You earned the license, opened the shop, and lost the company plan in the same move. Here's how electricians on their own are getting good coverage without overpaying for it.
Hi, I'm Sam. I'm a licensed health insurance broker based in Tampa, I'm licensed in 36 states, and I do all of my work over the phone. When it comes to health insurance, electricians' stories tend to rhyme.
You spent years as an apprentice and a journeyman, usually working for a contractor who handled the group health plan. Then you got your own license, maybe a van and a couple of good builders who send you work. Being your own boss feels great right up until open enrollment shows up and you realize the health plan is now your problem.
I'll walk you through how electricians in that spot usually land on the right plan. There are really only a few situations, and the right move depends on which one you're in.
Everything here hangs on one thing: whether your household income is low enough to get help paying premiums on the marketplace.
The line is drawn at 400 percent of the federal poverty level. For a single adult that comes to just over $60,000 a year, and it rises for a couple and rises again with each child. Here's why that matters so much for electricians in particular. The government's own wage figures put the typical electrician's pay close to that line for a single person, so a small change in your year can move you from one side to the other.
When you run the business yourself, the figure that counts is your net self-employment income, after the van, tools, licensing, insurance and the rest of your costs come out. Find your situation below.
For a lot of electricians running a one-truck operation, the honest answer is that some years land under the line and some land over. When yours lands under, the marketplace is nearly always where you'll find the most affordable plan, because the premium help only works on marketplace plans.
The thing to get right is the number you enroll with. You give the marketplace your best guess at this year's income, and if work picks up and you make more, you're supposed to update it. Leave it alone and the gap comes due at tax time, which can mean handing back part or all of what you were given.
That's why I like to work from last year's return plus what you already have lined up, then check in again mid-year.
Next step: Send me last year's return and a sense of your backlog, and we'll pick an income figure that holds up and a plan that fits it.
Once you're netting comfortably over the line, the subsidy disappears and the marketplace bills you the full rate. For a healthy family that full rate often feels like paying for a lot of coverage you hope to never touch.
This is where private underwritten plans come in. You answer medical questions on the application, and if your answers are clean, the price can come in well under the marketplace's full rate. They run on PPO networks that work nationwide, so a visit to an out-of-state specialist or urgent care on a family trip doesn't leave you hunting for an in-network door.
These plans can say no. They can also accept you but leave out something in your history. And no two of them pay benefits the same way, so before you choose, we go over what each one covers in plain language.
Next step: Call me and I'll price an underwritten PPO for your household and put it right next to the marketplace number.
Leaving a job where the employer provided coverage counts as a qualifying event. You'll typically have 60 days from losing that plan to enroll in a marketplace plan, no matter what month it is. If the old employer offers COBRA and you take it, let it run its course; canceling it early by choice doesn't give you a fresh window.
Your first year on your own is the hardest to predict. Some electricians land a big commercial job in month two, and some spend the spring chasing small service calls. We'll look at both paths and pick the one that fits the year you're most likely to have.
One word on injuries. If you're hurt on a job, workers' comp is the policy that deals with it, and it is not a health plan. It won't pay for your kid's ear infection or your annual physical.
Next step: Call me a few weeks before your last day so your new coverage starts the moment the old plan ends.
Diabetes, a heart issue, a child with asthma, a prescription that can't lapse. If any of those describe your household, the marketplace is usually where you should stay, even if you pay full price there. A marketplace plan can't refuse you, and it can't charge you extra for your health history. Underwritten plans make no such promise.
What I do here is narrow the marketplace choices down to the plans that keep your doctors in network and cover your medications at a reasonable tier, so the plan you pay for is the one that pays for your care.
Next step: Send me the names of your doctors and the medications you take, and I'll show you which plans near you cover them.
In many markets the marketplace offers only HMO or EPO plans, or its PPO costs far more than anyone wants to pay. A lot of electricians take that to mean a PPO is gone. It isn't. I can get you a nationwide PPO in any of the 36 states I'm licensed in. If you're healthy, a quick call is all it takes to see a real price.
You don't need to dig through files first, but these help:
Calling me won't cost you a thing. My commission comes from the insurer after you're enrolled, and no broker markup gets tacked onto your premium.
Straight answers, no sales pitch.
Through the marketplace, where premium help depends on household income, or through a private underwritten plan if you're healthy and earn too much for help. Losing an employer plan gives you a window to sign up right away.
It depends on household size and your net self-employment income, not your gross billing. The cutoff is four times the federal poverty level, a little over $60,000 for one person and more for larger households. Above it, you can still buy a marketplace plan at full price.
Often it's worth pricing. Keep in mind that for tax purposes, months when you could have been on a spouse's employer-subsidized plan generally don't count toward the self-employed health insurance deduction. Your tax preparer can confirm how that applies to you.
Many can. Self-employed people can often deduct premiums, but the deduction is limited to the net profit of the business. Ask your tax preparer to confirm your figure.
A rough number for what you netted last year, who's in your household, and your zip code is plenty to start. I'll tell you which way to go and what it runs, and if your current setup already makes sense, you'll hear that from me.
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