Most plumbers get their benefits from the shop they work for, right up until they open their own. Here's how plumbers and pipefitters on their own are covering their families for less.
Hi, I'm Sam Jaber, a licensed health insurance broker in Tampa. I'm licensed in 36 states and work entirely by phone, which suits plumbers just fine, since most of you are taking my call from a truck between jobs.
Plumbing is a trade where most people work for someone else. Government labor figures show most plumbers and pipefitters are employed by plumbing and heating contractors, and only a small slice are self-employed. So if you're in that slice, you probably came out of a shop that handled your benefits, and the day you opened your own, that part of the paycheck vanished.
On this page I'll show you how plumbers in your position are picking coverage that costs less without leaving gaps. It starts with one question.
Here's the question that sorts everything: is your household income under the cutoff for marketplace premium help?
Subsidies stop at roughly four times the poverty level. If you're single, think of that as a bit more than sixty thousand dollars of income, and every person you add to the household raises it. The typical wage for an employed plumber sits right around that figure for one person, which is why this question really splits the trade down the middle.
If you own the shop, the marketplace doesn't look at what you invoice. It looks at your net self-employment income, after parts, the truck, licensing, liability coverage and your other expenses. Emergency call-out months and slow months both feed into that. Now pick the description that fits you.
If your household comes in under the cutoff, the marketplace is usually your most affordable option by a wide margin, because premium help is only available on marketplace plans.
Plumbing income isn't steady, though. A freeze can fill your calendar for a month and a quiet summer can empty it. The marketplace asks you to report your expected income for the year and keep it updated as things change. If you report low and end up high, the extra help you got is reconciled when you file taxes, and you may need to repay some of it or all of it.
So we start with what you actually netted last year, look at what's changed, and settle on a number you'd be comfortable defending.
Next step: Send me last year's tax return and I'll help you build an honest estimate and match it to a plan.
Plenty of shop owners with a few trucks on the road end up here. No subsidy means the marketplace charges full freight, and for a healthy family that price can be hard to swallow.
There's a second set of plans for exactly this situation. They're private plans that look at your health when you apply, using a medical questionnaire. Since the insurer can choose whom to accept, a healthy applicant often pays much less than the full marketplace rate. They're built on PPO networks with national reach, so you aren't boxed into one local group of doctors.
Know what you're signing up for. A medical questionnaire means an application can be declined, or approved with something in your past excluded. Benefits differ from plan to plan, so I go through what each one actually covers with you before you make a choice.
Next step: Call me and we'll compare a nationwide PPO price with what the marketplace would charge your family, side by side.
When you leave a job that gave you health coverage, you qualify for a special enrollment period. That's usually 60 days to join a marketplace plan, even in the middle of the year. If you elect COBRA, ride it to the end rather than canceling early, because walking away from COBRA by choice doesn't count as a qualifying event.
An underwritten plan needs time to process your application, so I'd rather start this conversation a few weeks before your last day than after.
While you're setting up the business, you'll also be sorting out liability coverage and possibly workers' comp. Keep the categories straight: workers' comp handles job injuries, and that's all. It won't touch a sinus infection, a routine checkup or anything your family needs.
Next step: Call me before you hand in your notice and we'll line up coverage that starts the day after your shop plan ends.
Your household's health history matters more than income in this case. If someone sees a specialist often, or needs a prescription that can't wait, stick with the marketplace even at full price. Every marketplace plan has to accept you, and none of them can price you higher for a pre-existing condition. A medically underwritten plan could turn you down or leave the condition uncovered.
My job then is to find the marketplace plan where your specialists are in network and your medications are covered, so you're paying for a plan that actually handles the care you use.
Next step: Tell me who your doctors are and what you take, and I'll check them against the marketplace plans in your county.
Lots of marketplaces lean on HMO and EPO plans, which usually pay nothing out of network outside an emergency. Where a PPO does show up, the price can be eye-watering. That's not the end of it. A plumber in any of the 36 states where I hold a license can get a PPO with a national network by working with me. If you're in good health, a short call will show you the number.
Have these nearby if you can:
Your wallet stays out of my side of it. The insurer compensates me when your plan starts, and that doesn't raise what you pay each month.
Straight answers, no sales pitch.
Your employer plan typically ends when you leave, and losing it gives you about 60 days to enroll in a marketplace plan. If you're healthy and earn too much for premium help, a private underwritten plan is worth pricing too.
The marketplace uses net self-employment income, which is what's left after business expenses. Your total billings don't count; your profit does, along with any other household income.
In many cases, yes. The self-employed health insurance deduction is capped at the net profit of your business, and it doesn't apply in months you could have been on an employer-subsidized plan. Check the details with your tax preparer.
No. Workers' comp is for injuries that happen at work. It doesn't pay for illness, preventive care or your family's medical bills, so a health plan is still a must.
What the shop cleared, how many people you're covering and where you live is all I need to get going. I'll point you at the path that fits and price it, and if you're already on the right plan, I'll say so and let you get back to work.
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