A nationwide PPO is still an option in Georgia, even where Georgia Access offers no PPO in metro Atlanta. I'll explain how builders, remodelers and general contractors throughout the state can cover their households at a lower cost.
Hi, I'm Sam Jaber. I specialize entirely in health insurance, hold a Georgia license, and work with clients exclusively by phone. That makes things convenient when you're a builder with a packed schedule.
Construction work has stayed active across Georgia. New subdivisions continue spreading beyond Atlanta through Forsyth, Cherokee and Henry, Savannah keeps expanding around its port, and renovation work fills schedules in older Macon, Augusta and Athens neighborhoods. If you operate your own company in those areas, you're also responsible for your household's insurance. Georgia now operates its own marketplace, but residents in central metro Atlanta won't find any PPO plans there.
Whether you're building in Marietta, working around Savannah or living in a north Georgia mountain town, I can still help you get a nationwide PPO.
For 2026, Georgia Access lists 211 individual medical plans: 203 HMOs and 8 PPOs. All 8 PPO choices belong to one insurer and are offered across 71 counties. They aren't available in Fulton, DeKalb, Cobb, Gwinnett, Clayton or Chatham. That leaves contractors in central Atlanta and Savannah choosing HMOs on the marketplace. HMOs generally exclude nonemergency care outside their networks. PPOs, by contrast, contribute toward out-of-network services without requiring referrals, although your share of those expenses is higher.
That's where private coverage with medical underwriting becomes relevant. A healthy household may find better pricing because these plans consider medical history and offer PPO networks extending nationwide.
Georgia Access, rather than HealthCare.gov, handles marketplace enrollment for Georgians. Your household's annual income determines the assistance available. For contractors, we calculate business profit after expenses such as lumber, concrete, subcontractors, trucks, machinery, permits and insurance.
Georgia's coverage system has a gap at lower incomes. Instead of adopting the Medicaid expansion, the state uses Georgia Pathways, which serves qualifying adults earning up to 100% of the federal poverty level who satisfy required work, education or volunteer hours. Marketplace premium credits generally begin at the poverty threshold and help households in the middle-income range. Once income exceeds the credit limit, the full premium becomes your responsibility.
A new contracting company or several unsuccessful bids can leave your family with very little income. That's particularly challenging in Georgia. The state hasn't expanded Medicaid, so the lower-income route is Georgia Pathways, which requires qualifying hours. Marketplace tax credits generally aren't available until household earnings reach the federal poverty line.
If profits appear headed that far down, let's discuss your Georgia Access income projection and when to apply. Both decisions matter, and it's better to address them before submitting anything.
Next step: Call me before enrolling if you're expecting a low-income year. We'll review the requirements and identify which coverage you're eligible to receive.
Many smaller construction companies fall into this income bracket. When your household earns enough for a Georgia Access premium credit but not too much to lose it, marketplace insurance is almost always less expensive than private coverage. That's because the federal credit applies only to marketplace plans.
For households around Savannah or metro Atlanta, the marketplace choice is an HMO. That can be a good fit when your family's providers are local, provided we confirm they participate in the network.
Builder earnings can swing when Closings and draws come through. If an early sale of a large home increases your annual income, update the reported amount so the premium credit doesn't get settled against your tax refund.
Next step: Bring your previous tax return and the jobs you've already contracted. I'll help estimate this year's income and select a Georgia Access plan with you.
Successful, established builders often make too much to receive premium credits. In central Atlanta counties, that leaves full-price HMOs as the only marketplace choice. Elsewhere, the marketplace's single PPO insurer may offer coverage worth comparing with private alternatives.
If your household is healthy, I'd start by quoting a nationwide PPO with medical underwriting. The insurer examines everyone's medical history before approving, declining, or offering coverage that excludes a particular existing condition. That health screening can bring premiums below unsubsidized marketplace prices. Benefits differ between policies, so we'll review the details together. A national network also makes sense when your projects take you into Alabama, Tennessee or the Carolinas.
Don't confuse workers' compensation with family health insurance, either. Workers' comp addresses injuries sustained while working, not sickness or routine doctor appointments for your household.
Next step: Tell me your county and the ages of everyone needing coverage. I'll compare a nationwide PPO quote with the Georgia Access choices available locally.
Straight answers, no sales pitch.
No, not in Fulton, DeKalb, Cobb, Gwinnett, Clayton or Savannah's Chatham County. Georgia Access offers 8 PPO plans in 71 other counties for 2026. Healthy contractors statewide can still obtain nationwide PPO coverage through private plans.
No. Georgia Pathways is more restrictive than Medicaid expansion elsewhere, covering adults earning no more than 100% of the federal poverty level who also satisfy an hours requirement.
No. Starting with the 2025 plan year, Georgia residents have used the state-operated Georgia Access marketplace to purchase coverage.
No. Job-related injuries fall under workers' compensation. You need health insurance for sickness, preventive appointments and medical care for your family.
Tell me where you live, who needs insurance, and approximately what your company earned after expenses last year. I'll price the choices that fit and let you know plainly whether your existing plan is already the best direction.
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