You can still get a nationwide PPO in Delaware. For an HVAC owner in western Sussex County who bought a marketplace EPO, this fall's open enrollment is a must-act year. Here's why, and how to choose.
Hi, I'm Sam Jaber. I'm a broker licensed in Delaware, I handle health insurance only, and I do it all by phone, which suits an HVAC owner who's in a crawl space half the day.
Think of a heating and cooling shop in Seaford, run by a husband and wife with one tech. Their calls run from Seaford and Laurel out to Bridgeville and Delmar: heat pumps in newer homes, oil furnaces in old farmhouses, and summer calls from the retirement communities spreading west from the beaches. They're in their fifties. Their family doctor is in Seaford, but for anything bigger they drive across the line to Salisbury, Maryland, which is closer than Dover. Last fall they picked a marketplace EPO because it was the lowest-priced plan they saw.
For this couple: you can still get a nationwide PPO in Delaware, and I can quote one for a Seaford household.
Here's why this fall matters. In 2026, Delaware's 40 marketplace medical plans come from 3 insurance companies, and they divide neatly: one company sells all 17 EPOs, another all 15 PPOs, the third all 8 HMOs. The state's Plan Year 2027 rate announcement lists approved marketplace rates for only two companies, one with 16 comprehensive plans and a catastrophic plan, the other with 9 plans. The company behind this year's EPOs isn't on it. If you're on a Delaware marketplace EPO now, plan on choosing something new for 2027.
Don't wait for a letter, and don't assume an automatic move lands you somewhere good. Open enrollment for 2027 coverage runs November 1 to January 15, and you need to pick by December 15 for coverage that starts January 1. Prices have been climbing, too: KFF's average benchmark premium in Delaware rose 29.4% from 2025 to 2026.
Your credit depends on the household's estimated net income for the coverage year: the shop's receipts minus the tech's pay, the vans, equipment, parts and refrigerant, licensing and insurance.
If your doctors are in Seaford and in a network that's on the 2027 menu, the marketplace is usually your lowest-priced path, since the credit only works there. Among the plans left on the 2027 menu, the lower-priced one whose network has your doctors is usually the better buy when your care stays local, because your credit doesn't grow with a pricier plan. We'll compare the 2027 prices as soon as they post. Ask the Seaford practice which networks it plans to accept for 2027, since that answer drives the choice more than the premium does.
Next step: Send me last year's return and your doctors' names, and I'll price the 2027 plans with your credit as soon as they're posted.
If the household is past the credit range, every marketplace plan is full price, and a couple in their fifties feels that. If you're both healthy, a medically underwritten nationwide PPO deserves a quote. You each answer health questions; the insurer approves, approves with one earlier condition excluded, or declines. Healthy applicants often come in under the marketplace's full price, and the network covers Maryland as well as Delaware. Bring your list of Salisbury specialists too.
Next step: Call me with both birth years and your health history, and I'll quote a nationwide PPO against the 2027 marketplace prices.
Straight answers, no sales pitch.
Plan on it. All 2026 EPOs come from a company that isn't on the state's 2027 rate list.
Two, down from three selling marketplace plans in 2026.
Yes. KFF's average benchmark premium in Delaware rose 29.4% from 2025 to 2026.
By December 15 for coverage starting January 1. Open enrollment runs November 1 to January 15.
Tell me your current plan, who's on it, the doctors you see in Seaford and Salisbury, and last year's net. I'll show you what's on the 2027 menu with your credit, plus a nationwide PPO.
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