You can still get a nationwide PPO in South Carolina through me. Here is how owners of small family companies around Columbia are covering the household when the business is the only paycheck.
Hi, I'm Sam Jaber. I'm a licensed health insurance broker in Tampa, I hold licenses in 36 states, and South Carolina business owners can work through their family coverage with me by phone.
Picture a husband and wife in West Columbia who run a print and promotional products shop as an LLC: banners for the fall football weekends, shirts for church groups, signs for real estate offices. They have two kids in middle school. The business has carried the family for eight years, but it's lumpy. September and October are huge, and January can be thin. There's no group plan, so they buy on HealthCare.gov as Lexington County residents.
Lexington County shoppers have 52 individual medical plans for 2026 from three insurers: 30 HMOs, 13 EPOs and 9 PPOs. The PPO costs more here than in the typical county. Price silver plans for a 40-year-old without a subsidy, and in Lexington or Richland the most affordable PPO lands 33% above the least expensive silver HMO, while the statewide county median is 28%.
You can still get a nationwide PPO in South Carolina through me: private coverage, underwritten person by person, with a network that goes with the family on vacation, to college visits and to the grandparents out of state.
The marketplace looks at household income for the coverage year: the shop's profit after ink, blank stock, equipment leases, rent and wages for any help, plus any other income in the house. The credit reaches households up to four times the federal poverty level, which for a family of four is a much bigger number than for a single adult.
The bottom end is unusual in South Carolina. The state hasn't adopted the Medicaid expansion, and KFF lists the parent limit at just 67% of the poverty level, while the marketplace credit generally begins at 100%. A disastrous year can leave a family between the two.
Prices rose noticeably for 2026. The South Carolina Department of Insurance reported a 19.49% weighted average increase in individual-market rates.
HealthCare.gov is where the credit can be used, so start there. Your credit is a fixed amount pegged to a benchmark silver plan and won't climb if you pick the PPO, which means its 33% extra would come out of the business. For most families the better value is an HMO or EPO whose network holds their pediatrician and family doctor. If you'd rather keep a broad network, that's a choice we can price honestly.
Next step: Share the family's doctors with me along with last year's return, and you'll see which Lexington County plans cover them after the credit.
Above the credit range, each of the four of you pays the full sticker. A private plan is often the better buy for a healthy family. Every person completes a health questionnaire, and each application comes back approved, approved excluding one condition, or declined. Benefits differ between plans, so we compare them before you choose.
Keep the estimate current in a big year. If you take credit in advance and the fall season pushes profit up, the excess is repaid at tax time, and after 2025 there's no ceiling on that repayment.
Next step: Call me and I'll price a nationwide PPO for the family against the full HealthCare.gov prices in Lexington County.
That family member usually belongs on a marketplace plan, which can't refuse them or charge more for health, chosen for the network that keeps their specialist in Columbia. Everyone else in the house may be better off on a private plan if they're healthy.
Next step: Tell me who sees which doctors and takes what, and I'll price a split household against putting everyone on HealthCare.gov.
Once you bring on a worker from outside the family who owns no part of the company, the business may qualify for SHOP, the small-business marketplace, for a group plan. Whether that beats the family's individual coverage depends on the employee and the budget.
Next step: Phone me ahead of the first day on payroll, and we'll weigh a group plan against the family's current coverage.
Straight answers, no sales pitch.
In Lexington and Richland counties, the least expensive silver PPO costs 33% more than the least expensive silver HMO.
Only at very low incomes. KFF lists the parent limit at 67% of the federal poverty level, since the state hasn't expanded Medicaid.
Through SHOP, once it employs someone who is neither an owner nor a relative.
Yes. If your household is healthy, I can set up private nationwide PPO coverage.
Share your county, everyone's ages, about what the business cleared, and whether anyone can get coverage through a job. You'll get both paths priced and an honest pick.
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