You can still get a nationwide PPO in Georgia, even in the counties where Georgia Access sells none. Here is how agents paid at closing are choosing coverage around commissions, health and where they live.
Hi, I'm Sam Jaber, licensed in 36 states and based in Tampa. Agents across Georgia, from Buckhead brokerages to small offices in Statesboro, can sort out their health insurance with me over the phone.
For a Georgia agent, the right plan depends more on your home county than you might expect. Georgia runs its own exchange, Georgia Access, and that exchange's PPO shows up in some counties and not others. The four biggest counties around Atlanta are among the ones without it.
Here's the map in numbers. Georgia Access lists 211 individual medical plans for this year; just 8 are PPOs. One insurer sells all eight, in 71 of Georgia's 159 counties, and Fulton, DeKalb, Cobb and Gwinnett aren't on that list. Agents who live there are choosing among HMOs.
In the counties that do have it, the marketplace PPO is fairly priced. Its least expensive silver version runs between 4% and 21% above the least expensive silver HMO in those rating areas, so an agent there who qualifies for the credit may be well served by it.
For everyone else, and for any agent paying the full sticker, you can still get a nationwide PPO in Georgia by working with me. It's a private plan, priced after a health questionnaire, with doctors in network across the country.
Georgia Access sizes the premium tax credit to your household's income for the coverage year. For an agent, that's commission minus the split, desk fees, MLS and board dues, signs, photography and miles.
Georgia's floor is unusual. The state passed on the ACA Medicaid expansion and instead runs Georgia Pathways, which KFF lists at 100% of the federal poverty level and which attaches a work or activity requirement. Since the marketplace credit generally kicks in at that same 100%, an agent with a terrible year who doesn't meet the Pathways rules can fall through.
And at the top, a strong fall can backfire. For tax years after 2025, repayment of credit you weren't owed has no ceiling.
Buy through Georgia Access; it's the only place your credit can go. In a PPO county, weigh that plan seriously. Inside the Atlanta core, compare HMO networks doctor by doctor.
Then keep your income current on the exchange. When a big listing closes, log the change that week.
Next step: Bring last year's return and what's pending, and we'll build an estimate and land on a plan that includes your physicians.
At full price, the Atlanta-area agent is buying an HMO, and an agent in a PPO county is paying full price for the one marketplace PPO. Plenty of team leads find the private side reads better.
Underwriting works like this: you complete a medical questionnaire, and the company either accepts you as is, declines, or accepts you minus a specific diagnosis. Good health is what lets the premium come in below the exchange's full rate. Each policy spells out its own benefits, and we'll read them together.
Next step: Ring me for a side-by-side: a nationwide PPO quote for your family against what Georgia Access charges in your county.
If income drops toward the poverty line, check where you stand before enrolling. Under 100% of it, the marketplace credit generally disappears and Medicaid exists only through Pathways and its work or activity rules. One closing can rescue the year, so the estimate deserves care.
Next step: Before you sign up in a slow year, call and we'll work out which side of that line your household sits on.
Stay with Georgia Access, even past the credit range. Plans on Georgia Access have to take every applicant and can't price around a diagnosis. The work is matching specialists to a network, and in a PPO county, deciding whether the marketplace PPO's modest premium is worth it for a particular doctor.
Next step: List your doctors and prescriptions, and I'll tell you which Georgia Access plans in your county keep them.
Straight answers, no sales pitch.
Not in Fulton, DeKalb, Cobb or Gwinnett. The marketplace PPO is sold in 71 of Georgia's 159 counties. A healthy agent living anywhere in the state can buy a nationwide PPO through me instead.
No. Georgia has its own exchange, Georgia Access.
No. It runs Georgia Pathways, listed at 100% of the poverty level and tied to a work or activity requirement.
The excess credit gets settled at tax time, uncapped for tax years after 2025. Report big closings to Georgia Access as they happen.
Which Georgia county you live in, who's on the plan, and roughly what you netted after splits. Those three answers tell me whether Georgia Access or a private nationwide PPO is the better buy for you.
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