Cost comparison · 2026
Private Group PPO vs. ACA Marketplace vs. COBRA: What Each Actually Costs
Quick answer
For a self-employed or franchise owner who does not qualify for a meaningful ACA subsidy, a private group PPO is typically the cheapest of the three — roughly $300–$700 a month for owner-only coverage, versus $600–$1,200 for an unsubsidized Marketplace plan and $1,000–$1,800 for COBRA. COBRA is the most expensive because you pay the entire employer premium plus a 2% fee.
Key facts
- Private group PPO is up to 50% less than an unsubsidized ACA Marketplace plan
- Fixed-benefit and group options run up to 75% less than COBRA
- The group PPO uses a nationwide PPO network — the savings are from pooling, not a narrower network
- Group coverage enrolls year-round; ACA requires Open Enrollment or a qualifying event
- A large ACA subsidy can flip the math — we quote both and tell you which wins
- Available in all 50 states, usually effective within 24–72 hours
Side-by-side comparison
| Private group PPO | Unsubsidized ACA | COBRA | |
|---|---|---|---|
| Typical monthly cost, owner only | $300 – $700 | $600 – $1,200 | $1,000 – $1,800 |
| Typical monthly cost, family | $900 – $1,600 | $1,600 – $2,400 | $2,500+ |
| How you're rated | Pooled, like a large employer group | As an individual household | Full former-employer rate + 2% fee |
| Deductible options | $500 / $750 / $1,000 / $1,500 | Plan-dependent, often $3,000+ | Whatever your old plan had |
| Telemedicine | $0 | Plan-dependent | Plan-dependent |
| Preventive care | $0 | $0 | $0 |
| Network | Nationwide PPO, all 50 states | Often narrow / regional HMO | Former employer's network |
| When you can enroll | Any month of the year | Open Enrollment or qualifying event | 60-day election window |
| How long it lasts | Ongoing while you stay enrolled | Plan year | 18 months in most cases |
Cost ranges are typical monthly premiums shown for comparison only, not a quote or a guarantee of rate.
Frequently asked questions
Which is cheaper: a private group PPO, ACA, or COBRA?
For owners who do not qualify for a meaningful ACA subsidy, the private group PPO is almost always cheapest — typically up to 50% less than an unsubsidized Marketplace plan and up to 75% less than COBRA. COBRA is nearly always the most expensive of the three because you pay the entire employer premium plus a 2% administrative fee.
When is the ACA Marketplace actually the better deal?
If your household income puts you in range for a substantial premium tax credit, a subsidized Marketplace plan can beat everything else. We run both numbers and tell you honestly which one wins for your household.
Do I have to wait for Open Enrollment?
No. Private group coverage and fixed-benefit plans enroll year-round with no Open Enrollment window and no qualifying life event required. ACA Marketplace plans do require Open Enrollment or a qualifying life event.
Does the cheaper plan mean a smaller network?
Not here. The private group plan uses a nationwide PPO provider network with in-network access in all 50 states. The savings come from group pooling, not from a narrower network.
How fast can coverage start?
Most enrollments take 24–72 hours, and an agent can sequence the effective date so there is no gap when you leave COBRA or an existing plan.
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