When you leave a job to start your own business, your employer plan usually goes away. That leaves you to buy coverage yourself, and the rules depend on how your business is set up.
Group plan or individual plan?
Group health plans generally require at least one employee who isn't the owner or the owner's spouse, and carriers set their own participation rules. A business with only the owner generally can't buy a group plan, so the usual route is an individual plan, either a Marketplace plan or a private PPO.
LLC owners and solo businesses
Forming an LLC doesn't change that. An LLC with just you in it is treated like a solo business for this purpose. Once you hire employees, a group plan may become possible, and we can look at that with you.
Your income estimate
- Premium help is based on your expected income for the year, which for a new business means estimating your net profit, not your revenue.
- Startup income moves around, so update your estimate if it changes.
- Many owners can deduct their premiums. Ask your tax professional how that applies to you.
When you can enroll
Starting a business doesn't open a special enrollment period by itself. Losing your job coverage does, with a window of about 60 days. Otherwise you'd wait for open enrollment, which starts November 1 for 2027 coverage. Check HealthCare.gov for the current end date. Private plans aren't tied to that calendar, though they ask health questions.
What to compare
- Doctors and hospitals you want to keep.
- The deductible and out-of-pocket maximum, not only the monthly price.
- Prescriptions and telehealth.
- How the plan handles care away from home if you travel for work.
We compare both kinds of plans with your real numbers. Start with our self-employed health insurance page, or read how to estimate your income for premium help and compare private PPO and ACA plans.
This article is general information, not a guarantee of coverage or pricing. Plan availability, benefits, and eligibility vary by state and individual. Some private plans are medically underwritten and do not include all ACA essential health benefits.