You can still get a nationwide PPO in North Carolina through me, alongside whatever Buncombe County's marketplace sells. Here is how owners of small Asheville companies, often on the road for shows and markets, are covering their families.
Hi, I'm Sam Jaber, a licensed broker based in Tampa with licenses in 36 states. Owners of small North Carolina companies can work out family coverage with me by phone.
Here's a family I could easily picture calling me from Asheville. A couple runs a pottery studio and shop in West Asheville as an LLC. They sell from the shop all year, but from spring into fall they're on the road for weeks at a time, doing craft shows in Atlanta, Charleston, Gatlinburg and Asheville's own fairs. Their two kids come along in the summer. There's no payroll beyond the two owners, so there's no group plan. Their coverage comes from HealthCare.gov, priced for Buncombe County, and has to work in a booth three states away.
Buncombe County's marketplace has 59 individual medical plans from five insurers for 2026: 50 HMOs and 9 PPOs. The PPO is there, and in Buncombe it's not wildly out of line. At age 40, before any subsidy, the least expensive silver PPO costs 19% more than the least expensive silver HMO.
You can still get a nationwide PPO in North Carolina through me, too. It's a private plan, priced after each person answers health questions, with a network that reaches the cities your shows are in. Which of the two wins depends mostly on the family's income and health.
For an LLC taxed as a sole proprietorship or partnership, the marketplace starts from net profit after the kiln, clay, booth fees, travel and the other costs of running the business. Everyone in the household counts, and the credit runs up to four times the federal poverty level, a line that rises with each family member. If you hire someone who isn't an owner or a relative, the small-business marketplace, SHOP, becomes an option too.
Full prices moved this year. KFF's benchmark silver premium for a 40-year-old in North Carolina rose 25.8% from 2025 to 2026, and a family pays that increase person by person.
Start on HealthCare.gov, since the credit only applies there. One thing to understand: the credit is set from a benchmark silver plan, so it's the same whether you choose an HMO or the PPO. The 19% difference is yours to pay.
For a family that spends months on the road, that difference can be well spent. A Buncombe HMO generally pays outside its network only in an emergency, so a routine visit for a child's ear infection at a show in South Carolina may not be covered. If the PPO's network includes your family's doctors and the extra fits the budget, it's a sensible buy with the credit behind it.
Next step: Bring last year's return and the family's doctors, and I'll price the HMOs and the PPO with your credit applied.
Past the credit range, a family of four pays the full sticker per person, and the PPO's sticker is higher. Healthy families often find a private plan easier on the budget. Each person answers medical questions, and the insurer offers coverage as applied, offers it with a particular condition excluded, or declines. Benefits are set plan by plan, and we go through them before you decide.
Watch the estimate in a good year, too. If you took advance credit and profit ends up higher, the excess is repaid at tax time with no cap for tax years after 2025.
Next step: Call me and I'll lay a nationwide PPO quote for the whole household beside Buncombe's full marketplace prices.
This is common, and it doesn't force one answer for everyone. The person with the condition should usually stay on a marketplace plan, which can't decline them or charge more for their health, picked for the network that keeps their specialist. The healthy members of the household may be priced privately on a nationwide PPO.
Next step: List each person's doctors and prescriptions, and I'll price the split and the all-marketplace option side by side.
Once someone who isn't an owner or family member joins the payroll, SHOP may open up for a group plan. Whether a group plan is worth it depends on the employee, your budget and what your own family already has.
Next step: Call me before the new hire starts, and we'll compare group and individual coverage for the owners.
Straight answers, no sales pitch.
Yes. Buncombe County has nine marketplace PPOs, and the least expensive silver one costs 19% more than the least expensive silver HMO.
No. The credit is based on a benchmark silver plan, so you pay any difference for a pricier plan.
Not through SHOP. That requires at least one employee who isn't an owner or family member.
Yes. Healthy owners and their families can buy one privately through me.
Your county, everyone's ages, roughly what the company netted, and how much of the year you spend on the road. I'll price the marketplace and a private nationwide PPO for your family and tell you plainly which one wins.
The guide for every state, and other work I help with