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

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

Healthcare Provider Update: Healthcare Provider for Franchise Group The Franchise Group, a company operating several retail and service brands, typically partners with major health insurance providers to offer healthcare coverage to its employees. While the exact provider may vary, large national insurers such as UnitedHealthcare, Anthem, and Aetna are commonly chosen by companies in similar industries for their comprehensive plan offerings. Potential Healthcare Cost Increases in 2026 As we look ahead to 2026, healthcare costs are anticipated to surge significantly, primarily driven by the expiration of enhanced federal premium subsidies associated with the Affordable Care Act (ACA). Many states are bracing for substantial rate hikes, with some insurers proposing increases of over 60%. The Kaiser Family Foundation highlights that without congressional intervention, nearly 92% of marketplace enrollees could face out-of-pocket premiums climbing by as much as 75%. Combined with rising medical costs, these factors are likely to put considerable financial pressure on consumers and companies alike in the coming year. Click here to learn more

'With ACA premiums expected to rise in 2026, Franchise Group 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, Franchise Group 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 Franchise Group 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 Franchise Group 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 retirement savings options does Franchise Group offer to its employees?

Franchise Group offers a 401(k) savings plan to help employees save for retirement.

How can employees at Franchise Group enroll in the 401(k) plan?

Employees at Franchise Group can enroll in the 401(k) plan by completing the enrollment forms provided during orientation or through the employee portal.

Does Franchise Group match employee contributions to the 401(k) plan?

Yes, Franchise Group offers a matching contribution up to a certain percentage of employee contributions to the 401(k) plan.

What is the vesting schedule for the 401(k) match at Franchise Group?

The vesting schedule for the 401(k) match at Franchise Group typically follows a graded vesting schedule over a period of time, which will be detailed in the plan documents.

Are there any fees associated with the Franchise Group 401(k) plan?

Yes, there may be administrative fees associated with the Franchise Group 401(k) plan, which will be disclosed in the plan documents.

Can employees take loans against their 401(k) balance at Franchise Group?

Yes, Franchise Group allows employees to take loans against their 401(k) balance, subject to the plan's terms and conditions.

What investment options are available in the Franchise Group 401(k) plan?

The Franchise Group 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and company stock.

How often can employees change their contribution amounts to the Franchise Group 401(k) plan?

Employees at Franchise Group can change their contribution amounts to the 401(k) plan typically on a quarterly basis or as specified in the plan documents.

What is the minimum contribution percentage for the Franchise Group 401(k) plan?

The minimum contribution percentage for the Franchise Group 401(k) plan is usually set at 1% of the employee's salary, but employees are encouraged to contribute more if possible.

Can employees at Franchise Group access their 401(k) funds before retirement?

Employees at Franchise Group may access their 401(k) funds before retirement under certain circumstances, such as financial hardship or termination of employment.

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

Franchise Group, like many companies, offers retirement plans to its employees, including both pension and 401(k) plans. As of 2022, 2023, and continuing into 2024, Franchise Group aligns its retirement benefits with federal legislation, including the SECURE Act and SECURE 2.0 enhancements (RSM US) (National Law Review). For its 401(k) plan, employees are automatically enrolled at a contribution rate of 3% of their salary, which escalates annually up to 10%, per changes beginning in 2024. Employees have the option to opt out, but this automatic enrollment is designed to help employees build savings consistently. Franchise Group’s 401(k) plan also offers employer matching contributions (CLA). Part-time employees become eligible to participate after two consecutive years of at least 500 hours of service

Restructuring and Layoffs: In early 2023, Franchise Group announced a significant restructuring plan aimed at streamlining operations and improving efficiency. This move included layoffs affecting approximately 10% of the workforce across various departments. The restructuring was driven by a need to adapt to changing market conditions and enhance financial performance. Company Benefit Changes: As part of the restructuring, Franchise Group also revised its employee benefits package. Changes included reduced health insurance coverage options and modifications to retirement plan contributions. These adjustments were made to better align with the company's new strategic goals and financial outlook.

Franchise Group provides stock options as part of its employee compensation package. These options allow employees to purchase company stock at a set price within a specific timeframe. Franchise Group typically grants stock options to senior management and key employees, based on performance and tenure. Franchise Group options are generally vested over several years, with certain performance metrics required for full vesting. Franchise Group RSUs (2022-2024): Franchise Group also offers Restricted Stock Units (RSUs) to its employees. RSUs are granted to employees but are subject to vesting schedules, which are usually tied to continued employment. Franchise Group grants RSUs to a broader range of employees compared to stock options, including mid-level managers and high performers.

Traditional Group Health Insurance Plans: Franchise Group offers traditional group health insurance plans where the company pays a fixed premium to the insurance carrier. These premiums cover a range of services, including medical, dental, and vision. The insurance carrier assumes the financial risk for claims, offering protection to the company against large, unexpected medical expenses. These plans, however, can become expensive and often require high participation rates from employees (StretchDollar). Health Savings Accounts (HSAs): Employees have access to HSAs, which allow them to set aside pre-tax dollars for medical expenses. These accounts are beneficial for both employees and employers, offering flexibility and tax advantages. However, HSAs are only available to employees who have high-deductible health plans (HDHPs), which could limit participation (StretchDollar). Individual Coverage Health Reimbursement Arrangement (ICHRA): Franchise Group also offers an ICHRA, which is a newer health benefit option. This allows employers to provide pre-tax funds that employees can use to purchase their own health insurance. This option is flexible and gives employees the freedom to select a plan that fits their needs. It is particularly useful for franchises with smaller workforces or employees located in various regions (StretchDollar) (Aflac). Compliance with New Regulations: Franchise Group ensures that their health plans comply with the latest federal requirements, including those related to mental health parity and transparency in pricing. The transparency rules require the disclosure of in-network rates, out-of-network allowances, and prescription drug costs, while the mental health parity rules enforce comparative analysis for mental health and substance use disorder treatments (Aflac). Recent Developments: The company has also been updating their healthcare offerings to align with new federal mandates regarding surprise billing, transparency in coverage, and parity in mental health services. These changes are designed to enhance employee protections, streamline claims, and provide clarity in pricing, which benefits employees seeking affordable care options