I can still help you purchase a nationwide PPO in Wyoming. Let's look at a Cody couple running a fly-fishing shop and guide service that earns most of its revenue from June through September, and how they arrange health insurance for their family throughout the entire year.
Hi, I'm Sam Jaber. I'm a health insurance broker holding licenses in 36 states, and I work with Wyoming business owners over the phone to arrange coverage for their families.
Picture a couple who own a fly-fishing shop and guide operation in Cody. Between June and September, anglers traveling to the Shoshone River and Yellowstone's east entrance keep the store busy and three seasonal guides working. Once late fall arrives, the business slows down to the owners themselves, a little online business and occasional winter classes teaching fly tying. They have two school-age children and no employer group coverage. Their HealthCare.gov renewal arrived showing a higher premium than the previous year. Now they're trying to figure out how to afford twelve months of health insurance when nearly all their business income comes during four months.
In 2026, Park County has 23 individual medical plans available through the marketplace. They're divided between two insurance companies, with one offering 11 PPOs and the other offering 12 EPOs. For a 40-year-old paying without a tax credit, the silver PPO is actually 2% less expensive than the silver EPO.
You also have the option of getting a private nationwide PPO in Wyoming through me. The insurer reviews your health before setting the price, and the provider network extends beyond both the Montana border and Yellowstone's boundaries.
HealthCare.gov looks at estimated household net income across the entire coverage year, not just what you earn during your busiest season. For a guide operation, that means taking sales and guiding fees, then subtracting expenses such as merchandise, guide payroll, permits, insurance, boats, trucks and fuel. Your estimate needs to reflect the full calendar year.
Premiums are another important part of the calculation. KFF reports that Wyoming's average benchmark silver premium for a 40-year-old in 2026 ranks second highest among all states and DC, after increasing 25.1% since 2025. The premium tax credit uses that benchmark and subtracts a required contribution determined by household income. When the benchmark goes up without an income increase, the credit generally rises too. Assistance typically applies to households earning between 100% and 400% of the federal poverty level.
If your family qualifies for a tax credit, that alarming renewal premium may look considerably better after the credit is deducted. Check the actual amount before canceling coverage. Then look at networks. Park County's silver PPO costs slightly less than its silver EPO, and the PPO provides some reimbursement for out-of-network services, although your costs are higher. EPOs generally don't pay outside their networks except during emergencies. I would usually favor the PPO for a family in this situation, unless the family's doctors participate exclusively in the EPO insurer's network.
Next step: Share last year's shop income figures and the doctors your family visits. I'll calculate the premiums for Park County's PPO and EPO after your available tax credit is applied.
A successful season could push your household above four times the poverty line, leaving you ineligible for the tax credit and paying Wyoming's full marketplace premium for a family of four. Before renewing, compare a private nationwide PPO. Every family member applying must answer medical questions. The insurance company can approve coverage, exclude a particular condition or decline an applicant. Healthy families often find a private premium below the marketplace's unsubsidized rate. I'll explain the benefits carefully before you decide.
Next step: Once fall arrives and you have the season's financial results, give me a call. I'll compare a private nationwide PPO quote with Park County's marketplace plans at their full, unsubsidized prices.
When a seasonal business has a poor year, household income can fall dramatically. Wyoming hasn't expanded Medicaid, so there isn't the same safety net available. KFF's January 2026 figures show that parents in a three-person family qualify only through 43% of the poverty level, while other adults cannot qualify based on income alone. HealthCare.gov also explains that adults below 100% of the poverty level in states without expansion generally receive no marketplace savings if they aren't otherwise eligible for Medicaid. Use your actual business results to build the income estimate, and talk it through with me before submitting the application.
Next step: If business was much slower than expected this season, call me before renewing. We'll review what your household really earned and work through the coverage choices available to you.
Straight answers, no sales pitch.
Yes. According to KFF, Wyoming's average benchmark silver premium for a 40-year-old increased 25.1% between 2025 and 2026.
Generally, yes. The credit calculation starts with the benchmark silver premium and subtracts an income-based contribution, so an increase in that benchmark will usually raise the credit too.
Use your expected net income across the entire year of coverage, including the quieter months, rather than estimating from your busiest season alone.
Yes. If you're a healthy Wyoming business owner or have a healthy family, I can help you get a private nationwide PPO outside HealthCare.gov.
Give me your town, the ages of everyone who needs insurance and an approximate figure for last year's household business profit. I'll compare Park County marketplace premiums after tax credits with a private nationwide PPO quote, then explain which I'd choose.
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