A nationwide PPO remains available in Maryland, and I can help you get one. Here's how seasonal business owners around Ocean City and the lower Eastern Shore handle family health insurance when roughly fourteen weeks produce most of their annual income.
Hi, I'm Sam Jaber. As a health insurance broker licensed in 36 states, I work with Maryland business owners over the phone to find coverage for their households.
Consider a married couple operating an LLC in Ocean City that owns both a boardwalk stand selling fries and lemonade and a modest gift store. Between Memorial Day and Labor Day, they're working daily with a team of seasonal employees. Business slows considerably by October, and come January, the family depends on the money earned during summer. Their home is in Berlin, where they live with two children. Without an employer group policy, they purchase insurance through Maryland Health Connection. Every fall, they face the challenge of estimating income for a year before its busiest season even begins.
For 2026, Maryland Health Connection offers Worcester County residents 32 individual medical plans, consisting of 28 HMOs and 4 PPOs. Rates are uniform across Maryland's rating areas, meaning the same comparison applies throughout the state. For an unsubsidized 40-year-old shopping silver coverage, the lowest-priced PPO is 64% more expensive than the lowest-priced HMO. Even against the HMO offered by the PPO carrier's own insurer, the difference remains 48%.
I can help you purchase a nationwide PPO in Maryland through a private insurer. Premiums are based on each person's medical history rather than that marketplace price difference, with participating providers throughout the country.
Your Maryland Health Connection tax credit is calculated using projected household income for the year you're buying coverage. For a seasonal LLC, that means taking summer revenue and subtracting merchandise, boardwalk rent, employee pay, equipment, and other operating expenses, then considering the result across twelve months. Premium assistance reaches households earning up to four times the federal poverty level, with a substantially higher limit for four family members than for a single person.
Seasonal families can avoid problems by following two practices. Base your projection on an ordinary summer rather than your strongest or weakest season. If August revenue pushes earnings significantly beyond expectations, revise the estimate promptly instead of waiting until April. For tax years after 2025, repayment of excess premium credits has no cap.
Maryland experienced a smaller premium increase than many other states. KFF calculates a 13.4% rise in the 2026 benchmark silver premium for a 40-year-old.
Start with Maryland Health Connection because marketplace credits can't be used elsewhere. The assistance amount comes from a benchmark silver policy, not the higher premium of whichever plan you select. That generally makes HMOs the better financial choice for families. Spending 64% extra on a PPO is usually worth considering only when someone needs an out-of-state specialist unavailable through every HMO network.
Next step: Provide last year's tax return and the doctors your household sees. I'll identify Worcester County HMOs that include those providers and show their prices after your credit.
When income rises beyond premium credit eligibility, your household becomes responsible for every member's full insurance cost. For healthy families, private coverage can then offer better value. Each applicant completes medical questions, and the carrier can approve, decline, or approve while excluding one stated condition. We'll examine the different benefits carefully, item by item, before you agree to a policy.
Next step: Phone me and I'll put a nationwide PPO price for your family alongside the full-premium options on Maryland Health Connection.
Once your seasonal earnings are known, fall is a sensible time to review insurance. Maryland's enrollment period extends from November 1 to January 15, and choosing coverage by December 31 gives you a January 1 start. Begin sooner if you're considering private insurance because the carrier needs time to make its approval decision.
Next step: Once October arrives and you've finished the season's bookkeeping, give me a call. We'll use those actual results to plan your family's coverage for next year.
Straight answers, no sales pitch.
Across Maryland, the lowest-priced silver PPO has a premium 64% above the lowest-priced silver HMO. That difference applies statewide.
Use the net earnings from a normal full business year as your starting estimate, adjusting it whenever the season performs significantly better or worse.
Complete enrollment no later than December 31. Maryland's entire enrollment period extends from November 1 until January 15.
Yes. I can help arrange a private nationwide PPO for your household when the family meets the health requirements.
Tell me your county, the ages of everyone needing insurance, an estimate of last year's business profit, and whether employer benefits are available to anyone at home. I'll price marketplace and private coverage and share which option I recommend.
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