Plain-English answers for business owners, the self-employed, and families - plus calculators to run your own numbers.
Carriers generally want to see at least one full-time W-2 employee on the plan besides the owner — most set the floor at two enrolled members total. There is no upper limit: I work with teams from two people to fifty. If you are not sure your headcount qualifies, a five-minute call settles it.
This is actually my specialty. Solo entrepreneurs and 1099 earners usually cannot buy a traditional group plan, but you have strong alternatives: medically underwritten private plans (often the best value if you are in good health), ACA marketplace plans, and supplemental coverage like accident or fixed indemnity. As a bonus, self-employed individuals can typically deduct up to 100% of their premiums.
Yes — the legal structure is not the obstacle. What matters is having at least one eligible W-2 employee besides yourself on the plan. Multi-member LLCs and S-corps with staff qualify with most carriers. A single-member LLC with no employees does not, but that just moves you into the individual-plan lane, where I can usually find something comparable.
Usually not. Most carriers define an eligible employee as someone working 30+ hours a week. Some carriers bend on this, and choosing the right one matters if your workforce is mostly part-time — that is exactly the kind of carrier-by-carrier detail I sort out for you.
Plan on roughly $300–$700 per employee per month for employee-only coverage, depending on ages, plan type, and deductible. Employers typically pick up 50–75% of that, with employees paying the balance through payroll. Use the calculator below for a ballpark, then let me quote your actual numbers — it is free and same-day in most cases.
Not if you are under 50 full-time-equivalent employees — the ACA employer mandate only applies at 50 and above. But carriers will usually require you to contribute at least half of the employee-only premium to issue a group plan. Most owners I work with offer coverage anyway: it is tax-deductible, and it is the single most requested benefit when you are competing for good people.
Generally yes — employer contributions are treated as a deductible business expense. Businesses under 25 full-time-equivalent employees with modest average wages may also qualify for the Small Business Health Care Tax Credit, worth up to half of premiums paid. I am not a tax professional, so run your specifics past your CPA — but bring them the quote first so they have real numbers.
In most cases, yes — self-employed individuals can typically deduct up to 100% of health insurance premiums for themselves and their family, even without itemizing. It is one of the most overlooked write-offs I see. The estimator below shows what that could mean for you; confirm specifics with your tax professional.
An HMO gives you a lower premium in exchange for staying in-network and routing everything through a primary care doctor. A PPO costs more but lets you see any doctor, anywhere — no referrals, with some out-of-network coverage. Most of my self-employed and traveling clients choose PPO for the freedom; budget-focused teams often land on HMO. There is no wrong answer, only a wrong fit.
ACA marketplace plans accept everyone regardless of health history, and price accordingly. A medically underwritten private plan asks health questions up front — and if you are reasonably healthy, that often unlocks nationwide PPO networks and meaningfully lower premiums than the marketplace. It is not for everyone, which is exactly why you want someone who quotes both lanes and shows you the math.
No — those ride as separate, inexpensive add-on policies. I quote dental and vision alongside every health plan so you can bundle a complete package: preventative and major dental care, eye exams, frames allowances, and contact lens coverage.
Yes — group plans allow employees to enroll a spouse and dependent children (typically to age 26). You as the employer are not required to contribute toward dependents, though many owners do. Employees usually pay their dependent share pre-tax through payroll, which softens the cost.
Individuals: often within days — private plans can start as soon as the 1st of the next month, sometimes sooner. Small groups: budget 2–4 weeks from quote to active coverage, with the carrier processing being the long pole. I provide same-day quotes, so the clock starts immediately.
Their group coverage typically runs through the end of their departure month. After that, COBRA (for companies with 20+ employees) or state continuation rules let them keep the plan by paying the full premium, and losing job-based coverage also opens a special enrollment window for an individual plan. I help departing employees land somewhere — it costs you nothing and they remember it.
Zero. Brokers are paid by the carriers, and your premium is identical whether you buy through me or directly from the insurance company. The difference is that with me you get every major carrier compared side by side, plain-English explanations, and a human who answers the phone after you have enrolled.
Group and ACA plans generally lock you to the annual open enrollment window unless you have a qualifying life event — marriage, a baby, losing other coverage. But here is what most people do not know: many private medically underwritten plans can be applied for year-round. If you missed open enrollment, call me before you assume you are stuck.
Health insurance is a plan you pay a monthly premium for, and in return the insurer helps cover your medical costs — doctor visits, hospital stays, prescriptions and more. You share costs through a deductible (what you pay before coverage kicks in), copays and coinsurance, up to a yearly out-of-pocket maximum that caps what you can ever pay. It protects you from large, unexpected bills.
The main types are HMO, PPO, EPO and POS plans, plus ACA marketplace plans and private medically-underwritten plans. They differ mainly in which doctors you can see and the balance of freedom versus cost. As an independent broker I compare all of them so you land on the right fit, not just what one carrier sells.
Start with your people and your usage: who needs covering, their ages, your budget, your preferred doctors and any ongoing prescriptions. Then weigh premium, deductible, network and out-of-pocket maximum together — the cheapest premium is not always the cheapest plan. A free consultation makes this simple.
Compare six things side by side: monthly premium, deductible, network (are your doctors in it?), out-of-pocket maximum, what is actually covered, and total yearly cost — not just the monthly price. If you are self-employed, also factor in the tax deduction. I line every quote up on the same factors so it is apples-to-apples.
An HMO is the cheapest but keeps you in-network and usually needs referrals. A PPO costs more but lets you see almost any doctor, in or out of network, with no referrals. An EPO sits in between — no referrals, but no out-of-network coverage except emergencies. Most self-employed and traveling clients choose a PPO for the freedom.
Three paths: ACA marketplace plans (with income-based subsidies you may qualify for), private medically-underwritten plans (often cheaper if you are healthy), and matching your deductible to how much care you actually use. A broker costs you nothing and can compare all three to find your lowest real cost.
A deductible is the amount you pay out of pocket each year before your plan starts sharing costs. A higher deductible means a lower monthly premium but more you pay when you need care; a lower deductible means the reverse. The right balance depends on how often you expect to use your coverage.
It protects you from catastrophic medical bills, gives you access to preventive care that catches problems early, and unlocks negotiated rates far below the cash price. For the self-employed, premiums are usually tax-deductible. The real benefit is peace of mind that one accident will not wreck your finances.
In most cases your doctor or hospital files the claim directly with your insurer and you just pay your share. If you paid out of pocket or saw an out-of-network provider, you submit a claim form (from your insurer's website or app) with the itemized bill. If you ever get stuck, I help my clients sort it out.
Do not panic — many denials are fixable. First, read the denial reason on your Explanation of Benefits; it is often a coding or paperwork error. You have the right to appeal: request a formal review with your insurer and add a letter from your doctor if it is about medical necessity. I help my clients push back on denials that are not right.
In Florida, individual plans commonly run about $250 to $700+ a month depending on your age, plan type and deductible; families and older applicants pay more. The right number is the lowest premium that still gives you a deductible, network and out-of-pocket maximum you can live with. A quick quote shows your real number.
No — $200 a month is on the lower end for health insurance in Florida and is a good rate, common for younger, healthy individuals or higher-deductible plans. Just check what you get for it: the deductible and network matter as much as the premium. If you are paying $200 for solid coverage, that is a win.
Yes — around $500 a month is fairly normal for individual coverage in Florida, especially for people in their 40s and 50s or those who want a lower deductible. Whether it is a good deal depends on the plan's network and out-of-pocket maximum. It is worth comparing a private plan to see if you can get the same coverage for less.
Not necessarily — $600 a month is within the normal range, particularly for older individuals or richer plans, but it is worth a second look. If you are healthy, a private medically-underwritten plan can sometimes deliver similar coverage for less. A free comparison tells you whether you are overpaying.
$900 a month is on the higher side for one person, though it can be normal for older applicants, families or low-deductible PPOs. Whether it is good depends on what it covers — if you are healthy and paying that much, you may have cheaper options. It is exactly the kind of bill worth having a broker review for free.
For a single healthy person, yes — $1,000 a month is high and worth reviewing. For a family or an older couple it can be normal. Either way, if you are paying around $1,000, get a second opinion: a private plan or a different deductible could lower it without giving up much coverage.
ACA ("Obamacare") prices vary widely because they are income-based. Many Floridians qualify for subsidies that drop the net premium to well under $100 a month, while others without subsidies pay full price (often $400 to $700+). The only way to know your number is to run your income and ZIP code — I can check what subsidy you would get for free.
The lowest-premium options are usually high-deductible ACA bronze plans or private medically-underwritten plans for healthy applicants. But the best low-premium plan is the one that still covers your doctors and caps your worst-case cost — a cheap premium with a useless network is not a deal. I find the lowest premium that still protects you.
There is no single best carrier — the best plan depends on your health, budget, doctors and whether you are an individual, family or business. The smart approach is to compare ACA marketplace, private PPO and supplemental options side by side. As an independent broker I am not tied to one company, so I match you to the best fit, not a sales quota.
Ballpark your monthly and annual cost as the employer.
*Assumes a 25% effective tax rate and fully deductible employer contributions. Estimates only — premiums vary by ages, location, and carrier. Not tax advice; confirm with your CPA. Get your real numbers →
Self-employed? See what deducting your premiums could be worth.
*Self-employed individuals can typically deduct up to 100% of premiums. Estimates only — not tax advice. Book a discovery call →
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