I can help North Carolina business owners get a nationwide PPO in addition to the coverage sold through Buncombe County's marketplace. Here's how Asheville entrepreneurs who regularly travel to markets and shows can compare insurance for their families.
Hi, I'm Sam Jaber. I hold insurance licenses in 36 states and help North Carolina small-business owners choose family coverage over the phone.
Picture a family calling me from Asheville about their health insurance. The parents operate an LLC pottery studio and retail shop in West Asheville. Their storefront stays open throughout the year, but between spring and fall they spend weeks traveling to craft fairs in Atlanta, Charleston, Gatlinburg and Asheville. Their two children join them during summer. Since the business has no employees beyond its two owners, group coverage isn't available. They buy their insurance through HealthCare.gov using Buncombe County rates, but the plan needs to serve them while they're working at shows three states away.
For 2026, five insurers offer 59 individual medical plans in Buncombe County, including 50 HMOs and 9 PPOs. Marketplace PPO coverage is available here, and its premium isn't dramatically higher. For a 40-year-old without a subsidy, the lowest-priced silver PPO is 19% more expensive than the lowest-priced silver HMO.
I can also help your household apply for a private nationwide PPO in North Carolina. Each family member answers medical questions that determine pricing, and the network extends to cities where you attend shows. Whether that or marketplace coverage makes more sense largely comes down to your income and everyone's health.
For LLCs treated as sole proprietorships or partnerships for tax purposes, marketplace income calculations begin with business profit after expenses such as clay, kiln costs, travel, booth rentals and other operating costs. Total household income matters, and premium credits extend up to four times the federal poverty level, with larger households having higher limits. Hiring a worker outside the ownership and family may also make SHOP, the small-business marketplace, available.
North Carolina's unsubsidized premiums increased this year. KFF reports that the benchmark silver premium for a 40-year-old rose 25.8% between 2025 and 2026, affecting each covered family member's premium.
I'd begin by comparing HealthCare.gov coverage because that's where premium credits can be used. The credit amount comes from a benchmark silver plan, meaning it doesn't increase when you select the PPO instead of an HMO. You'll pay the additional 19% yourself.
That additional premium may make sense when your family travels for several months each year. Buncombe County HMOs generally exclude routine out-of-network treatment, so a child's ear infection during a South Carolina show might leave you paying the bill. If the PPO includes your regular doctors and the higher premium works financially, combining it with marketplace credits can be a practical choice.
Next step: Have your previous tax return and your family's doctor information ready. I'll calculate what the HMOs and PPO cost after your premium credit.
Once your income is too high for credits, every member of a four-person household pays full premiums, including the PPO's higher price. Healthy families can often spend less with private insurance. The carrier reviews medical questionnaires for each person and either approves the requested coverage, approves it with a specified condition excluded or denies the application. We'll compare each policy's actual benefits before you make your decision.
Keep your income projection updated during profitable years as well. If advance premium credits were based on lower earnings, you'll repay the excess when filing taxes, without a repayment limit for tax years after 2025.
Next step: Call me, and I'll compare a nationwide PPO quote covering your entire family with Buncombe County's unsubsidized marketplace premiums.
Hiring an employee who isn't an owner or relative may make your business eligible for a SHOP group plan. Whether group coverage makes sense will depend on that worker, your available budget and the individual insurance your family currently uses.
Next step: Give me a call before your employee begins working. We'll compare group insurance against individual plans for the business owners.
Straight answers, no sales pitch.
Yes. Buncombe County offers nine marketplace PPOs. Its lowest-priced silver PPO costs 19% more than the lowest-priced silver HMO.
No. Your credit is calculated using a benchmark silver plan, and any additional premium for a higher-priced plan is your responsibility.
No, not through SHOP. You'll need at least one employee who isn't part of the ownership or your family.
Yes. I can arrange a private nationwide PPO for healthy business owners and their families.
Tell me your county, the ages of your family members, approximately what the business earned after expenses and how often you're traveling. I'll compare marketplace coverage with a private nationwide PPO and explain which I'd favor for your household.
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