Health insurance for Montana construction contractors when one of three insurers is leaving

Sam Jaber, Licensed Health Insurance Advisor · Updated October 2026

NPN 20698748 · Licensed in Montana, one of 31 states where Sam Jaber holds a license · Licensing details

Short answer: Builders whose income earns a tax credit usually pay least on HealthCare.gov. Above the credit you pay full price after a 24.9% benchmark rise, and a healthy builder should price an underwritten plan with a national PPO network. And if your insurer is the one leaving after 2026, plan the switch early.

• My season earns a credit
• I'm over the credit line
• Over it and healthy
• Over it with a condition
• My insurer is leaving or my job plan is ending
• Help me decide

This page is for Montana builders who work for themselves: general contractors, framers, finish carpenters, roofers and the rest of the trades who bid jobs, hire help by the season and carry their own health insurance. There is no company plan behind you, and in Montana the market you buy from is small.

Three private insurers sell plans on HealthCare.gov in Montana for 2026, and one of them is leaving the state's individual market at the end of the year, which leaves two for 2027. Prices climbed too: a 40-year-old's average benchmark premium went from $554 a month in 2025 to $692 in 2026, about 24.9% higher.

The question that decides your route: will this year's building income qualify you for a premium tax credit? Go to the section that fits.

If the season's income keeps you in the credit range

Montana buyers use HealthCare.gov, and the premium tax credit only works there. For a contractor whose expected income sits in the credit range, buying there with the credit is usually the least costly route.

Construction makes the estimate harder than it looks. Most of the year's work may land between spring thaw and the first hard freeze, and a single large job can carry a whole winter. The credit runs on your estimate of the year's income, gets settled on your tax return, and a bigger year than you planned for can mean handing some or all of it back. Past 400% of the federal poverty level, $63,840 for a single person buying 2027 coverage ($62,600 for 2026), there is no credit, since the enhanced credits ended after 2025. See how the subsidy cliff works before you lock in a figure.

Base the number on jobs under contract, and update HealthCare.gov when a big bid comes through.

If a strong building year puts you past the credit

Above the line you carry the full premium. For a 40-year-old on the benchmark plan, Montana's increase adds $138 a month, or $1,656 over the year, money that has to come out of jobs before it reaches your own pocket.

The benchmark is a statewide average at one age. Your premium turns on your age, county, household and the plan you pick.

Montana does run a reinsurance program that pays part of insurers' largest claims, and its federal approval covers plan years 2025 through 2029, so that support is not up for renewal every year. Even so, rates rose by about a quarter for 2026, and for many builders above the line the full price is more than the budget will carry. Your health decides the next step.

Past the credit and healthy

For a healthy contractor, the option to price sits off the marketplace: private plans that use medical underwriting and run on PPO networks covering the whole country. They choose their members on health, which keeps their group healthier than a marketplace that takes all applicants, and that is why a healthy builder can sometimes pay less than full price on HealthCare.gov.

• The insurer looks at your health first. It may approve you, turn you down, or approve you without coverage for a condition you already have.
• A network that does not stop at the state line. If you take work in Wyoming or North Dakota, or see a specialist out of state, a national PPO network can count those doctors as in network.
• Its benefits are its own. Plans sold off the marketplace do not follow marketplace benefit rules, so read the coverage before you sign. Our explainer on medical underwriting covers how the review works.

Past the credit with a health condition

If you are being treated for an ongoing condition or rely on a costly prescription, keep your coverage on HealthCare.gov at full price. Every marketplace plan has to enroll you, cannot charge more because of your health, and covers the essential benefits. An underwritten insurer is under no such rule and could decline you or exclude what you need.

In a three-insurer market the real decision is network. The plan that includes your doctor and the hospital you would actually use may be the only one worth considering, so start there and let price come second.

If your insurer is leaving, or your job plan is ending

Two situations put Montana contractors on a deadline.

Your insurer is the one leaving. If the insurer exiting the individual market is the one on your card, it will not renew for 2027, and you will choose between the two that remain. Make that choice early in open enrollment rather than in the last week, and recheck your income and health questions while you are at it.

You are leaving a crew or a company job. If the employer had 20 or more workers, federal COBRA generally lets you keep the crew's group plan as long as 18 months, paying as much as 102% of the cost. Smaller employers are a different story: reporting indicates Montana has no state continuation law for them, so when you leave, the group coverage may simply end. Confirm with the employer or Montana's Commissioner of Securities and Insurance, and have the next plan ready. Losing job-based coverage gives you 60 days to sign up on HealthCare.gov, and the application can usually go in before your last day. Our guide to coverage between jobs covers the timing.

Find your row

Each row ends in the same place. Your income, county and health settle it faster than a table can.

The Montana guide for self-employed buyers has the rest of the state's rules, and Delaware advisors are also watching their insurer list shrink for 2027.

Common questions