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

Largest Increase Ever From Top Insurers. Will CSX Employees Be Affected?

Healthcare Provider Update: Healthcare Provider for CSX: CSX Corporation has partnered with Aetna, a division of CVS Health, to provide healthcare benefits for its employees. This collaboration allows CSX employees access to a wide range of health services and insurance plans tailored to meet their specific needs. Potential Healthcare Cost Increases in 2026: In 2026, CSX and its employees may face significant healthcare cost challenges, as the landscape for health insurance is set to experience considerable changes. With proposed premium hikes in the Affordable Care Act marketplace reaching as much as 66% in some states, the potential expiration of enhanced federal premium subsidies may exacerbate out-of-pocket expenses for many enrollees. A forecast indicates that over 22 million individuals could see their premiums increase by more than 75%, driven by rising medical costs and insurers' aggressive rate adjustments. This surge in costs could create financial strain not only for individual employees but also for the company's overall healthcare budget, necessitating strategic planning and proactive measures for 2026. Click here to learn more

'With ACA premiums expected to rise in 2026, CSX employees should compare marketplace and employer-related options early, model net costs with and without current subsidies, and coordinate with HR and a qualified tax professional for decisions suited to their situation.' — Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

'With ACA marketplace premiums expected to climb in 2026, CSX employees should compare employer and marketplace options early, estimate net costs under both current and lapsed subsidy scenarios, and coordinate with HR and a qualified tax professional to align coverage with their budget.' — Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article we will discuss:
1. The expected premium increases for ACA marketplace plans in 2026 and their potential impact on CSX employees and retirees.
2. The major national insurers and states with the largest requested rate hikes.
3. The primary economic, legislative, and industry factors driving these increases.
In 2026, health insurance rates for plans purchased through the Affordable Care Act (ACA) marketplace are expected to surge, with several insurers requesting increases exceeding 60%. ¹ For CSX employees and retirees using ACA coverage, this could mean a substantial rise in health care costs. State insurance filings and industry publications point to higher medical expenses, the potential end of enhanced federal premium subsidies, and significant rate-hike proposals from major insurers as key drivers of the increase.

According to KFF’s analyses, the vast majority of marketplace enrollees receive premium tax credits, and if the enhanced credits expire after 2025, average out-of-pocket premium payments for subsidized enrollees could rise by more than 75% in 2026. ¹ As of January 2025, 24.2 million people selected 2025 marketplace coverage, ² and about 93% of marketplace enrollees rely on premium tax credits. ³ KFF also reports that requested premium increases for 2026 are the largest in years, with most proposals falling between roughly 12% and 27% and a median of 18% across reviewed filings. ⁴

Top 10 States With the Largest Requested Premium Increases for 2026:
- New York: UnitedHealthcare requesting up to +66.4% (individual market).
- Arkansas: QualChoice +54.4% , Ambetter (Celtic) +42.5% , statewide average +36.1% .
- Colorado: Western Slope ~+38.8% ; statewide average +28.4% . Rocky Mountain HMO +36.4% , Cigna +29.4% , Anthem +33.6% , Kaiser +15.3% .
- Florida: Molina ~+41% , Florida Blue +27% , Centene Venture +18.73%
- Maine: Anthem (revised) +24.8% ; statewide weighted average +25.9% .
- Washington: 14 insurers; requested average +21.2% .
- Vermont: BCBS Vermont +23.3% .
- Maryland: Requested statewide average +17.1% (individual market).
- Illinois: BCBS Illinois +27% .
- Texas: BCBS Texas +21% .
Major National Insurers and Their 2026 Requests:
- UnitedHealthcare (UnitedHealth Group): Up to +66.4% in New York.
- Elevance Health (Anthem BCBS): +33.6% in Colorado; +24.8% in Maine.
- Kaiser Permanente: +15.3% in Colorado (individual market).
- Centene Corporation (Ambetter/Celtic): +42.5% in Arkansas; +18.73% in Florida.
- Cigna Healthcare: +29.4% in Colorado.
- Molina Healthcare: ~41% in Florida.
- HCSC (BCBS IL, TX): +27% in Illinois; +21% in Texas.
- GuideWell (Florida Blue): +27% in Florida.
- CareFirst BlueCross BlueShield: Maryland requested statewide average +17.1% .
- CVS Health/Aetna: Withdrawing ACA marketplace plans in 17 states in 2026, affecting ~1 million members.
Key Factors Driving the Increases:
- Loss of Enhanced Premium Subsidies: The American Rescue Plan and Inflation Reduction Act extended ACA subsidies through 2025. Without renewal, subsidized enrollees could see sharp increases in monthly premiums beginning in 2026 (KFF estimates more than a 75% jump in average out-of-pocket premiums for subsidized enrollees if the enhancements lapse). ¹
- Medical Cost Inflation: Leading consultancies report elevated medical cost trends heading into 2026—about 7.5% in the individual market and 8.5% in the group market ⁵ —driven by hospital/physician services and prescription drugs.
- Regulatory Shifts: Market rules and state laws have influenced filings. For example, analysts note federal policy changes (e.g., the Marketplace Integrity rule) as a factor cited in filings, adding operational uncertainty for vertically integrated insurers/PBMs.

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Sources:

1. KFF, Health System Tracker. ' How much and why ACA Marketplace premiums are going up in 2026 ,' by J. Ortaliza, M. McGough, K. Vu, I. Telesford, S. Rakshit, E. Wager, L. Cotter, C. Cox. 6 Aug. 2026.

2. CMS.gov. ' Over 24 Million Consumers Selected Affordable Health Coverage in ACA Marketplace for 2025 .' 17 Jan. 2025.

3. The Commonwealth Fund. ' Proposed Rule Will Make Consumers Pay More for Health Insurance and Care in ACA Marketplaces ,' by Sara Collins. 7 May 2025.

4. Fierce Healthcare. ' KFF Analysis finds a median ACA premium hike of 18% for 2026 ,' by Paige Minemyer. 8 Aug. 2025.

5. PwC Health Research Institute. Medical Cost Trend: Behind the Numbers 2026 . PwC , 16 July 2025, https://www.pwc.com/us/en/industries/health-industries/library/behind-the-numbers.html .

Other reources:

1. New York State Department of Financial Services. “Summary of 2026 Requested Rate Actions.” DFS Portal , 2 June 2025, https://myportal.dfs.ny.gov/web/prior-approval/ind-and-sg-medical/summary-of-2026-requested-rate-actions .

2. Centers for Medicare & Medicaid Services (CMS). Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability (Final Rule). 18 June 2025, PDF, https://www.cms.gov/files/document/cms-9884-f-2025-pi-rule-master-5cr-062025.pdf .

3. Minemyer, Paige. “Aetna to Exit the ACA Exchanges in 2026.” Fierce Healthcare , 1 May 2025, https://www.fiercehealthcare.com/payers/aetna-exit-aca-exchanges-2026 .
Pages/Sections referenced: Article body noting ~1 million exchange members and the 2026 exit (single web page; n. pag.).

What is the purpose of the 401(k) plan at CSX?

The 401(k) plan at CSX is designed to help employees save for retirement by allowing them to contribute a portion of their salary on a pre-tax basis.

How can CSX employees enroll in the 401(k) plan?

CSX employees can enroll in the 401(k) plan through the company’s HR portal or by contacting the HR department for assistance.

Does CSX offer a company match for 401(k) contributions?

Yes, CSX offers a company match for 401(k) contributions, which allows employees to increase their retirement savings.

What is the maximum contribution limit for CSX employees under the 401(k) plan?

The maximum contribution limit for CSX employees under the 401(k) plan is determined by the IRS and may change annually. Employees should check the latest IRS guidelines for the current limit.

Can CSX employees take loans against their 401(k) savings?

Yes, CSX allows employees to take loans against their 401(k) savings, subject to certain conditions and limits outlined in the plan documents.

What investment options are available in CSX's 401(k) plan?

CSX's 401(k) plan offers a variety of investment options, including mutual funds, stocks, and bonds, allowing employees to choose based on their risk tolerance and retirement goals.

When can CSX employees start withdrawing from their 401(k) plan?

CSX employees can start withdrawing from their 401(k) plan at age 59½, or earlier under certain circumstances, such as financial hardship.

Is there a vesting schedule for CSX's 401(k) company match?

Yes, CSX has a vesting schedule for the company match, which means employees must work for a certain period to fully own the matched contributions.

How often can CSX employees change their 401(k) contribution amount?

CSX employees can change their 401(k) contribution amount at any time, subject to the plan's guidelines and payroll processing schedules.

What happens to a CSX employee's 401(k) if they leave the company?

If a CSX employee leaves the company, they can choose to roll over their 401(k) balance to another retirement account, cash out, or leave the funds in the CSX plan if permitted.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.

The pension plan for CSX employees is part of the Railroad Retirement Act, specifically referred to as the CSX Railroad Retirement plan. Eligibility and Qualifications: Years of Service: Employees typically need to have at least 10 years of service to be eligible for the pension plan benefits. Age Qualification: Full retirement benefits are available at age 60 with 30 years of service or age 62 with fewer years of service. Pension Formula: The pension is calculated based on the highest three earning years. The formula generally provides 80% of the average highest earnings after 30 years of service. Specific Terms and Acronyms: RRB (Railroad Retirement Board): Governs the administration of the railroad retirement benefits. Tier I and Tier II Benefits: Components of the Railroad Retirement benefits, with Tier I similar to Social Security and Tier II providing additional benefits based on railroad earnings. CSX 401(k) Plan: Name of 401(k) Plan: CSX offers the CSXtra 401(k) plan. Eligibility and Qualifications: Who Qualifies: All full-time employees are eligible to participate in the CSXtra 401(k) plan. Contribution Limits: Employees can contribute from 1% to 50% of their eligible pay up to the IRS limits, with additional catch-up contributions for those aged 50 and older. Company Match: CSX matches 100% of the first 1% of the employee's contribution and 50% of the next 5% of the contributions.

Layoffs and Restructuring: CSX has not announced significant layoffs recently but is continuously adjusting its workforce through normal attrition and targeted hiring to meet changing market demands.

2022: In 2022, CSX granted stock options and RSUs to key executives, focusing on aligning their incentives with the company's strategic goals. The grants were part of the annual executive compensation review. 2023: The 2023 program continued to emphasize performance-based RSUs, rewarding employees for meeting specific operational and financial targets. This year's grants included a significant component tied to sustainability and ESG (Environmental, Social, Governance) metrics, reflecting the company's commitment to sustainable growth. 2024: In 2024, CSX expanded its RSU program to include more mid-level management positions, recognizing the broader impact of these roles on company performance. This year’s stock options included features to enhance retention and reward long-term loyalty among employees.

Health Insurance: CSX offers various health insurance plans, including options with low co-pays and comprehensive coverage through Aetna. These plans cover a wide range of medical services and prescriptions. Wellness Programs: To promote physical and mental health, CSX has implemented wellness programs that include health assessments, fitness challenges, and access to wellness resources. Flexible Spending Accounts (FSAs): Employees can set aside pre-tax dollars for healthcare expenses through Health Care FSAs. The contribution limit for 2024 is $3,050, with a carryover limit of $610 from the previous year. Accidental Death and Dismemberment (AD&D) Insurance: CSX provides AD&D insurance, which covers employees in case of serious injuries or death due to accidents, with various coverage options based on annual pay. Recent Employee Healthcare News: In recent years, CSX has maintained stable health insurance premiums while enhancing the benefits package to meet evolving needs. The company continues to focus on offering competitive and comprehensive health benefits to attract and retain top talent. For instance, CSX has been recognized for its support of military and first responders through its Pride in Service program, which also contributes to the overall health and wellness of its employees.

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For more information you can reach the plan administrator for CSX at 500 Water St Jacksonville, FL 32202; or by calling them at (904) 359-3200.

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