A nationwide PPO remains an option for Florida business owners. Let's look at how people running LLCs, S-corps and smaller businesses are finding coverage for themselves and their families following a major increase in premiums.
Hi, I'm Sam Jaber, a licensed health insurance broker working out of Tampa. I help business owners find coverage, including plenty right here in Florida. Some run single-member LLCs, others have S-corps employing their spouses, and some operate small shops with a handful of workers. I hold licenses in 36 states, and we can handle the entire process over the phone.
Shopping for individual health insurance as a Florida business owner looks very different this year. Premiums have climbed sharply, the PPO offered on the marketplace costs considerably more than competing plans, and Florida's limited safety net can leave owners exposed during a slow startup year. Let's go through how business owners are handling each of these challenges.
First, something important: I can still arrange nationwide PPO coverage in Florida. For business owners and families in good health, that option may fit comfortably within what the company can afford.
It's easy to think that option has disappeared after checking HealthCare.gov. Only one carrier offers a marketplace PPO across Florida, and its premiums are substantially higher than competing networks. In Broward County, it costs 137% more than the lowest-priced silver alternative. That difference reaches 151% in Seminole County and 120% in Palm Beach County. Multiply those differences across a family paying without a credit, and the extra expense becomes substantial.
The other way to access PPO coverage is through a medically underwritten private policy. These plans use nationwide provider networks, and premiums are determined by the applicants' health. That's why families in good health sometimes find a much better price outside the marketplace.
Start by finding out whether your family qualifies for a premium tax credit. Florida residents purchase marketplace coverage through HealthCare.gov, where eligibility is based on household income for the year being insured. If you're a sole proprietor or operate a single-member LLC, the starting figure is your net business profit. If you own an S-corp, both your wages and the business profit passing through to your personal return are included.
That eligibility question matters even more with today's premiums. Florida regulators approved 2026 individual-market increases averaging 34.1% before subsidies, using an enrollment-weighted calculation. The credit can absorb a substantial portion of that increase for eligible households. Without eligibility, the business owner faces the full higher premium.
Let's find the situation that matches your business and household this year.
Businesses just starting out, companies putting earnings back into operations and owners experiencing low-profit years often qualify for this assistance. For a Florida business owner in that position, using the marketplace credit generally makes HealthCare.gov the most affordable route for family coverage, since private plans can't apply that credit.
Pay particular attention to the doctors included in each network. Florida's marketplace file contains 410 plans, and 316 of them are HMOs. That means most options rely on defined local networks and referrals. Check that your family's physicians participate before enrolling. Also keep your business income projection current throughout the year. If profits climb during the second half, your actual earnings could exceed what you originally reported, and any excess advance credit gets reconciled when you file your tax return.
Next step: Have your previous year's tax return handy, along with a reasonable projection of this year's business profit. We'll use those figures and your family's doctors to find coverage that makes sense.
When income exceeds the credit limits, Florida business owners must absorb the entire premium increase themselves. Insuring your spouse and children at full price is already expensive, and the marketplace's single PPO costs roughly twice as much. That's why owners in this situation frequently start comparing coverage outside HealthCare.gov.
With a medically underwritten nationwide PPO, every person seeking coverage completes health questions. Based on those answers, the insurance company can accept the application, turn it down or approve coverage while excluding a condition. A healthy household may qualify for premiums substantially below full marketplace prices, with access to a network extending beyond one Florida region. Since benefits vary from policy to policy, we'll examine the details before choosing.
Next step: Give me a call, and I'll compare the cost of a nationwide PPO for your family with the marketplace coverage available in your Florida county.
When you're building a new company, paying yourself can take time. In Florida, an extremely low-income year creates a particular problem. Medicaid hasn't been expanded, while marketplace premium credits generally require income of at least 100% of the federal poverty level. If your household falls below that threshold, you could end up eligible for neither program.
Rather than estimate blindly, we'll plan around the numbers. Before submitting an application, we'll review what your company should realistically earn over the entire year and see how that affects your eligibility.
Next step: Before signing up during a startup year, call me. We'll look at your projected household income and determine which coverage programs you can qualify for.
Having at least one employee who isn't an owner or part of your family may make your company eligible for SHOP, the small-business marketplace for group insurance. Workers paid as 1099 contractors don't satisfy that requirement. A group policy isn't necessarily better than separate individual plans, so given Florida's current market, I'd compare the costs for your actual team both ways.
Straight answers, no sales pitch.
Yes, as long as your household's yearly income qualifies for the credit. You'll apply through HealthCare.gov in Florida, using your company's net profit as the starting point for income.
There's just one marketplace insurer offering it, and in most Florida counties its premium is roughly twice that of the lowest-priced alternative network. That's why healthy business owners often compare private nationwide PPO coverage.
Watch out for the coverage gap. Florida hasn't adopted Medicaid expansion, and premium credits generally begin at the poverty level. An exceptionally low-income year could leave you without either option, so call me before enrolling.
SHOP may be an option once you employ at least one person outside the owners and their families. Without any employees, the business owner purchases individual health insurance instead.
Tell me which county you're in, how your company is structured, approximately how much profit it made, and everyone who needs insurance. I'll walk you through the available routes and calculate prices for your location. If keeping your current plan makes the most sense, I'll tell you that too.
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