The machines cost a fortune and the work stops when the ground freezes or the rain won't quit. Here's how equipment owner-operators are keeping health coverage affordable anyway.
Hi, I'm Sam Jaber, a licensed health insurance broker in Tampa. I'm licensed in 36 states and I work by phone, so you can call me from the cab during lunch.
If you run your own excavator, dozer or loader, or you've built a small site-work outfit with a few machines and operators, you already know the math is different for you. The equipment payments are big, the fuel and repair bills are bigger, and some months the weather shuts you down completely. Health insurance ends up being one more expense you have to plan around a lumpy year.
I'll walk you through how equipment owners in different situations are picking coverage that fits.
Everything starts with one question: is your household's yearly income below the cutoff for premium help on the marketplace?
The cutoff is four times the federal poverty level, just above $60,000 for someone in a household of one, with a higher cutoff for bigger households. Here's the part equipment owners need to understand. If you're self-employed, the marketplace uses your net self-employment income, which is what's left after business expenses. Fuel, repairs, insurance on the machines, trailer costs and the write-offs your tax preparer takes for the equipment itself all come off the top. A business with large invoices can still show a net figure that qualifies for help.
Now find the situation that sounds like you.
For a lot of owner-operators, especially in the early years of paying off equipment, the net lands below the line. If that's you, the marketplace is usually where the most affordable coverage is, because premium help only works on marketplace plans.
The tricky part is winter, or whatever your slow season is. You enroll based on an estimate for the year, and if things go better than expected, you're expected to update it. Skip that, and when you file taxes you could owe back some or all of the extra premium help you got.
So we'll start with your last tax return, factor in what jobs you have lined up and what your slow months usually look like, and settle on an honest estimate.
Next step: Send me last year's return and your job outlook, and I'll help you build an estimate and choose the right plan.
Owners with several machines and a few operators on payroll can clear the cutoff easily. With no premium help, the marketplace's full price can be hard to justify for a healthy family.
Private underwritten plans are worth a look here. You answer health questions on the application, and a healthy applicant often pays considerably less than the marketplace's full rate. These plans use nationwide PPO networks, so you have broad choice of doctors and coverage when you're traveling.
The trade-off: the insurer can turn down your application or approve it with a past condition excluded. Benefits are different plan to plan, so I'll walk through what each one covers before you decide. And since you have employees, it's worth knowing that a business with at least one non-owner, non-family employee may be eligible for the marketplace's small business option.
Next step: Call me and I'll show you a nationwide PPO price next to what the marketplace would charge for your household.
If you're running equipment for a contractor and getting ready to go out on your own, the contractor's health plan typically stops with your last paycheck. That loss qualifies you for a special enrollment period, most often 60 days, during which you can join a marketplace plan whatever the month. If you choose COBRA, let it run its full course, because canceling early by choice won't create a new enrollment window.
Your first year as an owner is hard to predict, with new payments and a customer list still being built. We'll look at both paths and choose the one that fits your most likely year.
One more thing. Workers' comp is about injuries on the job. It isn't a health plan, and it won't pay for an illness, a checkup or care for your family.
Next step: Call me a few weeks before your last day and we'll have new coverage ready to start when the old plan ends.
If anyone in your household has an ongoing condition or takes a medication they rely on, the marketplace is usually the better fit, even without help on the premium. A marketplace plan can't refuse you or charge more because of your health. An underwritten plan could decline you or leave that condition uncovered.
In that case I focus on finding the marketplace plan that keeps your doctors and covers your prescriptions, so you're paying for the care you actually need.
Next step: Send me your doctors and prescriptions and I'll check which plans in your area include them.
Some state marketplaces offer no PPO plans, and others offer one at a price that doesn't make sense. Plenty of people stop there. You don't have to. I can still line you up with a PPO that has a nationwide network, anywhere in my 36 licensed states. Healthy? Then a quick call gets you an actual price.
These make the conversation faster:
There's no charge for my time. The insurer covers my pay after you're enrolled, so the rate you see is the rate you'd get going direct.
Straight answers, no sales pitch.
The marketplace uses net self-employment income, so business expenses lower it. The cost of your machines usually shows up through deductions like depreciation and loan interest rather than the monthly payment itself. Your tax preparer can tell you how your equipment affects your net.
Report your best estimate for the full year when you enroll, then update it with the marketplace if your income changes. That keeps your premium help in line with what you actually earn.
You usually get 60 days from the date your job-based plan ends to pick a marketplace plan. Private underwritten plans take a while to approve, so get started a few weeks before you leave.
No. It pays for injuries you suffer while working and nothing else. Getting sick, a yearly physical, or care for your spouse and kids all call for a real health plan.
Tell me roughly what the business netted last year, how many people you have running equipment, and who's in your household. I'll point you to the path that fits and what it costs, and I'll tell you if your current plan is already the right one.
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