Wisconsin business owners

Here's how small-business owners in Wisconsin are saving money on their health insurance this year

You can still get a nationwide PPO in Wisconsin through me, and Brown County is one of the few places where the marketplace sells one at nearly the EPO price. Here is how Green Bay owners use that.

Sam Jaber, licensed health insurance broker

Hi, I'm Sam Jaber, a licensed broker in Tampa with licenses in 36 states. Wisconsin business owners can work through family coverage with me by phone.

Imagine a couple in De Pere who own a cheese and specialty-foods shop with a wholesale side that supplies restaurants around Green Bay and up into Door County. The holidays and summer tourist season carry the year. For a long time, one of them worked for a paper company in town, and that job provided the family's insurance. Now the wholesale business needs two full-time owners, and the family of four is about to buy coverage on HealthCare.gov for the first time.

You can still get a nationwide PPO in Wisconsin

Brown County has 57 individual medical plans for 2026: 31 HMOs, 18 EPOs and 8 PPOs. That makes it one of the few Wisconsin counties with a marketplace PPO at all; the PPOs are sold in just 15 of the state's 72. And it's priced fairly: compare silver plans for a 40-year-old with no subsidy, and the PPO sits just 4% above the most affordable EPO.

Through me, you can still get a nationwide PPO in Wisconsin on the private side as well, priced on each family member's health, with a network that reaches past the Fox Valley to wherever the family travels.

Leaving the job with benefits

Wisconsin's continuation law is broad: it applies to insured group plans at employers of any size and can extend coverage up to 18 months, although it doesn't cover self-funded employer plans. That can be a bridge while the business finds its footing. Losing the job's coverage also opens a marketplace enrollment window, so compare both before you decide.

What the shop's income means for the premium

The marketplace uses household income for the coverage year: the shop's profit after inventory, cooler and delivery-van costs, rent and wages, plus other household income. Help applies up to four times the federal poverty level, a much higher figure for a family of four than for a single adult. Wisconsin also runs its own reinsurance program, the Wisconsin Healthcare Stability Plan, in place since 2019 and extended through 2028.

Scenario 1 of 3

The first year's profit qualifies us for the credit

HealthCare.gov is the only place the credit applies. Because the credit is tied to a benchmark silver plan, the PPO's extra 4% comes out of the family budget, which is a small price for broader coverage. Off-network care on an EPO is generally covered only in emergencies, whereas the PPO still contributes, leaving more of the cost with you. With trips to see family or kids playing tournaments around the Midwest, the credit-backed marketplace PPO is often a smart buy here.

Scenario 2 of 3

The business is strong and everyone is healthy

Above the credit line, each family member pays the full sticker. Compare the marketplace PPO against a private nationwide PPO. On the private side, each person completes a health questionnaire and comes back approved, approved minus one specific condition, or declined. Healthy families frequently pay less than the marketplace's full rate. We look at benefits plan by plan.

Scenario 3 of 3

We're adding our first employee

Hiring someone who isn't an owner or a relative may let the shop offer a group plan through SHOP, the small-business marketplace. Whether that beats the family's individual coverage depends on the employee and the budget.

Where the Wisconsin figures come from

  • Wisconsin's individual marketplace is HealthCare.gov Source
  • Brown County has 57 individual medical plans for 2026: 31 HMOs, 18 EPOs and 8 PPOs Source
  • In Brown County, the lowest-priced silver PPO costs 4% more than the lowest-priced silver EPO (age 40, before any subsidy); marketplace PPOs are sold in only 15 of Wisconsin's 72 counties Source
  • Wisconsin runs a state reinsurance program, the Wisconsin Healthcare Stability Plan, launched January 1, 2019 and extended through 2028 Source
  • Wisconsin's continuation law applies to insured group policies of employers of any size and allows up to 18 months of continued coverage; it does not apply to self-funded employer plans Source
  • The premium tax credit is based on the second-lowest-cost silver plan and generally covers households with income from 100% to 400% of the federal poverty level Source
  • Self-employed people with no employees use the individual marketplace; a business with at least one employee who is not an owner or family member may qualify for SHOP Source
  • EPOs generally cover care outside their network only in an emergency; a PPO covers out-of-network care at a higher cost to you Source

Questions small-business owners ask me

Straight answers, no sales pitch.

Is there a PPO on the marketplace in Green Bay?

Yes, eight of them, and in Brown County the most affordable silver PPO runs 4% above the most affordable silver EPO.

Can I keep my employer's plan after leaving to run my Wisconsin business?

Possibly. Wisconsin's continuation law covers insured group plans at employers of any size for up to 18 months, but not self-funded plans.

Does Wisconsin have a state reinsurance program?

Yes. The Wisconsin Healthcare Stability Plan began in 2019 and has been extended through 2028.

Can a Wisconsin business owner get a nationwide PPO?

Yes. Healthy owners and their families can buy one privately through me.

Tell me about the shop and the family

Send your county, everyone's ages, roughly what the business netted, and whether either of you has a job with group coverage. You'll get the marketplace PPO and a private one priced side by side, plus my pick.

More for small-business owners

The guide for every state, and other work I help with