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ACA vs. Private Health Insurance for California Realtors
Realtors in California ask us this more than any other group. Here's the direct comparison for a commission-based income.
ACA (Covered California)
Priced on income, which for you means after-expense MAGI. If you qualify for a subsidy, it's unbeatable. The risks: a strong year pushes you over the cliff and you repay subsidies at tax time; most plans are HMO and tied to one hospital system; enrollment is only Nov 1 – Jan 15.
Private shared-network PPO
Priced on age and health — your income is irrelevant. National PPO on Cigna, Aetna and PHCS PPO, no referrals, enroll any month, month to month. The risk: underwriting. A serious pre-existing condition can be declined.
Decision guide for agents
Under the subsidy line after deductions → ACA. Over the line and healthy → private PPO, usually $300–$500 a month less. Over the line with a significant condition → ACA at full price, or a small-group plan if your brokerage or spouse opens one.
The California angle
California regulates non-ACA coverage more tightly than most states, and the state mandate and Covered California's state subsidies change the math for many people, so private options here are narrower and the honest answer is often a careful comparison, not a promise of savings. California has its own individual mandate: residents without qualifying coverage owe a penalty on their state return.
Check your options and we'll show both markets for your ZIP.