Coverage by business model
The 2027 premium tax credit ends at 400% of the poverty level: $63,840 for one person, $86,560 for a couple and $132,000 for a family of four. Established advisors usually earn more, though income can swing with markets and a firm transition.
| Model | Typical coverage | Watch for |
|---|---|---|
| Wirehouse or bank employee | Employer group plan | Coverage timing when you leave for an independent model |
| Independent rep with a broker-dealer (1099) | Individual plan; association plans some broker-dealers arrange | Compare the network and renewal history |
| RIA owner with staff | Small-group plan, ICHRA or QSEHRA | Owner's deduction depends on the entity |
| Solo RIA | Individual plan plus the self-employed deduction | Income volatility and HSA funding |
Changing firms without a gap
Moving from an employer to an independent model usually ends group coverage at the end of the month you leave. You have 60 days to elect COBRA and 60 days to enroll in an individual plan. The cleanest move is to choose the individual plan before your last day so it starts the first of the following month. If clients and assets are slow to transfer, COBRA can bridge a few months, but price both.
Two examples
Illustrative examples using 2027 averages, not quotes.
Breakaway advisor in Charlotte. A 52-year-old with a 50-year-old spouse leaves a wirehouse in June to start an RIA. Benchmark Silver for the couple averages $1,930/month in North Carolina in 2027. Their income is above the $86,560 couple cutoff, so they pay full price and deduct it against RIA profits. With an HSA-eligible plan they contribute $9,000 to an HSA and invest it.
Solo advisor in Tampa with a down year. A 45-year-old's net profit drops to $58,000 in a bad market year, under the $63,840 single cutoff. The required contribution is about $494/month against a Florida benchmark averaging $834/month at age 45, so the credit is about $340/month. Updating the income estimate mid-year avoids paying it back.
What 2027 coverage costs by state
| State | Benchmark Silver, two adults age 52 | Per year | Where you enroll |
|---|---|---|---|
| Florida | $2,159/mo | $25,908 | HealthCare.gov |
| Texas | $2,156/mo | $25,872 | HealthCare.gov |
| North Carolina | $1,930/mo | $23,160 | HealthCare.gov |
| Georgia | $2,144/mo | $25,728 | Georgia Access |
| Missouri | $1,974/mo | $23,688 | HealthCare.gov |
| Wisconsin | $2,106/mo | $25,272 | HealthCare.gov |
| Tennessee | $2,328/mo | $27,936 | HealthCare.gov |
| Maryland | $1,436/mo | $17,232 | Maryland Health Connection |
| U.S. average | $2,059/mo | $24,708 | — |
Full price before any tax credit, 2027 state averages (KFF) adjusted with the federal age curve. Your county, carrier and metal level change the real number; PPO and Gold plans usually cost more.
State notes for advisors
- Price spread: in this list, Tennessee has the highest 2027 average benchmark ($796/month at age 40) and Maryland the lowest ($491). Moving or splitting time between states can change your premium more than switching carriers.
- No state income tax: Florida, Texas, Tennessee. The self-employed health insurance deduction only saves federal tax there, so the after-tax cost is a little higher than in states with an income tax.
- State-run marketplaces: Georgia (Georgia Access), Maryland (Maryland Health Connection) run their own enrollment sites and can set their own deadlines. Everywhere else in the list uses HealthCare.gov.
- Clients in other states: your plan follows where you live. Advisors who travel to clients should check how the plan covers care away from home.
The planner's view: deduction plus HSA
For 2027 an HSA-eligible plan must have a deductible of at least $1,750 (self-only) or $3,500 (family). You can then contribute up to $4,500 or $9,000 a year, plus $1,000 if you are 55 or older. Contributions are deductible, growth is tax-free and withdrawals for qualified medical costs are tax-free, so a healthy high earner can treat the account as a second retirement account.
Advisors already know the HSA math. Paying current medical bills out of pocket and letting the HSA grow, then reimbursing yourself later from saved receipts, is permitted and keeps the account invested.
Which plan type fits financial advisors and ria owners
| Plan type | How it works | Best fit |
|---|---|---|
| PPO | In- and out-of-network coverage, no referrals; usually the highest premium | Advisors who travel to clients and want out-of-network coverage. |
| EPO | In-network only except emergencies, usually no referrals; lower premium | Advisors who want a lower premium and use one local health system. |
| HSA-eligible plan | Deductible of at least $1,750 / $3,500 in 2027; unlocks an HSA | Advisors who already think of the HSA as an investment account. |
| Gold or Platinum | Higher premium, lower deductible and coinsurance | Couples who expect regular care and value a low deductible. |
The label matters less than the specific network. Two PPOs from different carriers can include very different hospitals, so check your doctors by name for the 2027 plan year.
What to check before you choose
- Out-of-pocket maximum and the realistic worst case, not just the premium.
- Network access for the hospitals you would use for serious care.
- For RIA owners: whether a group plan, ICHRA or QSEHRA fits your staff.
- Coordinating coverage dates with your firm transition.
2027 enrollment dates
For 2027 coverage, Open Enrollment runs November 1, 2026 to January 15, 2027 on HealthCare.gov. Enroll by December 15 for coverage starting January 1; enrollments from December 16 to January 15 start February 1. State-run marketplaces can set different deadlines. Outside Open Enrollment you need a qualifying event, such as losing other coverage, moving, marriage or a new child, which opens a 60-day Special Enrollment Period. Plans bought directly from an insurer off the marketplace follow the same windows. Renewing? Compare again: networks, formularies and prices change every year, and staying put is rarely the cheapest choice.
Frequently Asked Questions
Guides for other professions: Attorneys and Law Firm Partners · Dentists and Practice Owners · Tech Workers, Founders and Contractors · Executives and Business Leaders · Pilots · Engineers · Pharmacists · Nurse Practitioners · Physicians and Doctors
Sources: IRS Rev. Proc. 2026-26 (2027 premium tax credit table) and Rev. Proc. 2026-24 (2027 HSA limits); 2026 HHS poverty guidelines; KFF, 2027 average benchmark premiums by state. Premium figures are averages for planning, not quotes. Examples are illustrative. Tax rules depend on your situation; confirm with your tax advisor.