Comp isn't coverage

Health Insurance for Construction Contractors and Skilled Trades

Workers comp covers you on the job. It does nothing for you at home on a Sunday.

Talk through my coverage gap Call (352) 769-2245

Comp ≠ healthon-the-job injuries only
50 FTEwhere the employer mandate starts
ICHRAa fixed-cost crew benefit

Photo by Mr. Brian on Wikimedia Commons (CC BY 2.0)

The quick answer

Workers’ compensation only pays for injuries arising out of the job — it does nothing for illness, family coverage, or a weekend injury. Self-employed contractors buy individual health plans on net profit after materials, subs, and equipment, and owners with a crew can use an ICHRA or small group plan.

Tradespeople are among the most likely of any occupation to conflate two entirely different products. Workers compensation is required, it is occupational, and it pays for injuries arising out of employment. It is not health insurance, and a great many contractors have discovered that distinction at an inconvenient moment.

What Makes Construction & Skilled Trades Different

Workers compensation and general liability are mandatory in most contracting work, which creates a widespread and costly assumption that health coverage is somehow included.
Income is seasonal in much of the country, so the annual estimate has to average across strong and slow months rather than extrapolate from either.
Once you put a crew on, the question changes from covering yourself to whether you offer something to employees — and the answer affects hiring more than most owners expect.

Workers Comp, Liability, and Health Are Three Different Things

Workers compensation pays for injury arising out of and in the course of employment. General liability covers damage or injury you cause to others. Neither covers your appendix, your childs asthma, or a knee that gave out on a weekend.

The trap is that a contractor carrying both feels comprehensively insured, because in a professional sense they are. Sole proprietors who exempt themselves from workers comp — which several states permit — are especially exposed, because at that point nothing covers an on-site injury either.

Estimating Income Across a Seasonal Year

In much of the country, exterior trades have a strong season and a slow one. The marketplace wants a full-year MAGI, so the estimate has to average — a projection built off summer billing overstates, one built off February understates.

Use net profit after materials, subs, fuel, tools, insurance, and vehicle costs. Contractors frequently estimate off contract value rather than what is left, which is a much larger number and produces a much smaller subsidy.

When You Start Putting a Crew On

Below 50 full-time equivalent employees there is no federal requirement to offer coverage. That said, in trades where experienced people are hard to keep, benefits are a genuine retention lever, and increasingly the thing a good journeyman asks about.

Small group plans, and Individual Coverage HRAs where you reimburse employees for individual plans they choose themselves, are both worth understanding before you assume group coverage is out of reach at your size.

Tools & Downloads for Construction & Skilled Trades

Use them here, download them, share them — no email wall, no cost.

Income worksheetEstimate the MAGI figure the marketplace asks construction & skilled trades for

Contract revenue (full year)

Materials & subs

Fuel & vehicle

Tools & insurance

Other household income (spouse W-2, etc.)

Estimated MAGI:$0This is the number the marketplace asks for — an estimate, not an eligibility determination.

Average the whole year rather than annualizing your busy season.

Review this number with Carter

60-day deadline calculatorLosing coverage? Find the exact day your enrollment window closes

Last day of your current coverage

Special Enrollment window closes:—

Losing qualifying coverage generally opens a 60-day Special Enrollment Period from the coverage end date. The window is firm — start before it is close.

Premium vs. deductible break-evenTwo quotes side by side — see what the monthly difference buys

Plan A monthly premium

Plan A deductible

Plan B monthly premium

Plan B deductible

Premium difference over a year:—

Arithmetic only — networks, copays, and out-of-pocket maximums matter just as much, which is what the call is for.

↓ Construction & Skilled Trades expense tracker (CSV)↓ Construction & Skilled Trades coverage checklist ↓ 60-day Special Enrollment checklist ↓ Open Enrollment prep checklist ↓ What to bring to our first call

Everything here is free to use and share — no email required. Browse the full tool & download library →

What I Hear From Construction & Skilled Trades

Assuming workers comp covers non-work illness or injury.
Sole proprietors exempt from comp with no health plan behind them.
Projecting a full year off peak-season billing.
Wanting to offer crew benefits without knowing what is realistic at a small headcount.

Questions Construction & Skilled Trades Ask

Does workers comp mean I do not need health insurance?

No. Workers compensation only responds to injuries arising out of your work. Illness, injuries at home, your familys care, and anything outside the course of employment fall entirely outside it. Contractors who carry comp and nothing else are uninsured for the large majority of what actually happens to people.

I am a sole proprietor and exempt from workers comp. What covers me on site?

If you have filed an exemption, potentially nothing does. Several states let sole proprietors and certain officers opt out of workers compensation, and contractors do it to reduce cost. The consequence is that an on-site injury falls to your health plan — so if you are exempt and also uninsured, an ordinary job-site accident becomes a direct personal liability. If you have taken the exemption, health coverage matters more, not less.

My income swings by season. How do I estimate it?

Average the whole year rather than annualizing a good month. Start from last years Schedule C net profit, adjust for what you know is different this year — a larger contract, a piece of equipment, a slower spring — and use that. If the year runs well ahead of plan, update the application mid-year so the subsidy adjusts before reconciliation does it for you.

Can I offer coverage to my crew without a full group plan?

Often yes. An Individual Coverage HRA lets you reimburse employees tax-free for individual plans they select themselves, with you setting the contribution amount. It gives you a predictable cost and gives them portability. Whether an ICHRA or a small group plan fits better depends on headcount, ages, and how much you want to contribute — worth comparing both rather than assuming.

Cover the gap your comp policy leaves open

If you are carrying workers comp and liability but nothing for yourself, that is the gap worth closing first. We can look at your own coverage and, if you have people, what offering something to the crew would realistically cost.

Talk through my coverage gap Call (352) 769-2245