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How California Realtors Should Compare Health Insurance Plans
Agents compare premiums and stop. Here's the order that actually protects you.
1. Out-of-pocket maximum
The most you can spend in a year on covered care. This is the number that matters in a bad year. Marketplace plans in California cap around $9,200 individual; private PPOs commonly $6,000–$9,000.
2. Network — and where it works
Is your doctor in it? Is the hospital you'd actually go to in Los Angeles County in it? Does it work in another state? HMO vs. PPO decides this. Cigna, Aetna and PHCS PPO PPOs are national.
3. Deductible
How much you pay before the plan pays. Healthy agents usually do best with a mid-range deductible and lower premium, plus an HSA.
4. Premium
Only now. And compare net of subsidy if you qualify, net of the self-employed deduction either way. California has the highest top state income tax rate in the country, so the self-employed health premium deduction is worth real money here.
5. Enrollment flexibility
Marketplace: once a year. Private: any month. If your income is volatile, flexibility has value.
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.
Our quoting tool shows every private plan in California with deductible and out-of-pocket max side by side. Or check your options and we'll compare both markets for you.