You can still get a nationwide PPO in Missouri, even with a marketplace that sells EPOs only. Here's how heating and cooling owners in Missouri are sorting out coverage as they grow from one truck to a small crew.
Hi, I'm Sam Jaber. I run a health insurance practice out of Tampa, Missouri is one of the states I'm licensed in, and I do everything by phone.
Missouri hands an HVAC company two hard seasons. Summer in Kansas City, St. Louis and the Bootheel is hot and sticky, and January brings the kind of cold that kills old furnaces. A tech who built a following often reaches the point where one truck isn't enough, and the next step is hiring. That's the moment this page is about, because adding a person to payroll changes your health insurance options in ways most owners don't expect.
For you and your family, you can still get a nationwide PPO in Missouri through me, however your crew ends up covered.
Missouri's marketplace won't supply one. For 2026, HealthCare.gov lists 117 individual medical plans for Missouri, from 8 insurers, covering every county and St. Louis city, and every plan is an EPO. An EPO pays out of network only in an emergency. A PPO pays for doctors outside its network too, at a higher share for you, and needs no referral. Medically underwritten private plans provide that on national networks, priced by your health.
While it's just you, you're a self-employed person buying on the individual marketplace, and your household's yearly profit decides whether the federal premium tax credit helps. Profit means what's left after the van, equipment, refrigerant, parts, licensing and insurance.
Hiring changes the picture. Once you have at least one employee who isn't an owner or a family member, your business may be able to offer coverage through SHOP, the small-business side of the marketplace. People you pay as 1099 contractors don't count toward that, so a helper on a 1099 doesn't change anything.
This is the situation the page is built around. Here are the questions I'd walk through with you:
There's no single right answer; it depends on your margins and your household. Workers' comp is a separate thing again: it covers the tech if he's hurt on a job, but it isn't health insurance for anyone.
Next step: Call me before the new hire's first day and we'll lay out the group and individual options side by side.
Once the company is busy all year, the owner's household often earns past the credit range and pays full price for an EPO. For a healthy family, a medically underwritten nationwide PPO is worth pricing. The insurer reads your health answers and covers you, declines you, or covers you with one condition excluded. Good health is how the premium can come in under the marketplace's full rate. We'll compare benefits plan by plan.
Next step: Give me your county and your family's ages, and I'll quote a nationwide PPO next to the Missouri EPOs available to you.
If the year starts slow and household income lands at or under 138% of the federal poverty level, Missouri's Medicaid expansion means you can qualify. If someone in the family manages a chronic condition or a daily prescription, stay with a HealthCare.gov EPO even at full price, because marketplace plans can't turn you down or price you on health. We'd find the one that keeps your specialists.
Next step: Call me if either of those describes your household and we'll pick the right fit for this year.
Straight answers, no sales pitch.
It can. With at least one employee who isn't an owner or family member, your business may qualify for the marketplace's SHOP coverage. 1099 helpers don't count.
Not on the marketplace, where all 117 individual medical plans for 2026 are EPOs. A healthy owner can get a nationwide PPO outside the marketplace through me.
That's a decision to make on the numbers. We'd price your household both ways, on the group plan and on its own individual plan, and see which holds up.
Only injuries on the job. It doesn't replace a health plan for illness or routine care.
How many people are on payroll or on a 1099, your Missouri county and who's in your own household is what I need to start. You'll get options with prices for you and the business, and an honest word if the setup you have already works.
The guide for every state, and other work I help with