yourself.
Take a look at the situations below and see which one describes your year.
If your household's net income qualifies you for the premium credit, HealthCare.gov will almost always offer the lower-cost route in Florida. Private coverage purchased elsewhere cannot receive that credit. That's why I'd generally recommend the marketplace when you're eligible.
Across most Florida counties, HMOs and EPOs with regional provider networks tend to have the lower premiums. They can work perfectly well when your household gets its care locally. I'd first verify that your family doctor, pediatrician and preferred hospital all participate before recommending a particular plan.
We also need to be careful with your projected income. Construction draws and retainage can make profits difficult to predict. If a major project finishes ahead of schedule and increases your annual income, you might have to repay some premium credit when filing taxes.
Next step: Let me review your prior year's return and upcoming jobs. Together, we'll establish a reasonable income estimate and choose county-specific coverage that works with it.
Here's where a Florida builder feels the entire 34.1% increase. Without a tax credit, you're paying the marketplace premium in full. And choosing its PPO means selecting the single plan that generally costs about twice the lowest-priced coverage available in your county.
For families in good health, I'd compare those prices with a medically underwritten nationwide PPO. You'll answer questions about your health, and the insurer may accept your application, decline it, or approve coverage while excluding a previous condition. That process can make premiums lower than full marketplace rates for healthy applicants, but it also means we need to examine the actual benefits carefully. The nationwide provider network can be useful when you're working on projects in Georgia or Alabama, or when your children attend college away from home.
Next step: Give me a call. I'll get a medically underwritten PPO quote for your household and compare it directly with marketplace premiums in your Florida county.
A contractor launching a business or going without projects for a while may have almost no household income that year. Florida has an unexpected problem in that situation. The state didn't expand Medicaid, leaving many very-low-income adults ineligible. Meanwhile, marketplace premium assistance generally starts when income reaches the federal poverty line. Earn less than that and you may qualify for neither program.
When your income is expected to be that low, both your HealthCare.gov income projection and the date you submit your application become important. I'd rather work through those details with you before enrollment.
One more distinction matters when opening your own contracting company. Workers' compensation handles workplace injuries, not your family's medical coverage. It doesn't replace health insurance for illnesses or other household healthcare needs.
Next step: If business is slow this year, call me before submitting an application. We'll review your eligibility and work out the appropriate way to estimate and report income.
Florida presents three particular challenges. Unsubsidized premiums increased considerably this year. Its statewide marketplace PPO typically costs roughly double the lowest-priced alternative. And because Medicaid wasn't expanded, households with extremely low income can find themselves without either form of assistance.
I'd begin by getting your actual business profit estimate right. After that, your family's medical situation helps determine whether marketplace coverage or a nationwide PPO makes more sense. In Florida, getting either decision wrong can mean spending unnecessarily.
Straight answers, no sales pitch.
Yes. Florida's marketplace offers one PPO from a single insurance company, generally priced at about twice the least expensive plan in a typical county. Healthy builders can often spend less by purchasing a nationwide PPO privately instead.
Florida's regulator measured a 34.1% average approved increase in 2026 individual-plan rates, weighted by enrollment and calculated before subsidies. Eligible contractors can offset much of that with premium tax credits. Those earning beyond the qualifying range pay the entire increase.
Yes. A strong hurricane rebuilding season may increase your business profit, which affects the credit calculated from your annual income. When earnings rise after enrollment, revise your HealthCare.gov projection to keep your premium assistance accurate.
Prepare for that possibility early. Florida hasn't expanded Medicaid, and marketplace premium credits generally require income at the poverty line or above. A household earning almost nothing may qualify for neither. Contact me before enrolling so we can determine your next step.
Just tell me your county, which family members need insurance, and approximately how much profit your business made last year. I'll compare the costs and explain which direction I'd recommend. If keeping your existing coverage makes more sense, I'll tell you that too.
The guide for every state, and other work I help with