You can still get a nationwide PPO in Florida. Here is how advisors who own a practice or affiliate as contractors are covering their families after Florida's big price increase.
Hi, I'm Sam. I work out of Tampa as a licensed broker, helping advisors who own their practice or work under a firm's banner as 1099 contractors. I'm licensed in 36 states, everything happens by phone, and Florida is home.
You'll read this the way you read anything else: looking for the numbers. So here they are for Florida this year. Full prices rose sharply, the marketplace's PPO is a handful of plans from one insurer at a steep markup, and the state has no Medicaid expansion under very low incomes. For most established advisors, the first two matter most.
The fact that changes the comparison: you can still get a nationwide PPO in Florida, through me, and for a healthy advisor it is often priced well below the marketplace's own PPO.
The marketplace version is narrow. Only 14 of the 410 plans in Florida's file are PPOs, all sold by one insurer. Matched within the county, its markup over the least expensive silver plan on another network is 110% in Martin County, 85% in St. Lucie and 91% in Manatee.
The underwritten version is a private plan built on a national PPO network and priced on the health of the people applying. That's the plan worth pricing for a healthy household.
Florida buyers use HealthCare.gov, and its premium tax credit is based on household income for the coverage year. Many established advisors are above the range. In a transition year, after moving your book or opening your own office, it's worth confirming rather than assuming.
For a self-employed advisor, income starts from the practice's net after platform and compliance fees, licensing, staff and office costs. Quarterly fee billing can make one year look very different from the last, so we look at the year you're buying for.
The reason the answer matters: Florida's regulator put the average approved 2026 increase for individual plans at 34.1%, weighted by enrollment and before subsidies. Above the credit range, you pay all of it.
This is where the numbers point most clearly. With no credit, Florida's full-price increase applies to every person on your plan, and the marketplace PPO costs far more than the HMOs and EPOs around it.
An underwritten nationwide PPO reviews health answers for everyone applying. The insurer approves the application, declines it, or approves it with a condition excluded. For a healthy household, the price often comes in below the marketplace's full rate, with specialists available without a referral and a network that works when you travel to see clients. Benefit design differs from plan to plan, so we review it line by line.
Next step: Call me and I'll lay a nationwide PPO quote beside the marketplace plans in your county, for your whole household.
Leaving a W-2 role at a firm normally means its health plan stops too. Losing it opens a special enrollment period, generally 60 days, to buy through HealthCare.gov, and COBRA will be offered too. Dropping COBRA by choice later won't reopen enrollment, so pick your route first.
Private underwritten coverage can begin right as the firm plan stops, as long as the application is approved in time, so apply several weeks ahead.
Next step: Once your transition date is firm, call me and we'll have coverage waiting for the first day without the old plan.
If you employ someone outside the ownership and your family, your practice may be able to use SHOP, the small-business marketplace, for a group plan. A paraplanner on a 1099 doesn't count. In Florida's current market it's worth pricing both a group plan and individual coverage before you commit.
Next step: Give me your headcount and how each person is paid, and I'll price the group and individual options for the practice and your family.
If someone in your household has a chronic condition, keep their coverage on the marketplace even at full price. It can't refuse anyone or set the price by health. An underwritten plan can.
In Florida, the remaining decision is which network covers that person's care, and whether the marketplace PPO's markup buys access to a specialist the HMOs leave out.
Next step: Send me the doctors and medications that matter, and I'll show you which plans in your county include them.
For an advisor here, the most expensive mistake this year is paying full Florida price for a plan chosen by habit. A healthy household should see an underwritten nationwide PPO priced before deciding, and a household managing a condition should pick its marketplace plan by network, not just by premium. One more note for a lean transition year: Florida has not expanded Medicaid and the credit generally starts at 100% of the federal poverty level, so a very low year needs planning too.
Straight answers, no sales pitch.
Not in the usual sense. A practice with no employees buys individual coverage, through HealthCare.gov or an underwritten private plan. With an eligible employee, SHOP may be an option.
Florida's regulator put the average approved 2026 increase for individual plans at 34.1%, before subsidies. Advisors above the credit range pay that full increase.
There are a few, 14 of 410 plans, all from one insurer, and they cost far more than other plans in most counties. A healthy advisor can also get a nationwide PPO outside the marketplace through me.
Usually. The IRS caps the self-employed deduction at the practice's net profit, and it doesn't count months when an employer-subsidized plan was open to you. Your tax preparer can confirm the details.
Your county, the practice's net, how you're affiliated, and who needs coverage. I'll show you which route fits and what it costs for your address, and if you're already on the plan I'd pick, you'll hear that from me.
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