You can still get a nationwide PPO anywhere in Virginia, even though the state marketplace only sells one in a handful of Northern Virginia localities. Here's how builders and remodelers here are covering their families for less.
Hi, I'm Sam Jaber. Health insurance is the only thing I sell, I work from Tampa, and my licenses include Virginia, so a phone call is all it takes whether you're in a job trailer in Chesterfield or a remodel in Virginia Beach.
Virginia spreads a builder's work across very different markets: new subdivisions around Richmond, additions and kitchens in the older Northern Virginia suburbs, military families cycling through Hampton Roads, and steady custom work out in the Shenandoah Valley. Run your own firm in any of them and the health plan is your purchase to make, through an exchange Virginia operates on its own. That exchange has a PPO gap that only shows up when you go looking for one.
Whatever corner of the Commonwealth you build in, you can still get a nationwide PPO in Virginia through me.
Virginia's Insurance Marketplace lists 83 individual medical plans for 2026, from 8 insurers, and just 4 of them are PPOs. Those 4 stop at the edge of Northern Virginia: Alexandria, Arlington, Fairfax City and Falls Church, plus pieces of Fairfax, Loudoun and Prince William counties. Live in Henrico, Roanoke or Chesapeake and your marketplace menu is HMOs, which usually pay nothing out of network outside an emergency, and EPOs, which only pay out of network for emergencies. Even where the PPO is sold, its least expensive version runs 131% above the lowest-priced plan built on a different network.
Underwritten private coverage gets around all of that. The networks are national PPOs, the premium follows your health, and a healthy contractor in Lynchburg can carry the same kind of plan as one in Arlington.
Because Virginia runs its own exchange, you enroll through Virginia's Insurance Marketplace instead of HealthCare.gov. Your household's yearly income then sorts you. Virginia took the Medicaid expansion, so adults at or under 138% of the federal poverty level can qualify for Medicaid. Above that, the federal premium tax credit trims what a marketplace plan costs. Past the top of the credit, the premium is all yours.
Even full-price shoppers get some help here: the state's reinsurance program, run under a federal waiver, exists to push individual-market premiums down. And for a builder, "income" is profit, after materials, subs, trucks, machines, permits, bonding and liability coverage.
If you're in Arlington, Alexandria, Fairfax City, Falls Church or the covered parts of the three counties around them, you can buy a marketplace PPO. The question is whether you should. At more than double the price of the lowest-cost alternative, it's a tough sell for a healthy family paying full price.
So the comparison worth making is that marketplace PPO against an underwritten nationwide PPO. The underwritten plan screens your health with a questionnaire, and the company may take you, pass, or take you with a past problem written out of the policy. When your history is clean, that screening is how its premium can undercut the marketplace's.
Next step: Tell me your locality and household, and I'll put the marketplace PPO, an underwritten PPO and the best HMO side by side for you.
Most of Virginia's established builders live where the marketplace sells no PPO at all. Above the credit range, that leaves full price for an HMO or EPO tied to one region, while your jobs may take you into Maryland, North Carolina or West Virginia.
For a healthy household, an underwritten nationwide PPO is the plan to price. Benefits are written plan by plan, so we read the fine print together before anything gets signed.
Next step: Phone me with your county and your family's ages, and I'll quote a nationwide PPO against the Virginia marketplace plans sold there.
Above the Medicaid line but under the credit's ceiling, a marketplace plan with the federal credit almost always wins on monthly cost, since that credit can't be spent on anything sold privately.
Outside Northern Virginia you'll be picking among local HMOs and EPOs, which suit a family whose doctors are nearby. We'll confirm yours are in the network first. If someone in the household lives with a chronic condition or a must-have prescription, the exchange is also the safer home at any income, because no marketplace plan can refuse you or price you on your health.
Builders' income lurches with closings and retainage. When a large job settles sooner than you planned, tell the marketplace, so the credit doesn't have to be squared up on your tax return.
Next step: Go through last year's return and your signed contracts with me, and we'll choose an income figure and a plan that fit.
A rough stretch can drop a contractor's household near zero. Virginia's expansion means a household at or below 138% of the poverty line can get Medicaid instead of going without.
Watch the rebound. Once jobs return and income passes that line, report it and expect to move onto a marketplace plan. And keep injury coverage in its lane: workers' comp answers for job-site injuries only, never for the flu or a child's checkup.
Next step: Give me a call if the year has turned thin, and we'll work out whether Medicaid or a marketplace plan suits you today.
Straight answers, no sales pitch.
Only if you live in part of Northern Virginia, where 4 marketplace PPOs are sold. Everywhere in Virginia, a healthy contractor can still get a nationwide PPO outside the marketplace through me.
No. Virginians enroll through Virginia's Insurance Marketplace, which the State Corporation Commission runs.
Virginia adopted the Medicaid expansion, so adults with household income up to 138% of the federal poverty level may qualify.
No. It only answers for injuries on the job. You need a health plan for sickness, checkups and your family.
Tell me which Virginia county or city you live in, who should be on the plan, and a ballpark for the firm's profit last year. You'll get a straight recommendation with real prices, even if that recommendation is to stay put.
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