Storm season can make your whole year, or skip your town entirely. Here's how roofers who work for themselves are keeping solid health coverage without overpaying.
Hi, I'm Sam Jaber, a licensed health insurance broker in Tampa, where hurricane season shapes a roofer's whole calendar. I'm licensed in 36 states and I handle everything by phone.
Roofing has more self-employed people than most trades. Federal labor figures put it at about one in five roofers, and plenty more work as 1099 subs for a bigger outfit. That means a lot of roofers are buying their own health insurance, in a job that's hard on the body and where the money can swing wildly from one year to the next.
That swing is the whole story when it comes to picking a plan. Let me show you how roofers in different spots are handling it.
Your path starts with one question: will your household earn little enough this year to qualify for help with premiums on the marketplace?
Help is available up to four times the federal poverty level. That's a little over $60,000 for a single adult, and more for each extra person in the household. And for a roofer working for himself, the marketplace looks at net self-employment income, after materials, dumpsters, the trailer, crew pay, insurance and fuel come out. A season with big invoices can still leave a net figure that qualifies.
The hard part is predicting your year before you know what the weather will do. Here are the situations I see most.
For a lot of owner-operators and crew leads, a typical year lands below the cutoff. If that's you, the marketplace is usually the most affordable place to buy, because premium help only works on marketplace plans.
You'll enroll based on what you think you'll make. If a big storm rolls through and you end up way over, you're supposed to update your income with the marketplace. If you don't, the extra help you got gets reconciled on your tax return, and you may have to return some of it or every dollar of it.
We'll look at what you made last year, factor in how your season is going, and pick a number that's honest. If a storm changes the picture, we update it.
Next step: Send me last year's return and tell me how the season's going, and I'll help you land on a plan that fits.
If you've got crews, a sales team and steady insurance work, you're likely well past the cutoff. That means full price on the marketplace, and for a healthy family the full price can feel like a lot for a plan you hardly use.
You have another choice. Private underwritten plans look at your medical history when you apply. If you're healthy, they often cost significantly less than full-price marketplace coverage. They use nationwide PPO networks, which is a help if you chase storms across state lines and need care far from home.
The catch is that these plans can turn you down, or approve you and exclude a condition you've had treatment for. They also set their own benefits, so we walk through exactly what each one covers before you commit.
Next step: Call me and we'll compare an underwritten PPO with the marketplace's full price for your household, line by line.
Roofing is physical, and injuries come with it. This is where a lot of roofers mix up two kinds of coverage.
Workers' comp exists for injuries that happen on the job. It isn't health insurance. It won't pay for the flu, a checkup, your spouse's surgery or your son's broken arm from a soccer game. You need a real health plan for all of that, and if you run your own crew, it's worth asking whoever handles your business insurance how workers' comp applies to you personally.
If you're leaving a roofing company that gave you health coverage, losing that plan opens a 60-day window to enroll in a marketplace plan any time of year. If you take COBRA, use it until it runs out, because canceling it early on your own doesn't open a new window.
Next step: Call me if you're going out on your own or your crew plan is ending, and I'll have your coverage ready before the old one stops.
Years on roofs can leave you with a bad back, bad knees or worse, and you might also be managing blood pressure or a family member's diabetes. If anyone on your plan has an ongoing condition, the marketplace is usually the safer bet, even without a subsidy. A marketplace plan won't reject you and won't charge you more because of your health. An underwritten plan might do either.
So we focus on finding the marketplace plan that covers your doctors and your prescriptions, and that fits around a schedule where your busy season comes all at once.
Next step: Tell me your doctors and medications and I'll check which marketplace plans near you keep them covered.
Some marketplaces offer no PPO plans at all, and some offer one priced out of reach. Either way, you're not stuck with an HMO. Roofers in all 36 of my licensed states can get a PPO with coast-to-coast reach through me. If you're healthy, getting a price takes about fifteen minutes.
Not required, but these speed things up:
You owe me nothing for the help. The insurer pays me when you sign up, and you pay the same premium as someone who signed up on their own.
Straight answers, no sales pitch.
Use last year's net profit as a base and adjust for how this season is shaping up. Report your best estimate, then update it with the marketplace if a storm makes your year much bigger or smaller than planned.
You may. When your actual income comes in higher than the estimate you enrolled with, the difference in premium help is settled on your tax return. Updating your income during the year is the best way to avoid a big bill.
Usually not. If you're paid on a 1099, the company treats you as a business, not an employee, so you buy your own coverage.
No. Workers' comp only covers injuries on the job. You still need a health plan for illness, routine care and your family.
Give me a rough idea of what you cleared last year, how this season is shaping up, and who you need covered. I'll show you which way to go and what it costs, and if what you have already fits, I'll tell you to keep it.
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