Quitting a job to start a business: health insurance in Nevada

Ray Delgado is 42 and lives alone in a single-story house in Summerlin, on the west side of Las Vegas. For 9 years he was an operations manager at a logistics company, planning shifts for its warehouse crews and routes for its trucks. His health insurance came through that job.

Over the winter he decided to start his own operations consulting firm, helping small distribution businesses sort out their scheduling and inventory. He gave notice on Monday, February 2, 2026. His last day was Friday, February 27. HR told him his job-based health plan would end the next day, Saturday, February 28.

Does quitting your job let you buy a marketplace plan outside open enrollment? Yes. Losing job-based coverage counts as a qualifying life event whatever the reason, including quitting. In Nevada, it opens a 60-day Special Enrollment Period on Nevada Health Link, and a plan picked before the old one ends starts the first of the month after it ends.

Ray is fictional. The rules in his story come from Nevada Health Link, HealthCare.gov, CMS and the IRS.

Losing job-based coverage, in brief

• It counts whatever the reason. HealthCare.gov puts it this way: “Losing your job for any reason and your job-based health coverage qualifies you.” Quitting is a reason.
• Dropping the plan is different. Canceling job-based coverage while still employed doesn’t open a window. The federal rule says: “Loss of coverage does not include voluntary termination of coverage.”
• The window. A plan can be picked in the 60 days before the old coverage ends or in the 60 days after. Nevada Health Link takes reports of a coming loss as much as 60 days ahead.
• When coverage starts. A plan picked on or before the day the old coverage ends starts on “the first of the month after coverage ends”, in Nevada Health Link’s words. A plan picked after the loss starts the first of the month after it’s picked.
• Proof. Nevada Health Link may ask for documents proving the event. Its rule: “You have 30 days to submit the documents.”
• Where to enroll. Nevadans enroll through Nevada Health Link, the state’s own marketplace, not HealthCare.gov. In Nevada, the premium tax credit comes only with a plan bought through Nevada Health Link.

Ray’s story

The end date

The week he gave notice, Ray asked HR one question before any other: on what day would his health plan end? The answer was February 28. HR’s letter also explained COBRA, which would let him keep the same plan after he left if he paid for it himself.

That date set his clock. His Special Enrollment Period ran from 60 days before February 28 to 60 days after it. Picked on or before February 28, a new plan would start March 1, the day after his old one ended. Picked on March 10, it would start April 1, and he’d go through March uninsured.

He decided to settle it in mid-February, while he still had a paycheck and HR was still down the hall.

COBRA, or a Nevada Health Link plan

COBRA’s appeal was continuity: the same plan and the same network. Its problem, for a man about to give up a salary, was cost. COBRA itself comes with no premium tax credit.

Being offered COBRA didn’t shut him out of the credit. The IRS says a person offered COBRA “can decline the employer coverage, even if it is affordable and provides minimum value, and may be eligible for the Premium Tax Credit” on a marketplace plan. Whether Ray would qualify, and how much he’d be expected to pay toward a plan, came down to his income for 2026.

Estimating a year he hadn’t lived yet

The premium tax credit is based on household income for the whole calendar year, including wages earned before a job ends. Ray lives alone, so his household is 1 person, and his income for the year had 2 parts.

The first was on his pay stubs: $12,000 in wages for January and February.

The second was an estimate. HealthCare.gov’s guidance for self-employed people is to “include the income you expect to make from your business after expenses”, and the savings “are based on your estimated net income.” Ray had 1 client signed and 2 more in talks. On a Sunday afternoon he built a spreadsheet: what he expected to bill from March through December, minus what he expected to spend running the business. It came to $20,000 in net self-employment income.

$12,000 plus $20,000 is $32,000. That was the figure for his application.

Clearing the Medicaid line

Nevada expanded Medicaid, so adults qualify on income alone below 138% of the poverty guideline. For 1 person, that line is about $21,597. At $32,000, Ray was well above it. If his expected income had been under that line, his application would have checked whether he qualified for Nevada Medicaid instead.

Why 200% mattered

$32,000 is about 204% of the poverty guideline for 1 person, which is $15,650 for 2026 coverage. That put Ray just over 200%, and for cost-sharing reductions, 200% is a line.

Cost-sharing reductions come only with a Silver plan, and only for incomes from 100% to 250% of the poverty guideline. They raise the plan’s actuarial value, which means the plan pays a bigger share of covered costs, through lower deductibles and copays. A standard Silver plan has a 70% actuarial value. From 100% to 150%, a Silver plan comes with 94%. Over 150% to 200%, it comes with 87%. Over 200% to 250%, it comes with 73%. Above 250%, there are none.

At about 204%, Ray qualified at the 73% level. Under 200%, it would have been 87%.

Picking a plan

On Tuesday, February 17, Ray sat down at his kitchen table and opened Nevada Health Link. He reported the coming loss of his job-based plan, with February 28 as the end date. He listed his household of 1 and entered $32,000 as his expected income for 2026.

He looked at the Battle Born State Plans, which Nevada Health Link offers for the first time for 2026. They’re plans under contract with the state that must meet premium reduction targets. They’re sold only on Nevada Health Link and are open regardless of income.

He kept his choice to Silver. The credit can be used on any metal level, but the cost-sharing reductions he qualified for come only with a Silver plan. A Bronze plan would have had a lower premium and meant giving them up; at the 73% level they’re a modest step, so he weighed both before choosing Silver. Among the Silver plans, he checked which had his primary care doctor in network and picked one of those.

He took the credit in advance, based on his estimate. When he files his 2026 taxes, it will be checked against what he actually earned. Then he declined COBRA.

The paperwork

Nevada Health Link may ask for documents proving a qualifying event, and if it does, there are 30 days to submit them. Ray kept HR’s letter with the February 28 end date in a folder on his desk, with his last pay stubs and a printout of his spreadsheet.

The first months

His Nevada Health Link plan started on Sunday, March 1. He had no day without coverage.

He also put 4 dates on his calendar: the first Monday of April, July, October and January. On each, he compares what the business has actually earned with his estimate. Enrollees must report income changes within 30 days, and for a new business, the income estimate is the number most likely to move.

In April, he had billed a little less than he planned. In July, a second client had signed, and he was back on pace. At each check, the year was tracking his estimate, so it stayed at $32,000.

The numbers

Step 1. Add up the year’s household income. Ray is a household of 1. Wages for January and February: $12,000. Expected net self-employment income for March through December: $20,000. $12,000 plus $20,000 is $32,000.

Step 2. Compare it with the poverty guideline. For 2026 coverage, the guideline for 1 person is $15,650. $32,000 divided by $15,650 is about 2.04, or about 204%.

Step 3. Check the Medicaid line. 138% for 1 person is about $21,597. $32,000 is above it.

Step 4. Find the applicable percentage. For 2026, households from 200% to 250% are expected to pay between 6.60% and 8.44% of income toward the benchmark plan, rising on a sliding scale. At about 204%, near the bottom of that band, it’s about 6.76%.

Step 5. Work out the expected contribution. $32,000 times 6.76% is about $2,163 a year. Divided by 12, that’s about $180 a month.

Step 6. Apply it to the benchmark. The benchmark is the second-lowest-cost Silver plan where Ray lives. He’s expected to pay about $180 a month toward it, and the tax credit covers the rest of the benchmark’s premium, whatever that premium is. He can use the credit on any metal level.

Step 7. Check cost-sharing reductions. At about 204%, a Silver plan comes with a 73% actuarial value instead of the standard 70%. They come only with Silver.

The credit has limits. It’s for household incomes from 100% to 400% of the poverty guideline, for people who aren’t eligible for other qualifying coverage such as Medicaid or affordable job-based coverage. In Nevada, it comes only with a Nevada Health Link plan. And it’s based on an estimate, which his tax return settles.

What could have gone wrong

Dropping the plan instead of the job. If Ray had canceled his job-based plan while still working, to switch early, that wouldn’t have opened a window. Losing the plan because the job ended is what counts.

Picking late. The window closes 60 days after February 28. After that, with no other qualifying event, he’d have waited for open enrollment. Even inside the window, picking a plan after February 28 would have left him at least a month without coverage.

Taking COBRA first. COBRA itself comes with no premium tax credit. Inside the first 60 days after his job-based plan ended, he could still have switched to a Nevada Health Link plan. After that, “Voluntarily dropping COBRA doesn’t count”, and stopping payments doesn’t qualify either.

Comparing on premium alone. A Bronze plan can be a fair choice, but it would have cost him the cost-sharing reductions, which come only with Silver. The way to compare is what he’d pay through the year, premiums plus the care he expects to use, not the monthly premium by itself.

An estimate that’s too low. The IRS is plain about it: “There is no repayment cap for tax years after 2025.” If Ray’s income comes in higher than his estimate, he repays the extra advance credit at tax time, every dollar of it. The steepest edge is 400% of the poverty guideline, $62,600 for 1 person, because in 2026 there’s no credit above 400%. If a big contract pushed his 2026 income over $62,600, he’d have no credit for the year and would repay every advance dollar. If his income comes in lower than his estimate, he may get more back.

Questions to work through

Is your coverage ending because your job is ending? If your job-based plan ends because you leave the job, for any reason, that’s a loss of coverage. Canceling the plan while you keep the job isn’t.

What’s the exact end date? Ask HR. If you pick a plan on or before that date, coverage starts the first of the month after your old plan ends.

What will the business clear after expenses this year? Add that to the wages you’ve already earned this calendar year. The total is what your credit is figured on.

Where does your estimate land? For 1 person in 2026 coverage, 138% of the poverty guideline is about $21,597, 200% is $31,300, 250% is $39,125 and 400% is $62,600. Each line changes something: Medicaid, the level of cost-sharing reductions, or whether you get a credit.

Is a Silver plan worth a look? If your estimate is between 100% and 250%, a Silver plan comes with cost-sharing reductions. Above 250%, there are no cost-sharing reductions, so compare Silver with the other levels on price and network.

When will you check your numbers? Pick a day each quarter and compare what you’ve earned with your estimate. Report a change to Nevada Health Link within 30 days. A licensed broker can go over the numbers with you.

The short version

Ray quit his job in Las Vegas to start a consulting firm, and losing his job-based plan opened a 60-day Special Enrollment Period even though he left by choice. He picked a Nevada Health Link plan on February 17, so his coverage started March 1 with no gap. His estimate of $32,000 put him at about 204% of the poverty guideline, with an expected contribution of about $180 a month toward the benchmark Silver plan and cost-sharing reductions at the 73% level. He checks his income each quarter, because from 2026 there’s no cap on what he’d repay if he earns more than he estimated.

This is a summary of how the rules work, not legal or tax advice. Nevada Health Link, your plan’s documents and your own tax situation have the final word.