Health Insurance for Architects Who Own a Firm or Practice Solo

Where I start for a practice owner

When an architect leaves a firm to put their own name on the door, health coverage tends to land in the same month as the business license, the professional liability policy and the first signed proposal. For a healthy owner, my first quote is a private, medically underwritten plan. It is priced on your age, ZIP code and health, not on what the practice bills, so a commission that wraps up in December is not part of how your premium is set. You answer health questions to apply. Approval depends on those answers and is not guaranteed, and if you are approved, coverage can begin on the first of a month you pick.

Private plans are not ACA Marketplace plans, and benefits and pre-existing condition rules vary by plan. That is the reason I set each private option beside the Marketplace before you commit to anything.

Phased fees and a once-a-year income guess

Architecture income rarely arrives in even monthly pieces. There is a retainer at signing, a payment when schematic design is approved, another at design development, a bigger draw when construction documents are issued, then smaller amounts through construction administration. A job that stalls in permitting, or a developer who pauses after bids come in, can push a large share of your billing from one tax year into the next. Fees for additional services and change orders add another layer that is hard to predict in October.

The Marketplace asks you to forecast that number before the year begins. Under the 2027 rules, that forecast carries real weight:

• Premiums are climbing again. KFF's review of 2027 filings from 276 Marketplace insurers found a median proposed increase of 15 percent, on top of a steep rise for 2026.
• The credit stops at a fixed line. For 2027, help ends at 400 percent of the federal poverty level: $63,840 for one person, $86,560 for two, $109,280 for three and $132,000 for four. Go over by one dollar and the credit is zero.
• A low guess gets paid back. If you take an advance credit and your final income lands above the line, you repay the entire advance on Form 8962. One large project closing out in the fourth quarter is enough to do it.
• Networks drawn around one area. Many Marketplace plans are HMO or EPO designs built on a local network, with little or no coverage outside it except emergencies.
• A high ceiling on your share. The 2027 out-of-pocket maximum is $12,000 for one person and $24,000 for a family.
• One enrollment window. On HealthCare.gov, open enrollment runs November 1, 2026 to January 15, 2027, and December 15 is the deadline for a January 1 start. States that run their own exchange set their own dates. Outside the window you generally need a qualifying event.

For a sense of scale, the Bureau of Labor Statistics reported a median annual wage of $99,280 for architects in May 2025, counted about 124,600 architect jobs in 2025 and listed 14 percent of architects as self-employed. A single architect earning that median is already well past the one-person line of $63,840, and principals who own the firm frequently earn more.

Coverage that follows the project calendar

Because a private plan does not wait for open enrollment, you can time it around the work instead of around November. Some architects apply the month they sign a first anchor client. Others wait for the quiet stretch between one set of construction documents and the next. If approved, the plan can start on the first of the following month, and a renewal you dislike does not leave you stuck until the next annual window.

Many private plans use national PPO networks. That matters when you design a clinic in Texas, walk a jobsite in Georgia or hold licenses in several jurisdictions through NCARB Certificate reciprocity. Always check how a specific plan treats care away from home, because networks and benefits differ from plan to plan.

Leaving a larger firm to open your own

Most of my conversations with architects begin at this point. You have a few clients lined up, a launch date for the new practice and a final day at the firm. Losing that employer coverage opens a 60-day special enrollment period for the Marketplace. Federal COBRA applies to employers with 20 or more employees, lasts up to 18 months and can cost up to 102 percent of the full premium, which covers the firm's share, your share and a small fee.

The order I suggest:

1. Ask HR for the exact date firm coverage ends. It is often the last day of the month rather than your last day at a desk there.
2. Apply for a private plan with a requested start on the next first of the month, so there is no gap if you are approved.
3. Keep COBRA as the safety net. You have a window to elect it, and once elected and paid it reaches back to the day coverage ended, which protects you while underwriting is under review.
4. If a health condition makes private approval unlikely, enroll in a Marketplace plan inside the 60 days.
5. Put the COBRA election deadline on your calendar so the decision does not slip while you are registering the practice and setting up billing.

If the firm had fewer than 20 employees, federal COBRA may not apply, although many states have their own continuation rules for smaller employers. Our COBRA alternatives page covers the trade-offs in more depth.

Partners in a two-principal practice

When two architects launch a firm together, each household is usually priced on its own. One partner may be a strong candidate for a private plan while the other has a condition that points toward the Marketplace, and that is fine. The decision does not have to match across the partnership, and nothing requires the firm to hold a group plan before it is ready. If one partner's spouse has employer coverage, that household may simply join the spouse's plan, and the firm can revisit group benefits once revenue is steadier. I quote each household separately, so one partner's health answers never limit the other's options.

How the entity treats your premium

Sole proprietor, PLLC, partnership or S corporation: the structure you chose changes how health premiums are reported. Sole proprietors, partners and shareholders owning more than 2 percent of an S corporation can generally take the self-employed health insurance deduction. It is linked to the business that sets up the plan, capped by that business's net earnings, and unavailable for any month you could have joined a subsidized employer plan, a spouse's included. These rules work the same way for a private plan and a Marketplace plan. General information, not tax advice — confirm with your CPA based on your specific entity structure.

Adding drafters, designers and interns

Once the practice grows past you, a project architect, a drafter or a summer intern, the benefits question follows. A traditional small-group plan is one route. Two reimbursement arrangements often suit a small design firm better:

• QSEHRA: for employers with fewer than 50 full-time employees. You fund a monthly allowance, and staff buy their own individual coverage that meets the arrangement's rules.
• ICHRA: open to employers of any size, with allowances that can differ by employee class, such as full-time staff versus part-time interns.

Both come with notice and recordkeeping requirements. Our ICHRA guide and small business owner guide explain the setup.

Protection beyond the medical plan

A health plan is one piece of an owner's safety net. Disability, accident and critical illness coverage are separate policies, and what each one includes varies by plan. If the firm depends on you to review and seal drawings, it is worth pricing a disability policy on its own and reading exactly what it covers before you buy.

When the Marketplace makes more sense

Some architects belong on the Marketplace, and I will say so plainly. If you or someone on the plan has a significant health condition, the Marketplace must accept you during open enrollment or a special enrollment period and cannot set your price on health. It can also come out ahead in a launch year when profit will honestly finish below the line for your household size, because the credit may make the Marketplace the better value. I would rather tell you that at the start than walk you through an application likely to be declined.

Getting your side-by-side

I work by phone or video, in English or Spanish, and I am licensed in 31 states, including Florida. Send your ZIP code, the ages of everyone on the plan and a short health summary, and I will price private options next to the Marketplace. You can get a quote or call (786) 218-2384. Engineers and other professionals can browse health insurance by occupation.