Ranked 10 of 17 states · median $773/mo · CMS PY2026
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A 40-year-old general contractor in Tennessee pays a median $773/month for a Silver plan before subsidies — 10th of 17 on cost. The cheapest plan in the state is $646 from Ambetter of Tennessee in Fayette. On highest out-of-pocket maximum, Tennessee ranks 17 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.
None of that changes your price. ACA plans in Tennessee 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 Tennessee 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 |
|---|---|---|---|---|
| Tipton | $646 | Ambetter of Tennessee | $6,000 | 5 |
| Hamblen | $669 | Ambetter of Tennessee | $6,000 | 4 |
| Scott | $669 | Ambetter of Tennessee | $6,000 | 4 |
| Johnson | $678 | BlueCross BlueShield of Tennessee | $8,100 | 4 |
| Grundy | $698 | Ambetter of Tennessee | $6,000 | 5 |
| Sequatchie | $698 | Ambetter of Tennessee | $6,000 | 5 |
The spread across just these six is $52/month — $621 a year for the same metal tier. Statewide the range runs $646 to $1,001. Coverage by County publishes all 95 Tennessee counties individually.
| Tennessee — worst-case exposure | 2026 |
|---|---|
| Lowest annual out-of-pocket maximum | $5,200 |
| Highest annual out-of-pocket maximum | $10,600 |
| Cheapest Gold plan @40 | $636 — Oscar |
| Gold deductible | $2,000 |
| Cheapest Silver @40 | $646 — Ambetter of Tennessee |
| Cheapest Silver @50 | $903 |
For a general contractor, the gap between $5,200 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. 5,239 plan records across 95 Tennessee counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: South Dakota ($725), Oklahoma ($731), Kansas ($765). More expensive: Mississippi ($773), Florida ($789), Utah ($805).
Side-by-side: Tennessee vs Oklahoma · Tennessee vs Kansas · Tennessee vs Mississippi · Tennessee vs Florida
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 BLS median wage for First-Line Supervisors of Construction Trades and Extraction Workers in Tennessee is $71,840 a year (May 2024). Starting pay — the 10th percentile — is about $47,840. The middle half earn $58,450 to $83,560, and the top 10% more than $101,410. BLS counts about 16,780 people doing this work for an employer in Tennessee. 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 Tennessee is $646 per month from Ambetter of Tennessee, with a state median of $773. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
It cannot happen on an exchange plan. Rating in Tennessee uses four inputs only: age, ZIP code, tobacco use and how many people are on the policy. Trade, injury history and pre-existing conditions are all excluded from pricing by law.
No. Only EPO plans were filed for 2026.
Tennessee ranks 10 of 17 states covered here, at a median $773 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 Tennessee. 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 Tennessee 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 Tennessee and a blog covering deductibles, subsidies and special enrollment.
Tennessee loses a carrier this cycle: Cigna is out of the ACA individual market from January 1, 2027, leaving 5 filing here. For General Contractors that is a forced decision, and a better one made in November than in January.
On price the only honest number today is national: the Peterson-KFF read of 2027 filings puts the median proposed rise near 15%, spanning −1% to 54%. Final Tennessee rates are not approved, so any precise 2027 figure quoted for this state is guesswork.
Mark November 1, 2026 to open and December 15 to act. That second date guarantees cover from January 1 in Tennessee regardless of how the current litigation over the enrollment window resolves.
There is still no PPO on the Tennessee marketplace — not in any of its 95 counties. Every plan is an EPO, which for a general contractor working across a wide area is the binding constraint, not price.
You already know you are changing plans — Cigna is leaving. The only real question is whether you pick the replacement or the marketplace picks it for you, and that is a much easier decision made now than in the second week of December.
Enter a ZIP and a licensed agent will tell you three things:
Coverage for General Contractors is priced county by county across Tennessee. Enter your ZIP and a licensed agent will show you what is on the table.
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