Ranked 3 of 15 states · median $636/mo · CMS PY2026
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A 40-year-old general contractor in South Carolina pays a median $636/month for a Silver plan before subsidies — 3th of 15 on cost. The cheapest plan in the state is $456 from Ambetter from Absolute Total Care in Abbeville. On highest out-of-pocket maximum, South Carolina ranks 11 of 15 for this occupation.
Trade work concentrates cost into rare, expensive events rather than spreading it across the year. That inverts the usual shopping logic: a lower premium with a $9,200 ceiling is a worse deal than a higher premium with a $6,000 one, because the ceiling is what you actually hit. These rankings follow the ceiling.
Occupational context: Falls, struck-by injuries, and heavy-equipment exposure.
None of that changes your price. ACA plans in South Carolina are community rated — premium varies by age, ZIP code, tobacco use and household size only. Your occupation cannot be used to rate you, decline you, or exclude a condition. What it changes is which plan design is the right bet.
Premium is set by rating area, so a general contractor in one South Carolina 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 |
|---|---|---|---|---|
| Bamberg | $498 | Ambetter from Absolute Total Care | $6,000 | 3 |
| Darlington | $529 | InStil Health | $6,500 | 4 |
| Marion | $545 | Ambetter from Absolute Total Care | $6,000 | 4 |
| Hampton | $555 | Molina Healthcare | $7,000 | 4 |
| Laurens | $582 | Ambetter from Absolute Total Care | $6,000 | 4 |
| Lancaster | $601 | Molina Healthcare | $7,000 | 5 |
The spread across just these six is $103/month — $1,241 a year for the same metal tier. Statewide the range runs $456 to $931. Coverage by County publishes all 46 South Carolina counties individually.
| South Carolina — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $3,400 |
| Highest annual out-of-pocket maximum | $10,600 |
| Cheapest Gold plan @40 | $476 — Ambetter from Absolute Total Care |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $456 — Ambetter from Absolute Total Care |
| Cheapest Silver @50 | $637 |
For a general contractor, the gap between $3,400 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. 2,518 plan records across 46 South Carolina counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: Indiana ($558), Ohio ($625). More expensive: Alabama ($680), Wisconsin ($687), Michigan ($708).
Side-by-side: South Carolina vs Indiana · South Carolina vs Ohio · South Carolina vs Alabama · South Carolina vs Wisconsin
Read the comparison as context, not as a shopping list. Your county of residence determines what you can buy, and for a general contractor that is fixed unless you relocate. Where it is actionable is a move already in progress — that is a qualifying life event, and you have 60 days on either side of it.
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 cheapest Silver plan for a 40-year-old in South Carolina is $456 per month from Ambetter from Absolute Total Care, with a state median of $636. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
Yes. Plan types filed for 2026: EPO, HMO, POS, PPO.
South Carolina ranks 3 of 15 states covered here, at a median $636 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 2026 and pays the full premium.
This occupation sits above the cliff in 20 of the 21 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 South Carolina. 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 2026 the 400% FPL limit applies again, so household income above $62,600 ends premium tax credit eligibility outright.
This page compares states. For South Carolina 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 South Carolina and a blog covering deductibles, subsidies and special enrollment.
South Carolina has 6 carriers filing across 46 counties right now. That list is rebuilt every year, so what you can choose from in November may not match what you see today — and for a general contractor buying your own cover, who stays matters more than the headline rate.
Rate filings for 2027 point to roughly a 15% median increase nationally, from −1% at one end to 54% at the other. South Carolina has not finalised, so treat exact local 2027 pricing as unavailable rather than unknown.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in South Carolina and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
In your favour: PPOs are sold in all 46 South Carolina 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 South Carolina’s carriers under a deadline; today you can do it without one.
Give me a ZIP and I will tell you three things:
Coverage for General Contractors is priced county by county across South Carolina. Enter your ZIP and I will show you what is on the table.