Benchmark $455/mo · +21.6% approved · Virginia’s Insurance Marketplace
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A 40-year-old plumber in Virginia faces a benchmark premium of $455/month for 2026, up from $372 in 2025. That is 27% below the national benchmark of $625. Carriers were approved for an average increase of +21.6%.
There is no CMS plan-level file for Virginia, because Virginia operates Virginia’s Insurance Marketplace instead of healthcare.gov and its issuers file with the state rather than through the federal platform. That is a real gap in the public data, and it is the reason this page leads with approved rate changes and market concentration rather than a county premium grid.
Virginia has the widest carrier-to-carrier spread of the six. Approved increases ranged from +1.1% at Group Hospitalization & Medical Service to +40.2% at Optimum Choice, so what happened to a Virginian in 2026 depended almost entirely on which card was in their wallet.
| Virginia — 2026 | Figure |
|---|---|
| Benchmark premium, age 40 (2026) | $455 |
| Benchmark premium, age 40 (2025) | $372 |
| Year-over-year change | +22.3% |
| Approved average rate increase | +21.6% |
| Versus the national benchmark ($625) | -27% |
| Rank among your 21 licensed states | 2 of 21 |
| Counties | 133 |
| Carriers on the exchange | 8 |
| Exchange | Virginia’s Insurance Marketplace (state-run since 2024) |
| Carrier | Network | Members | 2026 approved |
|---|---|---|---|
| HealthKeepers (Anthem) | — | 140,000 | +20.4% |
| Sentara Health Plans | — | 109,393 | +20.6% |
| Cigna Health & Life | — | 45,639 | +22.3% |
| Kaiser Mid-Atlantic | — | 36,390 | +11.6% |
| Optimum Choice | — | 25,509 | +40.2% |
| CareFirst BlueChoice | — | 8,049 | +19.8% |
| Anthem Health Plans of VA | — | 3,500 | +23.1% |
| Group Hospitalization & Medical Service | — | 1,296 | +1.1% |
Two carriers exited for 2026 — Aetna Health (13,721 members) and Innovation Health Plan (27,720 members) — displacing roughly 41,000 people who had to pick a new plan.
Sources: Virginia Bureau of Insurance 2026 approved rate filings. KFF, “Marketplace Average Benchmark Premiums,” 2026. Benchmark is the second-lowest-cost Silver plan for a 40-year-old, weighted by plan selections.
Injury exposure makes the out-of-pocket maximum, not the premium, the number that decides a bad year.
Occupational context: Confined-space entry; sewage and biohazard exposure; back strain.
To be clear about what this does and does not affect: a Virginia carrier cannot ask your occupation, cannot charge a plumber more than anyone else of the same age in the same ZIP, and cannot exclude a condition you already have. Occupation only tells you which plan structure to shop for.
Ranked on the benchmark premium, the one measure published on the same basis for every state. Cheaper: Maryland ($414). More expensive: Indiana ($474), Nevada ($497), Ohio ($513).
You buy where you live, not where you work, so treat this as context rather than a shopping list. A genuine move does open a special enrollment period.
Expense categories that typically apply to this trade: Tools, van, licensing, materials, liability insurance. Health premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or a spouse. The deduction lowers your AGI, and AGI sets your premium tax credit, so the two calculate against each other — worth raising with your CPA before you enroll rather than after.
Virginia’s 2026 benchmark premium is $455 a month for a 40-year-old. The national benchmark is $625, so Virginia sits below average.
The 2026 benchmark premium in Virginia is $455 per month for a 40-year-old, up from $372 in 2025. That is full price before premium tax credits; most buyers pay less after subsidies.
Carriers in Virginia were approved for an average increase of 21.6%. Filings across the country cited the expiry of the enhanced federal premium tax credits at the end of 2025, rising medical and drug costs, and expectations that healthier people would drop coverage.
No. Exchange plans are guaranteed issue and community rated. Price varies only by age, ZIP code, tobacco use and household size. Occupation is not a rating factor.
No. Virginia runs its own exchange, Virginia’s Insurance Marketplace, state-operated since 2024. You enrolll there rather than on healthcare.gov.
Below the cliff. At this income a single-person household remains eligible for a premium tax credit in 2026.
This occupation sits above the cliff in 8 of the 21 states reported and below it in the other 13, so the answer changes with the state.
What this figure is. It is the median annual wage BLS reports for Plumbers, Pipefitters, and Steamfitters (SOC 47-2152) in Virginia. 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 plumber. 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 Virginia specifically — county-level carriers and enrollment help — I publish that on Coverage by County, including a page written for Plumbers in Virginia and a blog covering deductibles, subsidies and special enrollment.
Because Virginia operates a state-based exchange, its 2027 data is published separately from the federal landscape files. If you are a plumber here, the national summaries are usually either late or simply wrong about this state.
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 Virginia 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 Virginia regardless of how the current litigation over the enrollment window resolves.
Virginia publishes its 2027 plan data on its own schedule rather than in the federal files, so the earlier you get a read on your options the less you are relying on national summaries that may not apply here.
Give me a ZIP and I will tell you three things:
Rates for Plumbers in Virginia are set by county, not by occupation. Start with your ZIP and I will show you the plans actually filed where you live.