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Health Insurance Guide for Self-Employed, 1099 Contractors & Freelancers

Mar 15, 2024

Health Insurance Guide for Self-Employed, 1099 Contractors & Freelancers

If you’ve made the leap to the self-employed life, congratulations! There are now more than 16.5 million workers in the United States who identify as self-employed, as of 2024.


Some self-employed people choose this type of lifestyle because they want to become entrepreneurs and build their own businesses, while freelancers and contractors may enjoy the freedom to work on the assignments they choose, on their own schedule.


While the self-employed life can offer lots of flexibility and freedom, it also means you’ll need to manage your own health insurance. As a “business owner,” you are responsible for choosing, securing and paying for your health coverage.


Self-employed contractors and freelancers have a few options when buying health insurance. You may have been previously employed full-time and received group health insurance from your employer. As you handle your own health insurance needs, it can help to talk with a self-employed health insurance provider who can walk you through self-employed health insurance options like those below. 


1. COBRA Health Insurance


COBRA is short for the Consolidated Omnibus Budget Reconciliation Act. It covers workers and their families for up to 18 months when an employee has lost their job or experiences a specific circumstance, such as:

  • Death
  • Divorce
  • Transition between jobs
  • Voluntary job loss
  • Decrease in hours worked

With this coverage, being self-employed alone wouldn’t qualify you for COBRA. You’d need to lose your health insurance coverage due to losing your job with your former full-time employer or by experiencing another life event, like the ones above. Then, you can get COBRA and choose to pursue a self-employed career. 


COBRA may put the responsibility of paying for coverage on the individual, up to 102% cost of the plan, which includes administrative fees. So, even though you’ll still be eligible for the coverage you used to have at your job under COBRA, you may be required to pay for the entirety of the coverage, which your employer might have helped cover previously. 


COBRA generally does require that group health insurance plans offered by employers with 20 or more employees offer “continuation coverage,” which is a temporary extension of healthcare coverage. If you worked for a large company, you’re likely eligible for COBRA if you lose your job with health insurance. 


When you might want COBRA: COBRA might be a good option for you if you like your old health insurance plan, and you want to continue your current healthcare coverage arrangement in the meantime as you look for your next option. Also, if you’ve already met your deductible for the year, or if you take expensive prescriptions, continuing coverage under COBRA may make the most financial sense.


2. ACA / Government Health Insurance Plans


You may have heard of it as “Obamacare” or as the “Affordable Care Act,” ACA for short. ACA is the U.S. federal government-sponsored healthcare coverage. The ACA has an annual Open Enrollment Period, during which anyone can enroll in a plan or change their plan, beginning November 1 and ending December 15. Otherwise, you may qualify for an ACA plan if you are eligible for:


  • A Special Enrollment Period due to a life change: Qualifying life changes may include moving, having a baby, adopting a child or getting married.
  • Medicaid: Medicaid is an insurance program that offers free or low-cost healthcare coverage to people with low income, including people with disabilities, older adults, pregnant women, individuals, families and children.

Typically, if you’re eligible for COBRA, you’ll also be eligible for an ACA plan. When you purchase healthcare through the ACA marketplace, you may also be eligible for subsidies. These include a premium tax credit health insurance subsidy and a cost-sharing subsidy. 


There are also state-sponsored health insurance plans, depending on the state. Not all states have them, so check with yours to see what’s available. 


When you might want an ACA plan: ACA plans can vary greatly in provider options and in costs. If you have flexibility in what providers you’re willing to see, and you’re eligible for subsidies, an ACA plan may make sense. You’ll be able to research all your plan options and choose the one that works best for you. 

If you have pre-existing conditions, the ACA plan may also be a good option for coverage. Keep in mind, navigating the marketplace can be a little challenging with all the options that are available. You can call the ACA hotline if you have questions. 


3. Private Health Insurance Plans


Private health insurance plans are offered all times of the year through private insurance specialists, like AZ Health Insurance Brokers. Insurance brokers work directly with health insurers and can give you a customized quote that provides you with the best insurance offering for your budget and health needs.

Private plans can also vary widely in price and coverage. If you have a pre-existing condition, you may pay for a more expensive plan with a private insurer. But if you’re relatively healthy, you may be able to get a less expensive plan that still covers you for emergencies and preventive care.


When you might want a private plan: If you’re not eligible for COBRA, and if you won’t get any subsidies from the ACA marketplace, a private plan can be a good option. You can get an individual insurance quote for a private health insurance plan within minutes here.


Another benefit of a private health insurance plan is that the customer service can be much better compared to having to deal directly with the insurance company. Your self-employed health insurance broker can become a valuable partner for your business success, one who’s a direct phone call away. That saves you time, stress and hassle from having to deal with impersonal customer service representatives at a big company. 


4. Group Health Insurance Plans


If you’ve expanded your business to include at least one other employee in addition to yourself, you can explore group health insurance plan options. Providing your employees with health insurance coverage can be a good recruiting and retention benefit, as the Employee Benefit Research Institute reports in 2023, 83% of workers ranked healthcare coverage as extremely or very important when considering job decisions. According to Gallup, “well-being” is in the top two factors job seekers consider when looking for a new job, which healthcare benefits can support.


How do business/group health insurance plan options work? As the business owner, you purchase the plan and decide on specifics like employer healthcare coverage, copays and deductibles. Typically, employers cover a portion of the plan’s annual or monthly premium cost, while employees cover a premium portion, too. 


When you might want a group plan: If you have at least one other employee and plan to expand your business, it might benefit you as a business owner to offer group health insurance

We recently experienced a Great Resignation, where American workers quit their jobs in record numbers. Professionals are becoming clearer on what they want from an employer. In many cases, this includes health insurance coverage. If you can offer it, group health insurance plans can help you recruit and retain top talent. 


Need Help Getting Self-Employed Insurance?


Self-employed individuals have many diverse ways to secure valuable health insurance coverage. When you work for yourself, healthcare setbacks can also impact your business, so healthcare coverage is an essential part of successful business operations for self-employed individuals. 


Consult with an Arizona health insurance broker to evaluate your options. We’ll talk with you confidentially about your health history and needs, your budget and what you want out of your healthcare coverage. We can then recommend the top health insurance options for self-employed workers, so you can select a plan that works for your healthcare needs, your budget and your family’s requirements. 


Call us at 602.617.4107, contact us online, or email quotes@azhealthinsurancebrokers.com for more information.

Self-Employed Health Insurance FAQs

  • What are the main health insurance options for self-employed individuals?

    Self-employed workers can get private health insurance or federal marketplace coverage, also known as the Affordable Care Act (ACA) or Obamacare health insurance coverage. Self-employed workers who are leaving a previous job may qualify for COBRA health insurance coverage. Self-employed workers who employ other employees could also offer group health insurance plans to their employees.

  • Can self-employed health insurance premiums be deducted as a business expense?

    Yes. If you’re self-employed, you may be able to deduct health insurance premiums for yourself, your spouse and your dependents as a business expense on the federal income tax return.

  • How does being self-employed impact eligibility for premium subsidies/tax credits?

    Being self-employed can impact eligibility for premium subsidies or tax credits, particularly when purchasing an ACA health insurance plan through the federal health insurance marketplace, also known as the exchange. Talk with a health insurance broker to see what you might qualify for.

  • Can self-employed individuals contribute to a health savings account (HSA)?

    Yes, self-employed workers can contribute to an HSA, as long as they have a high-deductible health plan (HDHP). 

  • Are there an additional tax-advantaged savings healthcare programs for self-employed worker medical expenses?

    Yes. For self-employed workers, a health reimbursement arrangement (HRA) 105 or 

    HSA are popular options. In some instances, an individual coverage health reimbursement arrangement (ICHRA) may also be used.

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