'With ACA premiums expected to rise in 2026, Five Below 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, Five Below 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 Five Below 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 Five Below 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 2026, average out-of-pocket premium payments for subsidized enrollees could rise by more than 75% in 2026. ¹  As of January 2026, 24.2 million people selected 2026 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 2026. 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.

Dividing retirement assets in a QDRO proceeding requires a clear understanding of what Five Below offers through its benefit programs. Without a traditional pension, your 401(k) - alongside Social Security - forms the foundation of your retirement income at Five Below. Five Below may offer a 401(k) employer match - review your Summary Plan Description for current match rate and vesting details. Your overall withdrawal strategy, account sequence, and Roth conversion opportunities leading up to and into retirement deserve careful, personalized analysis given the income-sequencing implications.

Turning to healthcare, Five Below does not offer continued medical coverage to retirees, which means coverage through the company ends when employment does. Planning for the cost of health insurance during any gap between your retirement date and Medicare eligibility at age 65 is a critical step - marketplace coverage, COBRA continuation, or a spouse's employer plan are common options. Building an accurate estimate of bridge-coverage costs into your retirement income projection prevents underestimating one of the largest variable expenses retirees face. Building a retirement plan that weaves in every Five Below benefit - pension, healthcare, savings - is the most reliable way to project your future income.

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 2026 .' 17 Jan. 2026.

3. The Commonwealth Fund. ' Proposed Rule Will Make Consumers Pay More for Health Insurance and Care in ACA Marketplaces ,' by Sara Collins. 7 May 2026.

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

5. PwC Health Research Institute.  Medical Cost Trend: Behind the Numbers 2026 .  PwC , 16 July 2026,  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 2026,  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 2026, PDF,  https://www.cms.gov/files/document/cms-9884-f-2026-pi-rule-master-5cr-062025.pdf .

3. Minemyer, Paige. “Aetna to Exit the ACA Exchanges in 2026.”  Fierce Healthcare , 1 May 2026,  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.).