You can still get a nationwide PPO in Florida, even after a year when marketplace prices jumped. Here's how builders, remodelers and general contractors here are keeping coverage affordable.
Hi, I'm Sam Jaber. I'm a health insurance broker with an office in Tampa, and Florida keeps contractors busy. There's new construction going up across the state, remodels in every older neighborhood, and after a hurricane, months of rebuild work that can stack a builder's calendar well into the next year. I'm licensed in 36 states and work by phone.
The question builders here bring me most is some version of this: the business had a good year, so why does health insurance feel harder than ever? Part of the answer is how the subsidy works. Part of it is that Florida's full-price marketplace plans got a lot more expensive this year. Let me walk you through how contractors here are handling both.
You can still get a nationwide PPO in Florida. For a healthy contractor, it's often the piece that makes the whole budget work.
Most builders assume the opposite, and it's easy to see why. One insurer, and only one, sells a PPO on the Florida marketplace, though it's offered in every county. Line it up against the lowest-priced plan built on another kind of network in the same county, and the PPO runs a median of 110% more. In 43 of the state's 67 counties, it costs at least double. Most people take one look and settle for an HMO.
But the marketplace isn't the only source. Private underwritten plans run on PPO networks that reach across the country and are priced on your health, not the marketplace's rate table.
Florida's marketplace runs through HealthCare.gov. The help it offers is a premium tax credit, and whether you get it depends on your household income for the year. For a contractor, that means net profit, after materials, subs, trucks, insurance, bonds and the rest come out. Same revenue, very different results.
This year, that line carries more weight in Florida than usual. Florida's Office of Insurance Regulation reports that approved 2026 rate changes on individual plans averaged 34.1%, weighted by how many people are enrolled and measured before subsidies. Under the line, the credit soaks up much of that increase. Over it, the increase is yours.
Pick the description below that fits your year.
When the company's net leaves your household inside the range where the credit applies, you'll rarely beat a HealthCare.gov plan on price anywhere in Florida. Nothing sold outside the marketplace can use the credit, so for you the marketplace wins on price.
The lower-priced options in most Florida counties are HMOs and EPOs with local networks. For a family that lives and works in the same part of the state, that's often fine. Before you pick one, we'll make sure your pediatrician, your family doctor and the hospital you'd actually go to are inside the network.
The other thing to get right is the estimate. Draws and retainage make a builder's income hard to call, and if a big job closes early and pushes your year higher, part of the credit can come due at tax time.
Next step: Send me last year's return and your job list, and I'll help you set an income figure you can defend and find a plan in your county that fits it.
This is the Florida builder who feels the 34.1% in full. No credit, the full marketplace price, and if you want a PPO there, you're looking at the one plan that typically runs around double the lowest-priced option in your county.
For a healthy household, an underwritten nationwide PPO is the comparison worth making. The application includes a health questionnaire, and based on it the company may approve you, turn you down, or approve you with a past condition excluded. That screening is why a healthy applicant can often pay less than the full marketplace rate, and it's also why each plan's benefits deserve a careful read. The network runs nationwide, which helps if you bid jobs in Georgia or Alabama, or your kids are away at college.
Next step: Call me and I'll price an underwritten PPO for your family and line it up against what your county's marketplace plans charge.
If you or someone you cover takes a daily medication or sees a specialist regularly, stay on the marketplace, even at full price. Your health can't be used there to turn you down or raise your rate. An underwritten plan makes no such promise.
For a Florida family in that spot, the real decision is usually between a local HMO or EPO and the marketplace's one PPO. When every doctor you see is within a short drive, the local plan often does the job. When a specialist you rely on is in another state, paying more for the PPO may be the right trade. That depends on your actual care, so we look at it name by name.
Next step: Give me the names of your doctors and the prescriptions you fill, and I'll see which plans in your county keep all of them.
Starting your own firm, or waiting out a stretch between projects, can leave a household with very little income for a year. In Florida that creates a trap people don't expect. Because Florida never adopted the Medicaid expansion, adults with very low income often don't qualify for Medicaid here, and help with marketplace premiums usually doesn't begin until income reaches the poverty line. Land below it and you can miss both.
If your year looks that thin, the estimate you give HealthCare.gov and the timing of when you apply both matter a great deal. This is a conversation to have before you enroll, not after.
Also, keep this straight while you're setting up a new company: workers' comp covers injuries on the job site. It isn't a health plan, and it won't pay for an illness or anything your family needs.
Next step: If your year looks lean, talk to me before you apply so we can sort out what you qualify for and how to report your income.
Three things set Florida apart. Full-price coverage went up sharply this year. The marketplace PPO is available everywhere but usually costs about twice the lowest-priced alternative. And the state never expanded Medicaid, so a very low income year has a gap at the bottom.
The approach stays the same: pin down your real net income first, then let your family's health point you to the marketplace or to a nationwide PPO. In this state, a wrong answer on either one just costs more.
Straight answers, no sales pitch.
Yes. There's a single PPO on the Florida marketplace, from one insurer, and in a typical county it runs around double the lowest-priced plan. Healthy contractors often find a nationwide PPO outside the marketplace is the more affordable route.
Approved 2026 rates for individual plans in Florida rose an average of 34.1%, by the state regulator's enrollment-weighted measure, before subsidies. The tax credit cushions much of that for contractors who qualify. Builders above the line absorb all of it.
It can. A busy rebuild season can raise your net income for the year, and the credit is based on that year's income. If your income climbs after you enroll, update your estimate with HealthCare.gov so the credit stays in line.
Plan ahead for it. Without the Medicaid expansion in Florida, and with marketplace credits generally starting at the poverty line, a household with almost no income can fall between the two. Reach out before you apply and we'll figure out the right move.
Your county, who needs to be covered and roughly what the company netted last year is plenty. I'll show you which way makes sense and what it costs, and if the plan you're on is already the better deal, I'll say so.
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