North Carolina builders

Here's how general contractors and builders in North Carolina are saving money on their health insurance this year

A nationwide PPO is still an option in North Carolina, even in areas where marketplace PPO premiums are considerably higher than competing plans. Here's how contractors building around Charlotte can compare their coverage choices.

Book a free call → Call 813-999-0101

You can still get a nationwide PPO in North Carolina

Here's what you need to know first. Nationwide PPO insurance is available in North Carolina, and I can help you arrange it.

His county does have a marketplace PPO, but the premium is the problem. In 2026, the lowest-priced silver PPO in Mecklenburg, Cabarrus and Union costs 54% more than the lowest-priced plan using another network type, based on a 40-year-old without subsidies. Just one insurer offers the PPO. Private medically underwritten coverage provides another route, using nationwide PPO networks with premiums determined by your health.

The number that decides which way you go

Before comparing prices, I'd want to know whether his family's income makes them eligible for a premium tax credit through HealthCare.gov.

For someone in construction, we calculate that using net self-employment earnings. Start with revenue and subtract lumber, subcontractors, vehicle costs, permits, builder's risk insurance and other business expenses. The result is your projected income for the coverage year. Keep that projection current as jobs change. One home closing in January instead of December can make a substantial difference to the annual total.

Scenario 1 of 2

The company's doing well and the family is healthy

Our Union County contractor earns too much for a premium tax credit. That leaves him paying the entire HealthCare.gov premium himself, with the PPO priced substantially higher than the HMOs and EPOs offered alongside it.

I'd next compare private coverage based on the family's medical history. The insurer reviews health questions and may accept the application, reject it or accept it while excluding one previous condition. A healthy family's answers can lead to premiums below full marketplace prices. Nationwide network access also matters when they visit the beach, spend time at a mountain cabin or travel to South Carolina for a construction bid. Benefits vary between policies, so I'll review the details with him before he commits.

Next step: Give me a call with your county and your family's ages. I'll compare a nationwide PPO quote with the marketplace premiums around Charlotte.

Talk it through with Sam → Call 813-999-0101

Scenario 2 of 2

Closings slipped and this year looks thin

Spec home construction isn't profitable every season. Suppose two properties remain on the market all winter, bringing household net income into the tax credit range. HealthCare.gov generally becomes the lower-cost route because premium credits apply only to marketplace coverage. Around Charlotte, those credits tend to go furthest with HMOs and EPOs. We'd focus on finding a plan that includes the doctors your family already sees.

Income can drop enough to make Medicaid relevant too. North Carolina expanded Medicaid on December 1, 2023, for adults ages 19 through 64 earning up to 138% of the federal poverty line. Your income projection needs to stay accurate when business improves as well. If a property closes and you receive the proceeds, revise your estimate.

Next step: Have your previous tax return and upcoming closing dates ready when we talk. I'll help you estimate this year's income and choose coverage accordingly.

Talk it through with Sam → Call 813-999-0101

Where the North Carolina figures come from

North Carolina's individual marketplace runs on HealthCare.gov; North Carolina is one of the states in the federal 2026 QHP Landscape file Source
For 2026 a marketplace medical PPO is sold in 90 of North Carolina's 100 counties, and one insurer offers it Source
Matched within each county (silver plans, age 40, before any subsidy), the lowest-priced marketplace PPO costs 54% more than the lowest-priced plan of any other network type in Mecklenburg, Cabarrus and Union; across the 90 counties where both are sold, the median gap is 19% Source
HMO plans generally don't cover care outside their network except in an emergency, EPO plans cover out-of-network care only in an emergency, and PPO plans cover out-of-network care at a higher cost without a referral Source
Self-employed people report net self-employment income to the marketplace, estimate it for the coverage year, and should update it as soon as it changes Source
North Carolina expanded Medicaid on December 1, 2023, to adults ages 19 through 64 with income up to 138% of the federal poverty line Source

Questions general contractors and builders ask me

Straight answers, no sales pitch.

Is there a PPO on the North Carolina marketplace?

Yes, across most counties. In 2026, one insurer offers marketplace medical PPO coverage in 90 of North Carolina's 100 counties.

How much more does the marketplace PPO cost around Charlotte?

For a 40-year-old without subsidies, the lowest-priced silver PPO in Mecklenburg, Cabarrus and Union is 54% more expensive than the lowest-priced silver option with a different network.

What income does a North Carolina builder report to the marketplace?

Use your projected net self-employment earnings for the year you're getting insured. That's business profit after expenses, and you should revise it as circumstances change.

Can a healthy builder get a PPO without paying the marketplace's full price?

Yes, frequently. Nationwide PPO plans with medical underwriting base their premiums on your health. I can compare those quotes with marketplace coverage.

Tell me where the next slab is going

Let me know which county you live in, who needs insurance and approximately how much profit your business made last year. I'll compare actual marketplace prices with nationwide PPO quotes and explain which coverage makes the most sense.

Book a free call → Call 813-999-0101 Send a message