Private plans for the owner of a small business: no-deductible plans from $180 a month at 40 in North Carolina, the deduction by entity, what the team can.
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The short answer: the owner’s own coverage is a separate decision from the team’s. A healthy owner over the $63,840 line, where no credit applies, often pays less on a private plan: no-deductible plans from $180 a month at 40 in North Carolina to $350 in Colorado across the 23 priced states, on the UnitedHealthcare PPO network in 21 of them (PHCS in Illinois and South Dakota), any month of the year, with the medical part of the premium deducted the way the entity allows. For employees the business normally funds a group plan, an ICHRA or a QSEHRA; those are built around marketplace-type plans, so a private plan is the owner’s route, or something an employee buys for themselves.
Free private price check
ZIP, age, then headcount. A licensed agent prices the owner’s private options beside the full marketplace price, and a group plan, an ICHRA and a QSEHRA for the team from the same census. Free, and nothing is bought until you say so.
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“I run my own business and my time is valuable. Daniel handled everything — compared the private options, explained what I was actually getting, and had me covered fast. Way better experience than trying to navigate it myself.”
Sole proprietor or disregarded LLC: premiums for the household come off above the line, up to net profit (Form 7206). Partner: the partnership pays or reimburses, reports it as a guaranteed payment, and the partner takes the same deduction. S corporation, more than 2% owner: the corporation pays, adds the premium to Box 1 of the W-2, and the owner deducts it above the line. C corporation: premiums paid for an owner-employee are a business expense. In every case it is the medical coverage in the plan that counts; any life insurance or income benefit bundled into a package is not deductible, so the medical premium needs to be stated separately. None of it reduces self-employment tax, and none of it is tax advice: a tax professional owns the return. The owner’s coverage by entity type.
Illustration, not advice: a $400-a-month private premium is $4,800 a year; at a 22% federal bracket that is roughly $1,056 less federal income tax, before any state effect.
Pick a state and enter an age: the same estimate the sister sites show after a ZIP, from a licensed agent’s own rate table. Add a spouse and children for the household figure. The age is carried into the form above so you never type it twice.
No table price for this state yet. A licensed agent prices it from the carrier portal; put a ZIP in the box below.
At 40, healthy, before health questions, with the median marketplace Silver at full price beside it: the two numbers an owner over the line compares.
| State | Private plan at 40, healthy | PPO network | Deductible | Median marketplace Silver at 40, full price |
|---|---|---|---|---|
| North Carolina | $180 – $390 | UnitedHealthcare | no deductible | $866 |
| Kansas | $205 – $415 | UnitedHealthcare | no deductible | $973 |
| Georgia | $210 – $415 | UnitedHealthcare | no deductible | — |
| Nevada | $210 – $415 | UnitedHealthcare | no deductible | — |
| Utah | $210 – $385 | UnitedHealthcare | no deductible | $916 |
| South Dakota | $220 – $425 | PHCS | no deductible | $812 |
| Maryland | $240 – $375 | UnitedHealthcare | no deductible | — |
| Ohio | $245 – $385 | UnitedHealthcare | no deductible | $692 |
| Indiana | $270 – $350 | UnitedHealthcare | no deductible | $616 |
| Alabama | $300 – $415 | UnitedHealthcare | no deductible | $782 |
| Arkansas | $300 – $445 | UnitedHealthcare | no deductible | $780 |
| Michigan | $300 – $415 | UnitedHealthcare | no deductible | $774 |
| Mississippi | $300 – $435 | UnitedHealthcare | no deductible | $851 |
| Nebraska | $300 – $445 | UnitedHealthcare | no deductible | $991 |
| Oklahoma | $300 – $445 | UnitedHealthcare | no deductible | $775 |
| South Carolina | $300 – $445 | UnitedHealthcare | no deductible | $767 |
| Tennessee | $300 – $425 | UnitedHealthcare | no deductible | $902 |
| Virginia | $300 – $445 | UnitedHealthcare | no deductible | — |
| Wisconsin | $300 – $440 | UnitedHealthcare | no deductible | $801 |
| Florida | $310 – $450 | UnitedHealthcare | no deductible | $848 |
| Texas | $320 – $420 | UnitedHealthcare | no deductible | $909 |
| Illinois | $335 – $440 | PHCS | no deductible | — |
| Colorado | $350 – $445 | UnitedHealthcare | no deductible for day-to-day care | — |
Private plans are medically underwritten: your health history decides whether you qualify and the final price, and some applicants pay more or are declined. They are not ACA marketplace plans, they do not cover pre-existing conditions the way a marketplace plan does, and no premium tax credit applies. If you are not in good health, the marketplace is usually the better route. Not in the table: Delaware, Iowa, Louisiana, Missouri, Montana, West Virginia, Wyoming. A licensed agent prices those from the carrier portal.
The long version: the private insurance guide on Coverage by County; the 1099 side in full: Plans For 1099.
Yes, for the medical coverage in the plan. A sole proprietor, a partner or a more-than-2% S-corporation shareholder takes the self-employed health insurance deduction (Form 7206) up to the net profit of the business, in months with no employer plan available; the S corporation pays the premium and adds it to Box 1 of the W-2. A C corporation deducts premiums it pays for an owner-employee as a business expense. Any life insurance or income benefit bundled into a package is not deductible. A tax professional owns the return.
Usually not. Both are built around individual marketplace-type coverage, and a medically underwritten private plan is not that kind of coverage. Whether any part of an allowance can go toward a specific private plan is a question for a tax professional; plan on the answer being no.
The rules for a business paying for an employee’s individual policy outside a group plan or an HRA are strict and the penalties are large. A tax professional or benefits attorney answers that for a specific plan before the business pays anything. An employee can buy a private plan for themselves at any time.
No. It is medically underwritten coverage sold outside the marketplace: it pays set cash benefits for covered care, gives access to a national PPO network (UnitedHealthcare in 21 of the 23 priced states, PHCS in Illinois and South Dakota), is not minimum essential coverage, can exclude pre-existing conditions and benefits such as maternity, substance-use treatment and mental health, and no premium tax credit applies.
Anyone who qualifies for a meaningful premium tax credit. Anyone with ongoing treatment, a recent major diagnosis, expensive medications or a pregnancy. Anyone who needs maternity, substance-use or mental-health benefits covered. For them the marketplace, or the group plan, is the route.
Year-round. There is no November window; coverage usually starts within days of approval.
Price a private plan for the ownerBack to the ZIP box near the top of this page.