You can still get a nationwide PPO in South Dakota through me. Here is how a Rapid City worker going out on her own decides between keeping her old group plan, a marketplace plan and a private PPO.
Hi, I'm Sam Jaber, a health insurance broker in Tampa licensed in 36 states. Plenty of the people I help are paid on 1099s, and South Dakotans can do all of it with me over the phone.
Here's the picture I have in mind. A graphic designer in Rapid City spent six years on staff at a small marketing shop downtown. This spring she left to work for herself, and most of her new clients are Black Hills businesses: campgrounds near Custer, gift shops in Keystone, a couple of trail outfitters around Hill City. Her calendar is packed from Memorial Day through the end of summer and quiet once the visitors head home. Her old employer's plan ends with her last paycheck month, and she has three ways forward.
Pennington County has 28 individual medical plans on the marketplace for 2026 from three insurers: 21 PPOs and 7 EPOs. So the marketplace does sell PPOs in Rapid City, and the markup is small. At the silver level, for a 40-year-old before any subsidy, the least expensive PPO is 6% above the least expensive EPO.
You can still get a nationwide PPO in South Dakota through me, too, outside the marketplace. It's underwritten on your health, and its network goes with you if a client project or a family trip takes you out of state.
Keeping the old plan is the first. South Dakota law lets someone leaving a job continue the group coverage for up to eighteen months, with the departing employee paying the bill. That means the full premium, the share your employer used to cover included.
The second is HealthCare.gov. Losing job coverage generally gives you 60 days to pick a marketplace plan. The third, for a healthy person whose income is too high for help, is a private nationwide PPO.
What tips it is your income estimate. As a new contractor you guess your net self-employment income for the year, after software, equipment, a home office and mileage out to clients in the Hills, and you update the estimate as the real number shows up.
If the estimate lands between 100% and 400% of the poverty line, the marketplace credit usually makes it the most affordable path, and continuation at full price rarely competes. Between the two plan types, the 6% PPO premium buys out-of-network coverage. An EPO generally pays only inside its network, emergencies aside. If your doctors are in Rapid City and you rarely leave, the EPO probably wins. If you'd want a specialist the EPO doesn't include, the PPO may be worth it.
Next step: Send me your doctors and a first-year income guess, and I'll price the Pennington County EPOs and PPOs after the credit.
Above four times the poverty line there's no credit, so the real contest is continuation versus a private nationwide PPO. Before you elect continuation, let me quote the PPO. It asks health questions up front and comes back with an approval, an approval that leaves out one condition, or a decline. Healthy contractors often come in under the marketplace's unsubsidized price, and I'll still put that price and your continuation bill on the table so you see all three. We'll go through the benefits line by line.
Next step: Call me before your election deadline, and I'll put a private PPO quote next to your continuation price.
A first year can disappoint once the season ends. If the whole year comes in at or under 138% of the poverty level, KFF lists that as South Dakota's Medicaid limit for adults. The state's own guidance says that from January 1, 2027, most expansion adults ages 19 through 64 will need 80 hours a month of work, training, school or volunteering, and expansion renewals move to every 6 months.
Next step: If the season didn't pay the way you hoped, ring me before you apply anywhere, and we'll figure out which side of the line you're on.
Then continuation or a marketplace plan is the safer bet, because neither one turns you down over your health. If you're mid-treatment, staying on the old plan can keep your current network intact while you settle in. When it runs out, or at open enrollment, move to whichever Pennington County plan includes your specialists.
Next step: Tell me who's treating you and what you take, and I'll check which Rapid City plans keep that care in network.
Straight answers, no sales pitch.
Usually, yes. State law allows up to eighteen months of continuation, but you pay the whole premium.
Yes. Pennington County has 21 marketplace PPOs, and the least expensive silver PPO costs 6% more than the least expensive silver EPO.
Generally 60 days on HealthCare.gov from the date that coverage is lost.
Yes. Contractors in good health can buy one privately through me.
Tell me the date your job plan stops, who you're covering, and what you expect your 1099 work to net this year. I'll lay the old plan, the Pennington County marketplace and a private nationwide PPO side by side.
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