Illinois contractors can still purchase nationwide PPO coverage. For builders in Chicago's western suburbs, looking outside Get Covered Illinois may be worthwhile. Here's how I'd compare the choices for DuPage and Kane County households.
Hi, I'm Sam Jaber. Health insurance is my business, I'm licensed in Illinois, and I handle every client consultation and coverage discussion over the phone.
Imagine a Naperville remodeling contractor who's spent fifteen years earning a good reputation. He handles kitchens and home additions, occasionally tearing down and rebuilding a house on a large property in DuPage or neighboring Kane County. He employs two experienced carpenters and relies on familiar subcontractors. Recently, his wife quit her corporate position to manage their office, ending the family's employer health coverage. Now he's shopping through Get Covered Illinois, the state's marketplace, hoping to find a PPO.
The important thing to know is that nationwide PPO coverage remains available in Illinois, and I can help you arrange it.
Get Covered Illinois offers 285 medical plans for 2026, including 130 PPOs from a single insurer, available statewide. For our remodeler, the obstacle is the premium. Illinois publishes plan pricing using CMS rating areas, not individual counties, so I use that same breakdown. DuPage and Kane make up Rating Area 3. There, a 40-year-old buying silver coverage without subsidies pays 81% more for the lowest PPO than for the lowest HMO or POS. Across Illinois rating areas, the median difference is 57%. Private medically underwritten plans provide nationwide PPO networks outside the marketplace, with pricing tied to health history.
I'd first determine whether your family qualifies for a premium tax credit. That depends on projected net self-employment earnings during the coverage year. Take your company's revenue and subtract materials, subcontractors, vehicles, dumpsters, permits, insurance and bonding expenses. You'll estimate the result initially and update it as business changes. Construction profits don't arrive evenly, and an addition delayed by winter weather can move significant income into the following year.
Next I'd ask about everyone's health. Here's why that matters: the Illinois Department of Insurance reported a 28.8% statewide enrollment-weighted average increase for 2026 individual coverage. Families without premium credits face that increase themselves.
Consider our Naperville contractor. He doesn't qualify for the credit, so every dollar of his Get Covered Illinois premium comes from his household budget. Selecting its PPO means paying the highest-priced type of coverage there.
I'd compare that with a privately issued nationwide PPO requiring medical underwriting. The application asks about health history, after which the insurer can approve you, reject you, or approve the plan while excluding a previous medical condition. Healthy families can often get lower premiums than unsubsidized marketplace coverage through that process. The nationwide network also reaches a Wisconsin lake house or a child's college in another state. Because benefits aren't identical between plans, we'll examine the policy before making a choice.
Next step: Call me with your county and the birth dates of everyone needing insurance. I'll compare nationwide PPO pricing with marketplace premiums in DuPage and Kane.
Say a contractor receives the final payment for a large project in January rather than December. That shift may reduce annual household profit enough to qualify for a premium credit. In that case, Get Covered Illinois generally offers the lowest cost because the credit isn't available elsewhere. Western suburban HMOs usually make the credit go furthest, and there are many options. We'd select one that includes your family's current doctors. If income drops substantially, Illinois also has expanded Medicaid, which can cover qualifying adults at or below 138% of the federal poverty level.
Next step: Share last year's tax return and your upcoming construction schedule. We'll calculate a practical income projection and select coverage based on it.
Straight answers, no sales pitch.
Yes. Get Covered Illinois lists 130 PPOs among its 285 individual medical plans for 2026. One insurer provides all of them, with availability across every county.
For a 40-year-old before subsidies, Rating Area 3, covering DuPage and Kane, has a lowest-priced silver PPO premium 81% higher than the least expensive silver alternative using another network type.
The Illinois Department of Insurance reported that individual-plan rates increased by a statewide weighted average of 28.8%.
No. Marketplace enrollment in Illinois goes through its state-run exchange, Get Covered Illinois.
Give me your county, everyone who needs coverage, and an approximate figure for last year's company profit. I'll put Get Covered Illinois premiums alongside nationwide PPO pricing and explain which choice I'd make in your position.
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