You can still get a nationwide PPO in South Dakota through me. In Brookings County the marketplace PPO is actually priced under the EPO, so here is how a couple running a repair shop picks coverage for their own household.
Hi, I'm Sam Jaber. I'm a Tampa broker licensed in 36 states, and South Dakota business owners work through their health coverage with me on the phone.
Here's the owner I'm picturing. A husband and wife run a farm equipment repair and welding shop on the edge of Brookings, a few minutes off I-29. He handles the combines and grain carts that roll in at harvest; she keeps the books, the parts orders and the two mechanics on payroll. Their busiest weeks follow the planting and harvest calendar of the farms around them, and a wet spring or a short crop shows up in their numbers months later. The shop doesn't carry a group plan, so the two of them buy their own.
Brookings County offers 28 individual medical plans on the marketplace for 2026 from three insurers: 21 PPOs and 7 EPOs. Here the usual pattern flips. For a 40-year-old before any subsidy, the least expensive silver PPO costs 6% less than the least expensive silver EPO. The PPO comes out ahead in 22 of the 49 South Dakota counties that sell both kinds.
A nationwide PPO is still on the table for you in South Dakota, through me. It's sold privately, priced after a health review, and its network doesn't stop at the Minnesota line, which helps if a specialist referral sends you east.
For the marketplace credit, what counts is household income for the year you're covered. For an owner that generally means what the business nets to you after parts, steel, shop rent, insurance, payroll and equipment, not what it bills. Help stops once household income tops four times the federal poverty level.
South Dakota's prices rose modestly going into 2026. KFF puts the rise in the average benchmark silver plan for a 40-year-old at 5.8%, though your own bill turns on your ages, your county and your income.
The credit is pegged to the second-lowest-cost silver plan, and it doesn't grow if you pick something pricier. In Brookings County that works in your favor: the least expensive silver PPO already sits 6% below the least expensive silver EPO, so with the credit the PPO is usually the better buy. You get out-of-network coverage for less, while an EPO generally pays only inside its network outside an emergency. The one reason to take the EPO is if your doctors are in its network and not the PPO's.
Next step: Send me your doctors and last year's net from the business, and I'll show you the Brookings County PPOs and EPOs after the credit.
When the year carries the household past four times the poverty line, there's no credit and you pay the full marketplace price. Compare that with a private nationwide PPO. The insurer reviews each person's health and then approves, approves with one condition left out, or declines. Plenty of healthy couples land under the full marketplace price, and I'll go through each plan's benefits with you before anything is signed.
Next step: Phone me after you close the books for the year, and I'll price a nationwide PPO against the unsubsidized Brookings County plans.
That spouse belongs on a marketplace plan whatever the income, since those plans take every applicant at the same price regardless of health. With three insurers selling in Brookings County, choose by which network includes the doctors and the hospital that person already uses. The other spouse, if healthy, might still do better on a private plan, and we can price it both ways.
Next step: List the doctors and prescriptions involved, and I'll find the Brookings County plans that keep them.
When farmers park equipment instead of fixing it, the shop's net can drop a long way. If household income for the year falls to 138% of the poverty level or below, KFF lists that as South Dakota's Medicaid limit for adults. The state also says that from January 1, 2027, most expansion adults ages 19 through 64 must show 80 hours a month of work, training, school or service, so look at how it would apply to you. When the work comes back, update your income and return to a marketplace plan.
Next step: If this year looks thin, call me before you renew, and we'll work out where your household lands.
Straight answers, no sales pitch.
Yes. In Brookings County the least expensive silver PPO costs 6% less than the least expensive silver EPO, before any subsidy.
Generally the net. What counts is household income, and for an owner that's what the business nets after its expenses.
Not by much. By KFF's count, the statewide benchmark silver plan for a 40-year-old cost 5.8% more in 2026 than in 2025.
Yes. If you pass the health review, I can set one up for you off the marketplace.
Tell me your county, who's on your policy and roughly what the business paid the two of you last year. I'll price the Brookings County marketplace and a private nationwide PPO and tell you which I'd pick.
The guide for every state, and other work I help with