Louisiana agents can get a nationwide PPO privately through me without paying the high marketplace PPO premium found in St. Tammany. I'll explain how Northshore real estate agents can compare coverage based on their commission income, household health and provider needs.
Hi, I'm Sam Jaber. I help Louisiana real estate agents find their own health coverage over the phone, and I'm a licensed insurance broker serving 36 states.
Consider a Mandeville real estate agent whose business stretches across Lake Pontchartrain. She sells mainly in Covington, Madisonville and Slidell, while many clients are New Orleans families crossing the Causeway in search of more room and different schools. Most of her transactions close in spring and early summer, with very little happening during the holidays. Her brokerage pays commissions when sales fund but provides no health insurance. As a St. Tammany Parish resident, she turns to HealthCare.gov and discovers that its PPO carries a premium more suited to a luxury purchase.
For 2026, St. Tammany Parish residents can choose among 51 individual medical plans: 29 EPOs, 14 POS plans and 8 PPOs. The PPOs are substantially more expensive. Consider a 40-year-old shopping before subsidies. The lowest-priced silver PPO carries a premium 82% higher than the lowest-priced silver EPO. Even when you compare it with the silver offering from the PPO carrier's own HMO company, the PPO premium is still 75% higher. That's a considerable price difference for agents paying their own premiums.
I can also arrange a private nationwide PPO in Louisiana without the marketplace's high PPO markup. Your health questionnaire determines the private premium, and the network extends throughout the country. That means a participating doctor you visit while traveling outside Louisiana can still be considered in network.
Your premium tax credit depends on your household income during the coverage year and stops when that income exceeds four times the federal poverty level. For real estate agents, start with gross commissions and subtract the brokerage split, desk fees, MLS and board dues, signage, photography, and the mileage and toll expenses from crossing the lake.
Louisiana provides a stronger low-income coverage safety net than some neighboring states. It expanded Medicaid in 2016, and KFF reports an adult eligibility limit of 138% of the federal poverty level.
Marketplace premiums also increased for 2026. According to KFF, Louisiana's benchmark silver premium for someone age 40 rose 23.3% compared with 2025.
To receive the premium tax credit, you need to enroll through HealthCare.gov. The credit is calculated using a benchmark silver plan, not the premium of whichever plan you select. That means the PPO's 82% price difference remains your responsibility. For nearly every agent eligible for assistance, I'd start with an EPO or POS plan that includes the doctors they use. Remember that EPOs generally don't pay for nonemergency treatment outside their networks. Check both your physicians and your preferred hospital before choosing coverage.
Next step: Share your doctors' names and an approximate figure for what you netted. I'll show you which St. Tammany marketplace plans include those providers and what the premiums look like after your credit.
If your income puts you beyond the premium tax credit range, you're responsible for the entire marketplace premium. In St. Tammany, the PPO comes with the highest price tag. That's why many agents consider private coverage at this point. You'll complete a medical questionnaire, after which the insurer may approve you, decline you, or approve you with a particular condition excluded. Agents in good health who qualify often pay less than the marketplace's full premium while getting access to in-network providers nationwide. Coverage benefits aren't identical across private plans, so I'll review the details with you before you decide.
Next step: Give me a call and I'll compare a nationwide PPO quote with your parish's full HealthCare.gov premiums.
Real estate income can drop quickly when interest rates rise and buyers postpone purchases. If your realistic annual income estimate reaches 138% of the poverty level or falls below it, Louisiana Medicaid may provide coverage during that slower period. As transactions begin closing again and your earnings increase, report the change and transition to marketplace coverage.
Next step: After a slow sales period, call me before renewing so we can check where your household income falls.
For coverage beginning in 2027, open enrollment starts November 1, 2026 and ends January 15, 2027. To have your plan effective January 1, you must enroll by December 15.
Straight answers, no sales pitch.
Yes. There are eight marketplace PPOs, but the lowest-priced silver PPO has a premium 82% higher than the lowest-priced silver EPO.
Yes. Louisiana expanded Medicaid in 2016, and KFF places the adult income eligibility threshold at 138% of the federal poverty level.
Yes. If you're in good health, I can help you purchase a nationwide PPO through a private insurer.
Choose your coverage no later than December 15. Open enrollment begins November 1 and continues through January 15.
Tell me your parish, everyone who needs coverage, and approximately how much commission income you kept after your brokerage split. I'll compare HealthCare.gov pricing with private coverage and explain which choice I'd make in your situation.
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