Ranked 4 of 17 states · median $680/mo · CMS PY2026
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A 40-year-old general contractor in Alabama pays a median $680/month for a Silver plan before subsidies — 4th of 17 on cost. The cheapest plan in the state is $583 from Blue Cross and Blue Shield of Alabama in Greene. On highest out-of-pocket maximum, Alabama ranks 1 of 17 for this occupation.
For work with real injury exposure the premium is the wrong headline number. What decides a bad year is the annual out-of-pocket maximum — the ceiling you stop paying at. A fall, a fracture, an imaging series and a course of physical therapy will reach that ceiling on any metal tier, so the states below are ordered by worst-case exposure.
Occupational context: Falls, struck-by injuries, and heavy-equipment exposure.
Worth being clear about what this does and does not affect: a carrier in Alabama cannot ask what you do for a living, cannot charge a general contractor more than a librarian of the same age in the same ZIP, and cannot exclude anything you were already treated for. Occupation only tells you which plan structure to shop for.
Premium is set by rating area, so a general contractor in one Alabama county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Etowah | $610 | Blue Cross and Blue Shield of Alabama | $3,500 | 3 |
| Montgomery | $620 | Blue Cross and Blue Shield of Alabama | $3,500 | 2 |
| Walker | $625 | Blue Cross and Blue Shield of Alabama | $4,000 | 4 |
| Cleburne | $634 | Ambetter of Alabama | $6,000 | 3 |
| Franklin | $634 | Ambetter of Alabama | $6,000 | 3 |
| Sumter | $634 | Ambetter of Alabama | $6,000 | 3 |
The spread across just these six is $24/month — $289 a year for the same metal tier. Statewide the range runs $583 to $1,124. Coverage by County publishes all 67 Alabama counties individually.
| Alabama — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $6,000 |
| Highest annual out-of-pocket maximum | $10,600 |
| Cheapest Gold plan @40 | $657 — UnitedHealthcare |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $583 — Blue Cross and Blue Shield of Alabama |
| Cheapest Silver @50 | $815 |
For a general contractor, the gap between $6,000 and $10,600 in annual out-of-pocket maximum is worth more than any premium difference on this page. One serious injury reaches that ceiling regardless of which plan you picked.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 2,311 plan records across 67 Alabama counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Indiana ($558), Ohio ($625), South Carolina ($636). More expensive: Wisconsin ($687), Michigan ($708), South Dakota ($725).
Side-by-side: Alabama vs Ohio · Alabama vs South Carolina · Alabama vs Wisconsin · Alabama vs Michigan
A caveat on the table above: rating is by residence, not by job site. A general contractor living in Alabama and working across a state line still buys Alabama plans. A genuine permanent move does trigger a special enrollment period, but the plan year restarts with a fresh deductible.
Expense categories that typically apply to this trade: Tools, truck, liability insurance, bonding, licensing. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The BLS median wage for First-Line Supervisors of Construction Trades and Extraction Workers in Alabama is $64,030 a year (May 2024). Starting pay — the 10th percentile — is about $44,310. The middle half earn $52,430 to $79,110, and the top 10% more than $100,380. BLS counts about 13,810 people doing this work for an employer in Alabama. The self-employed are not in the BLS survey, so this is the going rate for the work, not your own number.
The cheapest Silver plan for a 40-year-old in Alabama is $583 per month from Blue Cross and Blue Shield of Alabama, with a state median of $680. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Alabama exchange plans are guaranteed issue and community rated, so a general contractor pays exactly what anyone else of the same age in the same ZIP pays. Occupation is not on the application as a rating factor.
Yes. Plan types filed for 2026: EPO, PPO.
Alabama ranks 4 of 17 states covered here, at a median $680 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
Above the cliff. At this income a single-person household receives no premium tax credit for 2027 and pays the full premium.
This occupation sits above the cliff in 22 of the 23 states reported and below it in the other 1, so the answer changes with the state.
What this figure is. It is the median annual wage BLS reports for First-Line Supervisors of Construction Trades and Extraction Workers (SOC 47-1011) in Alabama. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed general contractor. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2027 the 400% FPL limit applies again, so household income above $63,840 ends premium tax credit eligibility outright.
This page compares states. For Alabama specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for General Contractors in Alabama and a blog covering deductibles, subsidies and special enrollment.
Right now 4 carriers file plans across the 67 counties of Alabama. Participation is reset annually, which is why General Contractors should check the roster in November rather than assume this year’s options carry over.
Rate filings for 2027 point to roughly a 15% median increase nationally, from −1% at one end to 54% at the other. Alabama’s are final: insurers there were approved for an average 20.7% increase. Your own premium shows when 2027 plans post in late October.
Mark November 1, 2026 to open and December 15 to act. That second date guarantees cover from January 1 in Alabama regardless of how the current litigation over the enrollment window resolves.
In your favour: PPOs are sold in all 67 Alabama counties. That is the type most likely to pay toward out-of-network care, and worth defending at renewal if your work as a general contractor takes you around.
Nothing about 2027 is urgent yet, which is exactly why it is worth ten minutes now. Come November you will be choosing between Alabama’s carriers under a deadline; today you can do it without one.
Enter a ZIP and a licensed agent will tell you three things:
The sticker price is rarely what General Contractors in Alabama end up paying. Start with a ZIP and a licensed agent will work out your actual number.
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