Missouri's marketplace may offer only EPOs, but nationwide PPO coverage is still available. If you're taking your heating and cooling operation from a single truck to a small team, here's how I'd help you evaluate the insurance decisions that come with hiring.
Hi, I'm Sam Jaber. I specialize in health insurance, hold a Missouri license and take care of my clients entirely by phone.
An HVAC contractor in Missouri has to prepare for two demanding seasons. Kansas City, St. Louis and the Bootheel bring humid, scorching summers, followed by January cold severe enough to knock out aging furnaces. Once a technician builds a steady customer base, a single truck may no longer handle the workload. Hiring someone becomes the natural next move. But bringing that first person onto payroll can also open up health coverage choices the owner hasn't needed to consider before.
Whatever arrangement you choose for your employees, I can still help you get nationwide PPO coverage for yourself and your family in Missouri.
You won't find a PPO on Missouri's marketplace. HealthCare.gov shows 117 individual medical plans for 2026, offered by 8 insurers throughout every county and St. Louis city. All are EPOs, which generally cover outside-network care only during emergencies. PPOs also pay toward doctors beyond their network, with higher costs to you and no referral requirement. Private medically underwritten policies offer nationwide PPO networks, and your health helps determine the premium.
When you're operating alone, you purchase individual marketplace insurance as a self-employed owner. Eligibility for the federal premium tax credit depends on your household's annual business profit. Calculate that after expenses for equipment, the van, parts, refrigerant, licenses and insurance.
Once you hire at least one employee who isn't an owner or relative, your company might qualify to offer a SHOP plan through the small-business marketplace. The distinction is employment status. A worker paid on a 1099 doesn't satisfy that requirement, so hiring a 1099 helper alone doesn't open the same option.
For an HVAC owner making that first hire, these are the decisions I'd help you work through:
The best arrangement comes down to your household's needs and what the business can afford. Remember that workers' compensation is different from health coverage. It protects your technician against injuries at work, but doesn't provide ordinary medical insurance.
Next step: Before your new employee starts, give me a call. We'll compare individual and group coverage and see how the numbers work.
As the business develops steady year-round work, household earnings may rise beyond premium tax credit eligibility. That leaves you paying full price for a marketplace EPO. Healthy families should also compare a medically underwritten nationwide PPO. After reviewing your medical information, the insurer can approve coverage, reject the application or approve it while excluding one condition. Healthy applicants may qualify for premiums below full marketplace rates. I'll help you examine the benefits of each policy.
Next step: Send me your Missouri county and everyone's age. I'll put nationwide PPO pricing alongside the EPO plans available where you live.
If business is slow and your household earnings fall to 138% of the federal poverty level or less, you may be eligible for Missouri's expanded Medicaid program.
Next step: If your family's income falls into that situation, call me. We'll work through which coverage makes the most sense this year.
Straight answers, no sales pitch.
Possibly. A business with at least one employee who isn't an owner or family member may be eligible for SHOP marketplace coverage. Workers on 1099 contracts don't qualify toward that requirement.
No. Missouri's marketplace has 117 individual medical plans in 2026, all EPOs. I can help healthy business owners find nationwide PPO coverage privately.
We'd need to compare the costs. I'll price your family's coverage through the group plan and through a separate individual policy so you can judge which arrangement works better.
It applies to workplace injuries only. You'll still need health insurance for sickness and regular medical services.
To get started, I need your Missouri county, your household members and how many workers you employ through payroll or 1099 contracts. I'll compare prices for your personal and business coverage and tell you plainly if your existing arrangement is already a good fit.
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