You can still get a nationwide PPO in Georgia, wherever Georgia Access sells none. Here is how owners of Georgia LLCs, S-corps and small shops are covering themselves and their families.
Hi, I'm Sam Jaber. From Tampa, with licenses in 36 states, I help Georgia owners by phone, whether the business is a solo LLC in Alpharetta, a husband-and-wife S-corp in Savannah or a small machine shop in Rome with a few people on payroll.
Owners buying coverage in Georgia go through Georgia Access, the state's own exchange, and run into three Georgia-specific facts. The PPO doesn't reach the big Atlanta counties. Medicaid was never fully expanded. And the state's continuation rule, for owners walking away from a job, lasts only a few months.
Of the 211 individual medical plans Georgia Access offers this year, 203 are HMOs. The 8 PPOs, all from one carrier, reach 71 counties out of 159, skipping Fulton, DeKalb, Cobb and Gwinnett entirely.
You can still get a nationwide PPO in Georgia, no matter which county the business calls home, and I can arrange it privately. Each family member answers medical questions, the premium reflects the answers, and doctors and hospitals across the country are in network. A healthy family should see this number first.
A company of owners and relatives buys individual coverage, either on Georgia Access or privately. Bring on a worker who isn't an owner or family member, and the small-business exchange, SHOP, may become available for a group plan. Even then, pricing individual plans alongside the group option is worth the time.
The credit depends on the household's income for the coverage year. A Schedule C or single-member LLC owner starts from net profit. An S-corp owner adds the salary paid out to the profit that passes through. Since 2026, there's no repayment cap if the credit you took exceeds what you were owed, so a profit estimate that runs low can cost real money in April.
Georgia Access is where the credit lives, so start there. Outside the Atlanta core, check whether your county has the PPO. Inside it, compare HMOs by whether the pediatrician and specialists your family sees are on the list. Revise the profit figure when a big contract shifts the year.
Next step: Bring last year's business return and your read on this one, and we'll pick an estimate and a plan the family's doctors accept.
At full price, each person on an Atlanta-area plan costs HMO sticker price. That's typically where owners compare the private side.
Underwriting goes person by person: the company reviews each applicant's health and then accepts the application, declines it, or accepts it with a specified condition excluded. Healthy households often save against the exchange's full price, and a child at an out-of-state college stays in network. We'll compare policies benefit by benefit.
Next step: Call me, and I'll quote a nationwide PPO for the family against Georgia Access prices in your county.
Owners who barely pay themselves face Georgia's gap. There's no full Medicaid expansion; Pathways, at 100% of the poverty level, comes with a work or activity requirement; and the exchange credit generally doesn't begin until that same 100%. Map out the year honestly before enrolling.
Next step: Before a startup-year enrollment, phone me and we'll pin down what the household is eligible for.
Georgia's continuation statute gives you the rest of the month coverage ends plus three more policy months, no more. Employers big enough for COBRA offer that instead. Either way, losing job coverage opens a special enrollment window on Georgia Access.
With so short a bridge, arrange the new plan before you resign.
Next step: Get in touch a few weeks before your last day, and I'll price continuation, a Georgia Access plan and a private PPO for comparison.
Straight answers, no sales pitch.
Only in the 71 counties where it's sold, and not in Fulton, DeKalb, Cobb or Gwinnett. A healthy owner anywhere in Georgia can buy a nationwide PPO on the private market through me.
Not through SHOP until there's an employee who isn't an owner or relative.
The remainder of the month coverage ends, plus three policy months.
No. Its Pathways program is capped at 100% of the poverty level and requires qualifying work or activities.
How the business is organized, what it roughly cleared, your county, and who in the family needs coverage. That's enough for me to recommend a route and put a price on it.
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