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New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

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Five Below Employees Face Potential Health Care Cost Increases in 2026

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Healthcare Provider Update: Healthcare Provider for Five Below Five Below, a popular retail chain that focuses on selling a variety of items priced at $5 and below, utilizes Aetna as their healthcare provider. This partnership enables employees to access a range of health insurance plans and benefits that support their wellness needs. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, significant premium hikes are anticipated in 2026, particularly for those enrolled in Affordable Care Act (ACA) marketplace plans. With some states projecting increases exceeding 60%, the absence of enhanced federal premium subsidies will exacerbate this situation, potentially raising out-of-pocket premium costs by over 75% for most enrollees. This financial strain-coupled with ongoing medical cost inflation-could jeopardize access to affordable healthcare for millions of Americans, especially those with chronic conditions who rely on comprehensive coverage. Click here to learn more

'Five Below 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.

'Five Below 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:

  1. Why increasing health care costs are pushing Five Below employers to pass more expenses onto employees.

  2. The approaches companies are using to handle cost pressures, including changes in plan design and pharmacy benefit modifications.

  3. How marketplace premium hikes and medical cost trends affect overall health care affordability.

In 2026, Five Below employees may bear a greater share of health care expenses as costs keep climbing.

Many large U.S. companies, including those such as Five Below, 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 Five Below 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. Five Below 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.

What type of retirement savings plan does Five Below offer to its employees?

Five Below offers a 401(k) retirement savings plan to its employees.

Is participation in the 401(k) plan at Five Below mandatory?

No, participation in the 401(k) plan at Five Below is voluntary for employees.

Does Five Below provide any matching contributions to the 401(k) plan?

Yes, Five Below offers matching contributions to eligible employees who participate in the 401(k) plan.

At what age can employees at Five Below start contributing to the 401(k) plan?

Employees at Five Below can start contributing to the 401(k) plan as soon as they meet the eligibility requirements, typically at age 18.

How can employees at Five Below enroll in the 401(k) plan?

Employees at Five Below can enroll in the 401(k) plan by completing the enrollment process through the company’s HR portal.

What investment options are available in the Five Below 401(k) plan?

The Five Below 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and other investment vehicles.

Can employees at Five Below change their contribution percentage to the 401(k) plan?

Yes, employees at Five Below can change their contribution percentage at any time, subject to plan rules.

What is the vesting schedule for Five Below's 401(k) matching contributions?

Five Below has a vesting schedule that typically requires employees to work for a certain number of years before they fully own the matching contributions.

How often can Five Below employees review their 401(k) account statements?

Employees at Five Below can review their 401(k) account statements quarterly or online at any time through the plan’s website.

What happens to the 401(k) plan if an employee leaves Five Below?

If an employee leaves Five Below, they can choose to roll over their 401(k) balance to another retirement account, cash out, or leave it in the Five Below plan if allowed.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
For Five Below, the company offers a 401(k) plan but does not provide a traditional pension plan. The 401(k) plan at Five Below includes several key features: Eligibility: Employees must be at least 21 years old to participate. Enrollment in the plan can occur after the first paycheck, with deferrals starting on January 1st or July 1st following the hire date. Employees become eligible for the employer match once they begin deferring contributions. Contributions: Employees can contribute on a pre-tax or after-tax (Roth) basis, up to the IRS annual limits. For 2022, the maximum employee contribution was $20,500, and it increased to $22,500 in 2023. Employees aged 50 and older can make catch-up contributions, with limits of $6,500 in 2022 and $7,500 in 2023. The company offers a match of 100% on the first 4% of eligible contributions and 50% on the next 2%. Vesting: Employees are immediately vested in all 401(k) contributions and any earnings from these contributions.
Restructuring Layoffs and Benefits Changes: Five Below has been focusing on optimizing its workforce as part of a broader strategy to maintain its competitive edge in the retail market. This has included targeted layoffs aimed at streamlining operations, particularly in underperforming locations. The company has also been reviewing its employee benefit structures, including adjustments to retirement plans to better align with current economic conditions. These changes are part of a proactive approach to manage costs while continuing to invest in growth areas like e-commerce.
Company Name: Five Below Stock Options and RSUs Available: Five Below offers stock options and RSUs to eligible employees, including executives and senior management. The RSUs are granted based on performance and tenure. Eligibility: Five Below typically awards stock options and RSUs to high-performing employees and those in key positions. Employees must meet certain performance metrics and tenure requirements to qualify. Company Name: Five Below Stock Options and RSUs for 2022: In 2022, Five Below granted stock options and RSUs to various employees, focusing on those who significantly contributed to the company's growth. The vesting schedule for RSUs is often tied to continued employment over a few years. Source: [Five Below 2022 Annual Report, Page 58] Company Name: Five Below Stock Options and RSUs for 2023 and 2024: For 2023 and 2024, Five Below continued offering stock options and RSUs, with increased emphasis on aligning employee incentives with company performance. The specific terms of these grants were detailed in their annual filings and shareholder communications. Source: [Five Below 2023 Proxy Statement, Page 42]; [Five Below 2024 Annual Report, Page 65] Sources: Five Below 2022 Annual Report, Page 58 Five Below 2023 Proxy Statement, Page 42 Five Below 2024 Annual Report, Page 65
Five Below offers a range of health benefits to its employees, tailored to different needs and employment statuses. Full-time employees can choose from multiple health plans, including High Deductible Health Plans (HDHP) and Exclusive Provider Organization (EPO) plans, each with varying levels of coverage and copays. For example, the EPO plan now features reduced copays, with visits to primary care doctors costing $20 and specialist visits $40. There is also an emphasis on preventive care, with certain plans covering preventive services at 100%. Additionally, Five Below provides access to telemedicine services through CirrusMD, which allows employees to consult with physicians 24/7 via secure video chat or phone. This is part of their partnership with Cigna, which also includes pharmacy benefits. The company has introduced new wellness initiatives like Wellbeats, which offers on-demand workouts, mental health classes, and nutrition education.
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For more information you can reach the plan administrator for Five Below at , ; or by calling them at .

https://contracts.justia.com/companies/five-below-531/contract/183893/ https://www.selecthub.com/hris/compensation-management/deferred-compensation-plan/ https://www.fidelity.com/viewpoints/retirement/nqdc-part-2 https://myfivebelowbenefits.com/pt/benefits.html https://www.ameriprise.com/financial-goals-priorities/taxes/net-unrealized-appreciation https://www.retirementwatch.com/the-net-unrealized-appreciation-nua-tax-strategy https://www.thelayoff.com/t/1oANHKhV https://investor.fivebelow.com/financial-information/annual-reports-and-proxy-statements/default.aspx https://support.fivebelow.com/hc/en-us/articles/4402437949079-payroll-info https://www.foxrothschild.com/publications/interest-rate-hikes-present-challenge-for-fully-funded-pension-plans https://www.principal.com/ https://www.milliman.com/en/ https://www.retaildive.com/ https://corpgov.law.harvard.edu/ https://www.spglobal.com/marketintelligence/en/news-insights/latest-news-headlines/corporate-layoffs-in-2023-8212-a-timeline-74012248 https://www.wral.com/story/2023-layoff-tracker-the-latest-on-which-companies-have-announced-job-cuts/20828325/ https://247wallst.com/special-report/2023/03/24/companies-planning-the-biggest-mass-layoffs-this-year/ https://www.emparion.com/cash-balance-pension-plan-faq/ https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/fact-sheets/cash-balance-pension-plans https://www.benefitequity.com/blog/cash-balance-plans

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