In January and July, you're flooded with service calls, but the months between can be much quieter. Here's how self-employed HVAC technicians can budget for health insurance when business follows the seasons.
Hi, I'm Sam Jaber. As a licensed health insurance broker based in Tampa, I work with people by phone across 36 states where I'm licensed. That makes things easier when your workday has you spending August inside a hot attic.
For many HVAC technicians, the career begins with employment at a heating and cooling company that provides health benefits. According to federal labor figures, approximately two out of three technicians work for HVAC and plumbing contractors. Once you start running your own service business, complete with your truck and customer agreements, finding and paying for health insurance becomes your responsibility.
Your industry's seasonal pattern makes coverage decisions especially important. Summer and winter often generate most of the revenue, while spring and fall may bring fewer calls. Those swings can influence which health insurance route makes the most sense. Here's how I approach it.
Before getting into prices or benefits, let's answer this question: is your household's projected annual income below the threshold for marketplace premium assistance?
The threshold is set at four times the federal poverty level, or a little above $60,000 for one person, with higher limits for larger households. When you own the business, marketplace calculations use net self-employment income after expenses such as tools, refrigerant, truck costs, parts, licensing and insurance. Since employed HVAC technicians typically earn close to that single-person threshold, many business owners may find themselves near it as well.
The challenge is choosing coverage before you know how busy the coming seasons will be. An especially hot summer might lift earnings above the threshold, while milder weather could leave them below it. See which situation describes you.
For households whose annual net income generally stays below the threshold, marketplace plans are usually the most affordable choice because that's the only place premium assistance applies.
Seasonal swings in income can cause problems if you're not paying attention. When you enroll, you give the marketplace an income estimate, and you're supposed to update it when your actual earnings change. If an unusually profitable summer brings in more money than you originally reported, and you don't report that increase, you could have to repay some or all of the extra premium assistance when you file your taxes. The way to stay ahead of that is to revise your income estimate as soon as you realize the busy season is bringing in more than expected.
We'll begin with your earnings from the previous year, account for additional service agreements, and identify a sensible point during the year to review your income projection again.
Next step: Share your previous tax return and the number of service agreements you have, and I'll help you estimate earnings and find coverage that matches.
Once your HVAC operation has multiple trucks and reliable service agreements generating steady revenue, your household income may exceed the subsidy threshold. Paying full marketplace premiums can feel disproportionate when your family is healthy and expects limited medical care.
Private coverage that uses medical underwriting may offer another solution. You'll provide health information when applying, and people in good health often qualify for monthly premiums considerably below unsubsidized marketplace prices. With nationwide PPO provider networks, these plans can give you more freedom in choosing doctors while also providing coverage when you're away from home.
Medical underwriting comes with important limitations. Based on your history, an insurer might reject the application or accept it while excluding a condition you've previously received treatment for. Plans also differ in their benefits, so I'll review the details with you before you make a selection.
Next step: Call me and we'll put a nationwide PPO quote alongside the marketplace's unsubsidized premium for your household, so you can compare them.
Bringing employees into your HVAC business can also change your insurance options. With at least one employee who isn't an owner or family member, you may qualify to offer coverage through the marketplace's small business option. Technicians classified as 1099 contractors don't satisfy that employee requirement.
Deciding whether to offer team coverage comes down to what you can budget, your hiring plans, and your household's insurance needs. For some shops, providing coverage for employees makes sense. For others, keeping the owner's family on a separate plan is the better choice for the time being.
While arranging workers' compensation for employees, don't confuse it with health insurance. Workers' comp addresses injuries connected to the job, not everyday medical appointments or illnesses for the people working with you.
Next step: Reach out before your first employee begins working, and we'll review the coverage choices for both your household and your growing team.
You may discover that your state's marketplace has no PPO plans, or that the PPO offered carries an uncomfortably high premium. That doesn't have to end your search. I can help HVAC shop owners in any of my 36 licensed states compare plans with nationwide PPO networks. If you're healthy, we can find out over the phone whether the pricing works for you.
Keep the following details nearby so we can make the most of our phone conversation:
My help doesn't come with a separate bill. Once your policy is in place, the insurer pays my compensation, and working with me doesn't change the price of your coverage.
Straight answers, no sales pitch.
Take your previous year's net business earnings and account for changes such as additional service agreements. Use that figure as your enrollment estimate, then revise it with the marketplace if your busiest season produces significantly more or less income than anticipated.
Your HVAC business might qualify for the marketplace's small business coverage option when you have at least one employee who isn't an owner or family member. Technicians working under 1099 contractor arrangements aren't counted toward that requirement.
Possibly. When your final annual income exceeds what you projected, the subsidy difference is reconciled when you file taxes. Revising your marketplace estimate promptly when earnings change can reduce the chance of facing a substantial repayment.
Yes. For healthy applicants whose income exceeds the subsidy threshold, I can compare medically underwritten private coverage with nationwide PPO networks throughout the 36 states where I hold licenses.
Tell me approximately what your business netted last year, whether other technicians are on your payroll, and who needs coverage in your household. I'll walk you through the available routes, explain pricing, and tell you whether your existing plan is worth keeping.
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