One week you're working a show in one city, the next you're somewhere else, and sometimes there's a long break before another job comes along. Here's how musicians, stagehands and production crews who purchase their own health insurance are controlling the cost while making sure their coverage works wherever the road takes them.
Hi, I'm Sam Jaber, a licensed health insurance broker working out of Tampa. I hold insurance licenses in 36 states, and I work with everyone by phone. That makes the process convenient when your job keeps you traveling instead of staying in one location.
Few occupations have income that changes as much as the musicians and production crews I speak with. The Bureau of Labor Statistics says approximately half of musicians and singers are self-employed, with work that frequently comes in part-time or irregular stretches. It's a similar situation for stagehands, sound engineers, lighting technicians, backline workers and production crews. You might work nonstop for several weeks during a tour or festival, spend some time waiting for the next booking, and then get busy again. One job might pay you on a W-2, while another pays through a 1099.
With no consistent employer providing health benefits, many of you end up responsible for purchasing coverage yourselves. Let me explain how other people working in music and live production figure out which insurance direction is appropriate for their circumstances.
I realize that predicting income isn't easy when your calendar depends on tours and bookings. Still, this is the question that determines where we should begin: do you expect your household income during the coverage year to stay below the subsidy threshold?
We're talking about a threshold of roughly four times the federal poverty level. For a household of one, that's slightly above $60,000 annually. The amount increases when there are additional people in your household.
When jobs come in waves, your income for the entire year can vary considerably. For earnings reported on a 1099, the relevant amount is your net income after subtracting expenses connected with doing the work. Those business costs are taken into account before arriving at the figure, and your tax preparer can clarify which expenses qualify. Once you have a sense of that number, look through the situations below and find the one that matches yours.
This is where many musicians and production workers find themselves, and marketplace coverage is generally the most practical choice. Since subsidies are available exclusively on marketplace plans, that financial assistance can reduce your monthly insurance payment to a more manageable amount.
The biggest challenge is projecting your earnings. You enroll using an estimate of your income for the year, but in this industry, landing one major tour can change everything. If your final income exceeds what you reported, the subsidy difference gets reconciled on your tax return, and you may need to repay some of it. The important thing is to revise your marketplace income information promptly whenever you book a substantial tour or lose a scheduled job.
We also need to consider where your insurance network works. In some locations, marketplace coverage is limited to HMO or EPO options, which generally don't pay for treatment outside their networks unless it's an emergency. When you're traveling for weeks at a time, we'll need to discuss how you would get regular, non-emergency medical care while away from your home area before settling on a plan.
Next step: Share your previous tax return and a general outline of your upcoming work calendar. I'll help you calculate a reasonable income projection and select health insurance that works with the way you travel.
Maybe you just finished a production contract that included benefits, or perhaps you had insurance through a W-2 job that's now ended. Losing that employer coverage generally opens a special enrollment period of 60 days, allowing you to purchase marketplace insurance outside the normal open enrollment dates. Keep in mind that if you elect COBRA and voluntarily cancel it before it ends, that cancellation won't give you another enrollment window.
You don't want to miss your enrollment deadline because you're busy working another tour. Let's talk before your existing insurance expires so we have enough time to arrange replacement coverage that starts without leaving you uninsured between plans.
Next step: As soon as you learn that your current health insurance will be ending, give me a call. We'll arrange the next plan before you leave for another tour or production job.
If you're a headlining musician, music director, experienced touring technician, or someone with a calendar full of paid dates, your income could exceed the subsidy cutoff. At that point, you're paying the marketplace's full premium. When you're healthy and hardly ever visit a doctor, spending that much on insurance can be difficult to justify.
For people in that position, I also compare medically underwritten private health plans sold outside the marketplace. Applying involves answering questions about your medical history, which the insurer uses to decide whether to approve you and what premium to offer. If your health is good, you may qualify for coverage that costs less than an unsubsidized marketplace plan.
For anyone who tours regularly, the biggest attraction is having a network that travels. These private plans use nationwide PPO networks, which means an urgent care facility in the city where you're performing tonight might still count as an in-network provider.
There is an important catch with this type of coverage: approval depends on the medical application. A previous health condition could cause the insurer to reject your application or exclude that condition from coverage. The benefits aren't identical across every plan either. Before you agree to anything, I'll explain what the specific policy covers and what it pays.
Next step: When you have a break between tour dates, call me. I'll compare a nationwide PPO quote with the marketplace's full premium so you can choose coverage that makes sense after a successful earning year.
Even when the marketplace in your home area has nothing but HMO or EPO options, or its PPO costs more than you can afford, you may still be able to get PPO coverage. For healthy applicants, I can quote nationwide PPO plans throughout the 36 states where I'm licensed. If your job has you traveling constantly, spending 15 minutes on the phone to compare pricing is worthwhile.
You can get started without bringing anything, although the following details will make our conversation more productive:
You won't pay me a fee for helping you choose coverage. My compensation comes from the insurance carrier after you enroll, and the premium remains exactly the same whether you use my services or not.
Straight answers, no sales pitch.
That depends on which kind of insurance you choose. HMO and EPO plans typically cover out-of-network treatment only when there's an emergency. PPO coverage also provides benefits outside the network, although your share of the cost is higher. Choosing coverage with a nationwide PPO network can help you find in-network doctors while traveling for work.
Use your previous year's tax return and upcoming bookings to work out a reasonable income estimate for the marketplace. Revise that figure whenever a tour gets scheduled or canceled, since waiting too long to report changes could leave you owing money when you file taxes.
When insurance through an employer ends, you normally have 60 days to purchase marketplace coverage outside the regular enrollment period. Contact me while your existing plan is still active so we can arrange the next one without interrupting your coverage.
Yes, that's possible. For someone in good health whose household income exceeds the subsidy threshold, I can compare private health insurance plans using nationwide PPO networks in each of the 36 states where I hold a license.
Let me know approximately how much you made last year, who needs to be covered, and what portion of the year you're traveling for work. That's enough for me to compare the available directions and explain the prices. If the insurance you already have makes the most sense, I'll be straightforward about that as well.
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