Healthcare Provider Update: Healthcare Provider for Sears Holdings Sears Holdings typically provides healthcare benefits to its employees through various insurance plans, often with national insurers such as Aetna, UnitedHealthcare, or Anthem Blue Cross Blue Shield being among the health carriers they have partnered with. The specific providers can vary by location and employee selection during open enrollment periods. Potential Healthcare Cost Increases in 2026 As we progress into 2026, the healthcare landscape is expected to face significant challenges, particularly for employees of Sears Holdings. Forecasts indicate steep premium hikes, with some states imposing increases of over 60%, largely influenced by rising medical costs and the potential expiration of enhanced ACA premium subsidies. The Kaiser Family Foundation highlights that without congressional intervention, millions of marketplace enrollees could see their out-of-pocket costs surge by more than 75%. This convergence of factors threatens to impose a substantial financial burden on both individuals and employers, necessitating proactive strategies to mitigate rising expenses. Click here to learn more
'Sears Holdings employees should prepare for 2026 by reviewing upcoming benefit changes and exploring ways to manage rising out-of-pocket health care costs.' - Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.
'Sears Holdings employees can better navigate rising health care expenses in 2026 by understanding benefit adjustments early and making informed plan selections,' - Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article, we’ll examine:
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Why increasing health care costs are pushing Sears Holdings employers to pass more expenses onto employees.
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The approaches companies are using to handle cost pressures, including changes in plan design and pharmacy benefit modifications.
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How marketplace premium hikes and medical cost trends affect overall health care affordability.
In 2026, Sears Holdings employees may bear a greater share of health care expenses as costs keep climbing.
Many large U.S. companies, including those such as Sears Holdings, are preparing to adjust benefit structures to counter rising health care expenses. Mercer’s recent survey of 711 U.S. employers with 500 or more employees found that 51% are “likely” or “very likely” to raise deductibles, coinsurance, or out-of-pocket maximums in 2026—up from 45% who said the same for 2025. 1
Despite cost-saving actions, employers’ health care costs rose by 4.5% in 2024 and are expected to climb another 5.8% in 2025; absent these actions, Mercer estimates that costs could go up by ~8%. 2 A key contributing factor is the high price of GLP-1 medications for diabetes and weight loss, averaging around $1,000 per patient per month. 1 The survey also found that 77% of employers rated managing GLP-1 costs as extremely or very important. 1 Although many companies—including those in the energy sector—have expanded GLP-1 coverage, growing concerns suggest such plans may be untenable by 2026.
Shifting Employer Approaches to Benefits
Previously, employers hesitated to raise deductibles because of tight labor markets and concerns about affordability. Today, with economic uncertainty and slower wage growth, cost management may be taking precedence over hiring and retention efforts in some cases. In 2026, 35% of large firms intend to offer unconventional medical plan options—such as copay-based models aimed at reducing costs while maintaining quality. 1 Moreover, 61% are evaluating alternatives to traditional pharmacy benefit arrangements to bring more clarity to drug pricing and pharmacy benefit manager (PBM) services. 1
Rising Costs in the Individual Market
The pressure extends beyond employer-sponsored coverage. The ACA marketplace is slated to experience some of its biggest premium increases in over five years. According to state filings, 2026 premiums could jump dramatically—UnitedHealthcare in New York is seeking increases of up to 66.4%, 3 Arkansas expects an average increase of 36.1%, 4 and Florida Blue is looking at 27%. 5 If enhanced federal subsidies expire at the end of 2025, millions could be exposed to the full impact of these higher premiums.
Why Costs Are Rising Across the Board
Medical cost trends are projected to increase by 7–10% annually—far exceeding general inflation—driven by factors like brand name medications, hospital services, and specialist care. Regulatory changes are adding further pressure. Insurer earnings also contribute, as several major carriers posted record profits in 2024 while launching multibillion-dollar stock buybacks.
Key Take-Away for Sears Holdings Workers
With 51% of employers planning to transfer more health care costs onto workers—and ACA premiums rising sharply—2026 may become a critical year for health care affordability. Sears Holdings employees who familiarize themselves with upcoming benefit changes, optimize HSA/FSA contributions, and choose their 2026 plan with care may offset some of the added costs. Otherwise, households could see thousands in extra spending for equal—or even reduced—coverage.
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Sources:
1. Mercer. “ U.S. Employers Rethinking Benefit Strategy for 2026 amid Rapidly Rising Costs .” Mercer Newsroom , 16 July 2025.
2. Fierce Healthcare. ' Mercer survey: Employers may make a return to healthcare cost-shifting strategies ,' by Paige Minemyer. 16 Jul 2025.
3. New York State Department of Financial Services. ' 2026 Individual and Small Group Requested Rate Actions ,' 2 June 2025.
4. ACHI. ' Arkansas Insurers File Proposed Rate Increases for 2026 ,' by Chris Ray. 8 Aug. 2025.
5. Insurance Newsnet. ' Florida Blue among companies proposing double-digit healthcare increases ,' by Christine Sexton. 12 Aug. 2025.
Other Resources:
1. Ortaliza, Jared, et al. “How Much and Why ACA Marketplace Premiums Are Going Up in 2026.” Peterson-KFF Health System Tracker , 6 Aug. 2025.
2. New York State Department of Financial Services. “2026 Individual and Small Group Requested Rate Actions – Additional Information.” DFS Prior Approval Portal , accessed 13 Aug. 2025.
3. Sexton, Christine. “Watch Out for Double-Digit Health Insurance Increases in 2026.” The Florida Phoenix , 11 Aug. 2025.
4. Federal Trade Commission. Specialty Generic Drugs: A Growing Profit Center for Vertically Integrated Pharmacy Benefit Managers. Second Interim Staff Report. 14 Jan. 2025. pp. 5–6, 19–20, 32–34.
How does the Sears Holdings Pension Plan differentiate between normal retirement, early retirement, and late retirement options for Kmart participants? In what ways do these options influence the retirement planning process for employees of Sears Holdings, and what specific considerations should Kmart employees be aware of when choosing one of these retirement paths, particularly in relation to their vested status?
Differentiation of Retirement Options: The Sears Holdings Pension Plan offers distinct options for normal, early, and late retirement. Normal retirement is available at age 65 or after five years of plan participation, whichever is later. Early retirement can be taken from age 55 but before 65, provided the employee is vested, with benefits subject to actuarial reduction unless certain conditions are met (like having at least 90 points, which is a sum of age and years of credited service). Late retirement pertains to any retirement after the normal retirement age, with pensions recalculated to reflect the delay in benefit commencement.
Considering the frozen status of the Sears Holdings Pension Plan, how does this impact the benefits eligibility for Kmart employees, and what implications does it have for their retirement savings strategies? In what ways should current employees factor in this frozen status when evaluating their overall retirement readiness and potential alternatives outside of the company plan?
Impact of Frozen Status: The freezing of the Sears Holdings Pension Plan on January 31, 1996, means that there have been no new accruals of benefits or participants since that date. For Kmart employees, this impacts their benefits eligibility by capping the pension benefits at levels earned up to the freeze date. Employees need to consider this stagnation in benefits when planning for retirement, potentially seeking additional retirement savings avenues to bridge any shortfall.
What are the essential calculations involved in determining the retirement benefits under the Sears Holdings Pension Plan for Kmart employees? Specifically, how do the Career Average Pay and Final Average Pay formulas come into play, and what factors should employees consider when estimating their future retirement payouts?
Essential Calculations for Retirement Benefits: Pension benefits for Kmart employees under the Sears Holdings Pension Plan are calculated using either the Career Average Pay or the Final Average Pay formulas. These calculations take into account an employee's years of credited service and compensation up to the freeze date. Factors like estimated Social Security benefits and specific formulas (such as a deduction based on Social Security benefits under the Final Average Pay formula) play crucial roles in determining the final pension payout.
How can Sears Holdings employees best navigate the process of applying for benefits under the Pension Plan? What specific steps should participants take to ensure their applications are processed correctly, and what important deadlines should they be aware of to avoid any negative consequences on their retirement benefits?
Navigating the Benefits Application Process: To apply for pension benefits, employees must submit a formal application, ideally 30 to 90 days before the intended commencement date. It is crucial to ensure all personal information, including marital status and spouse details, is up-to-date to avoid delays or inaccuracies in benefit processing. Missing application deadlines can lead to postponed benefit payments or unwanted default options.
In what situations can Kmart employees expect to receive a Deferred Vested Pension, and how is the calculation for this pension affected by their previous employment and vesting service? Employees should be aware of the important factors influencing their eligibility and the steps necessary to maintain their retirement benefits after leaving the company.
Eligibility and Calculation for Deferred Vested Pension: A Deferred Vested Pension is available to employees who leave the company after becoming vested but prior to qualifying for retirement. The calculation mirrors that of a normal retirement pension, with possible early commencement reductions. Understanding the timing of benefit commencement and the potential reductions for early start is vital for planning.
How does the Sears Holdings Pension Plan address tax considerations for employees receiving both monthly payments and lump sum payments upon retirement? What tax implications should Kmart participants be aware of, particularly in relation to IRS rules for distributions and potential penalties for early withdrawal?
Tax Implications of Pension Receipt: Pension payments, whether monthly or lump sum, are subject to federal taxes. Monthly benefits are taxed as ordinary income, while lump sums might be eligible for special tax treatments or rollover options to defer taxes. It’s important for Kmart employees to consider these implications and possibly consult with a tax advisor to optimize tax liability.
What are the rights and protections afforded to Kmart participants under the Employee Retirement Income Security Act (ERISA) as they navigate their retirement benefits with the Sears Holdings Pension Plan? How can employees leverage these rights to ensure they are receiving all the benefits to which they are entitled?
ERISA Rights and Protections: Under ERISA, Kmart employees are entitled to certain rights including the ability to appeal denied benefits, access to plan information, and assurances of fair and equitable treatment of their benefits. Leveraging these protections ensures that employees receive all due benefits.
What steps should Kmart employees take to update their personal information to ensure they continue receiving their benefits without interruption, especially in the context of missing participants or uncashed checks? What resources and contacts at Sears Holdings are available to assist with these updates?
Updating Personal Information: Maintaining accurate personal information with the pension plan is crucial for uninterrupted benefit payments. Employees should promptly update changes such as address, marital status, or beneficiaries to prevent issues with benefit distributions or lost checks.
How does the process of transferring between affiliated employers impact pension benefits for Kmart employees under the Sears Holdings Pension Plan? What considerations should be taken into account concerning Credited Service and Vesting Service during such transfers, and how can employees ensure they do not lose any entitled benefits?
Impact of Transfers Between Affiliated Employers: Transferring between Sears Holdings’ affiliated employers can affect pension benefits differently depending on whether the employer participates in the pension plan. It's essential to understand how such transfers impact credited and vesting service accruals.
For Kmart employees seeking more information about their benefits under the Sears Holdings Pension Plan, what is the best way to contact company representatives? How can they effectively communicate their questions or concerns to ensure they receive accurate and timely information regarding their retirement benefits?
Contacting Plan Representatives: Kmart employees seeking clarity on their pension benefits should contact the Sears Holdings Pension Service Center. Effective communication, including prepared questions and necessary documentation, will aid in obtaining accurate and comprehensive information.