You can still get a nationwide PPO in Indiana, even though the marketplace sells none. Here is what this year's rate increase means for an agent paying full price, and what to compare.
Hi, I'm Sam Jaber. Indiana agents, from Carmel and Fishers to Fort Wayne and Evansville, can handle their coverage with me without leaving the office; I'm a Tampa-based broker licensed in 36 states.
This page is about the Indiana agent who had a good year. Your net commission is past the range where the marketplace credit applies, so you see the full price. And Indiana's full price moved a lot: the state's Department of Insurance put the approved average rate increase for 2026 at 27.2%.
Count the plans on HealthCare.gov for an Indiana address and you'll find 80 medical options split among 45 HMOs, 33 EPOs and 2 POS plans, but zero PPOs.
You can still get a nationwide PPO in Indiana, though, and arranging it is my job. The insurer sets the premium from a medical questionnaire, and in return you get a coast-to-coast network with specialists available directly. For a healthy agent paying full price, it's the number to beat.
The approved increase is an average across the market, and it's measured before any subsidy. An agent receiving the credit is protected from much of it, because the credit adjusts to income. An agent past the credit range isn't protected at all. The whole increase lands on you, for every person on the plan.
The other half of the problem is the network. Outside their own networks, Indiana's marketplace HMOs and EPOs typically pay only for emergencies, so an agent with a lake cottage in Michigan or family in Chicago is buying coverage at full price that barely travels.
This is the agent who usually comes out ahead privately. The insurer reads your health answers and responds with coverage as applied for, a decline, or coverage with one diagnosis excluded. A healthy applicant frequently lands under the marketplace's full price, with a network that works in every state. Benefits vary policy to policy, so we'll go over them before you commit.
Next step: Send me your county and the ages of everyone on your plan, and I'll quote a nationwide PPO against the full-price marketplace plans you'd otherwise renew.
A chronic condition changes the answer. Marketplace plans must accept every applicant without charging more for health history, which underwritten plans don't promise, so that person belongs on the marketplace even at full price. Choose among the HMO, EPO and POS plans by whose network includes their specialists.
Next step: Tell me the doctors and prescriptions involved, and I'll find the Indiana plans in your county that cover them.
Strong years don't always repeat. If next year's commissions might fall into the credit range, the marketplace with the credit usually becomes the more economical choice again. In a truly rough year, an agent might even qualify for the state's HIP program, whose adult cutoff KFF lists as 138% of the poverty line.
If you're taking the credit in a year that turns out better than expected, keep HealthCare.gov updated: for tax years after 2025 there's no cap on repaying excess credit.
Next step: Walk me through your pipeline, and we'll pick coverage that suits the year you're actually likely to have.
Straight answers, no sales pitch.
Indiana's Department of Insurance put the overall approved average increase for 2026 individual plans at 27.2%. Agents without the credit pay that increase in full.
No. Indiana's marketplace mixes HMOs, EPOs and two POS plans with no PPO. Agents in good health can buy a nationwide PPO privately, and I can set it up.
Possibly, through the Healthy Indiana Plan, if the year's income stays at or under the 138%-of-poverty limit KFF reports.
You may owe it back when you file, with no cap for tax years after 2025. Update HealthCare.gov as commissions come in.
Tell me your county, everyone on the plan and what you netted after splits last year. I'll set a nationwide PPO quote beside your county's full-price marketplace plans.
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