Even where Georgia Access doesn't offer a PPO, I can still help you find nationwide PPO coverage in Georgia. Here's how commission-based real estate agents can compare plans based on their health, their home county and the income they earn from closings.
Hi, I'm Sam Jaber, and I'm licensed to broker health insurance in 36 states. Whether you work at a brokerage in Buckhead or a smaller real estate office in Statesboro, I can help you arrange Georgia health coverage over the phone.
For Georgia real estate agents, your home county can have a bigger influence on coverage than you might think. The state operates Georgia Access, its own health insurance exchange. PPO availability varies across counties, and none of the four largest counties surrounding Atlanta has a marketplace PPO option.
Here's what Georgia Access offers this year: 211 individual medical plans statewide, including only 8 PPOs. A single insurer provides those eight PPO plans in 71 of Georgia's 159 counties. Fulton, DeKalb, Cobb and Gwinnett aren't included, leaving residents of those counties with HMO choices.
Where marketplace PPOs are available, the premiums are relatively competitive. Across those rating areas, the lowest-priced silver PPO costs between 4% and 21% more than the lowest-priced silver HMO. If you're an agent who qualifies for premium credits in one of those counties, the PPO deserves serious consideration.
If your county has no marketplace PPO, or you're paying the entire premium without assistance, I can still help you obtain a nationwide PPO in Georgia. These are private policies with premiums determined after medical questions, offering participating doctors across the country.
Georgia Access calculates your premium credit using projected household income for the coverage year. As a real estate agent, you'll start with commissions and deduct your brokerage split, desk charges, MLS and board dues, signs, photography and driving expenses.
Georgia handles the lowest income levels differently from many states. Instead of adopting the ACA Medicaid expansion, it operates Georgia Pathways. KFF places the program at 100% of the federal poverty level and notes its work or activity requirement. Marketplace credits generally begin at the same 100% threshold. If an agent has a very poor year and doesn't satisfy Pathways requirements, neither form of assistance may be available.
A successful fall selling season can create a different problem. For tax years after 2025, there's no maximum limit on repayment of premium credits you received but ultimately weren't eligible to keep.
If you qualify for the credit, enroll through Georgia Access because that's where the assistance applies. Consider the PPO carefully if your county offers one. In Atlanta's core counties, we'll need to check each HMO network against your physicians.
After enrolling, make sure Georgia Access has an up-to-date income estimate. When a substantial property transaction closes, report the additional income during that same week.
Next step: Show me your previous year's tax return and the transactions you expect to close. We'll develop a realistic income projection and choose coverage that keeps your doctors in network.
Without premium credits, Atlanta-area agents are paying full price for HMOs. Agents living in counties with marketplace PPOs face the full premium for that option. For many real estate team leaders, comparing private insurance produces a more attractive result.
Here's what medical underwriting involves. You answer questions about your health, and the insurer decides whether to accept you without changes, reject the application or approve coverage with a particular diagnosis excluded. Good health can help bring private premiums below the marketplace's unsubsidized price. Every policy has different benefits, so we'll review the details together.
Next step: Call me and we'll compare both choices directly: a private nationwide PPO quote for your household and the Georgia Access premiums available in your county.
When commissions drop and household income approaches the poverty level, check eligibility before you apply. Below 100% of that level, marketplace premium credits generally aren't available. Medicaid is limited to Georgia Pathways and its work or activity conditions. Since one closing can substantially change annual income, we need to estimate carefully.
Next step: If business has been slow, give me a call before enrolling. We'll calculate your household's expected income and see where it falls relative to that eligibility threshold.
Straight answers, no sales pitch.
Not through Georgia Access in Fulton, DeKalb, Cobb or Gwinnett. Marketplace PPOs are offered in 71 of Georgia's 159 counties. However, healthy real estate agents anywhere in Georgia can apply for private nationwide PPO coverage through me.
No. Georgia residents use the state's own health insurance marketplace, which is called Georgia Access.
No. Georgia operates Georgia Pathways instead, with eligibility listed at 100% of the poverty level and a requirement involving work or qualifying activities.
Any excess premium credit is reconciled when you file taxes, without a repayment ceiling for tax years after 2025. Keep Georgia Access informed whenever substantial commissions arrive.
Tell me your Georgia county, the people who need coverage, and approximately what you kept in commissions after brokerage splits. With those three details, I can compare Georgia Access against a private nationwide PPO and recommend the better value for your situation.
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