Individual Health Insurance – Private Plans Purchased Directly from the Carrier
If you need individual or family health coverage outside of the Affordable Care Act (ACA) Marketplace, we can help.
At Professional Insurance Programs, we work with private individual health insurance plans purchased directly from the carrier in Wisconsin. These plans are not part of the public Marketplace (Healthcare.gov) and can offer flexibility in premiums, provider networks, and plan design.
We guide you through the process from start to finish—helping you compare plans, understand benefits, and enroll. Once your plan is in place, we remain your agent and advocate for as long as you have coverage.
When You Can Enroll
You can only buy an individual health plan:
- During the Annual Open Enrollment Period, which, in Wisconsin, runs from November 1st to December 15th each year for a January 1st effective date.
- During a Special Enrollment Period (SEP) if you have a qualifying life event.
What Qualifies for a Special Enrollment Period (SEP)?
You may qualify for an SEP if you:
- Lose other qualifying health coverage (employer plan, COBRA, Medicaid, or another individual plan)
- Get married or divorced
- Have or adopt a child
- Permanently move to a new area with different health plan options
- Turn 26 and lose coverage under a parent’s plan
- Experience other specific changes in household or coverage status
SEP Timeline
In most cases, you have 60 days from the date of the qualifying event to enroll in a new plan. If you miss this window, you’ll need to wait until the next Open Enrollment Period.
Why Consider a Private Plan Purchased Directly from the Carrier?
Private (non-Marketplace) plans may be a good fit if:
- You don’t qualify for ACA subsidies.
- You want more flexibility in provider networks or plan design.
- You’re looking for plan options with different deductibles, copays, or premiums than ACA Marketplace plans.
- You do not have to notify Healthcare.gov of income or household changes during the year.
- You work directly with your insurance agent and the insurance carrier for service and support.
Important Details
- Available only in Wisconsin
- We do not sell ACA Marketplace (Healthcare.gov) plans
- Coverage varies by plan—our role is to help you understand your options before enrolling
- Plan Availability by Location – Available carriers and plan options are determined by the county you live in. During your consultation, we’ll review the plans offered in your area so you can compare options that fit your location, budget, and coverage needs.
To get started, fill out the census below, request information or you may also simply call us at 1-800-637-4676.
Individual/Family Health Census
Tools & Resources:
Do I qualify for the Special Enrollment Period? Find out here.
Do I qualify for a subsidy? Find out by using the Health Insurance Marketplace Calculator.
For a glossary of health coverage and medical terms, click here.
A summary of the Affordable Care Act can be found here.
Tools & Resources:
Do I qualify for the Special Enrollment Period? Find out here.
Do I qualify for a subsidy? Find out by using the Health Insurance Marketplace Calculator.
For a glossary of health coverage and medical terms, click here.
A summary of the Affordable Care Act can be found here.
Looking for information on health insurance for your employees? Click here.
Don’t forget to ask us about: Life, Disability, Medicare Supplements, Long Term Care, Vision and Dental.