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

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

Healthcare Provider Update: Healthcare Provider for Gilead Sciences Gilead Sciences, a leading biopharmaceutical company known for its innovative therapies, typically partners with various healthcare providers and networks to facilitate patient access to its medicines. Specific details about Gilead's healthcare providers can vary by region and therapeutic area, but they often collaborate with hospitals, specialty clinics, pharmacies, and physicians nationwide to ensure effective treatment and management of diseases, particularly in areas like HIV, oncology, and liver diseases. Potential Healthcare Cost Increases in 2026 In 2026, healthcare costs are anticipated to rise significantly due to a combination of factors affecting the Affordable Care Act (ACA) marketplace. With some states projecting premium increases of over 60%, the expiration of enhanced federal subsidies could lead to over 22 million enrollees experiencing out-of-pocket premium spikes exceeding 75%. Contributing to these increases are escalating medical costs driven by inflation, higher utilization of healthcare services, and record profitability reported by major insurers, which are amplifying price pressures on consumers seeking affordable healthcare solutions. Click here to learn more

'With ACA premiums expected to rise in 2026, Gilead Sciences 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, Gilead Sciences 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 Gilead Sciences 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 Gilead Sciences 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.).

How does Gilead's approach to employee benefits evolve to ensure comprehensive health coverage for full-time and part-time employees, and how do these benefits align with industry standards? Additionally, considering the competitive landscape, what specific initiatives does Gilead undertake to maintain and enhance its health benefits offering?

Gilead ensures comprehensive health coverage for both full-time and part-time employees by offering competitive medical, dental, and vision plans. Full-time employees, as well as part-time employees working at least 30 hours a week, are eligible for a range of health benefits, including coverage for spouses, domestic partners, and dependent children. This benefits package includes life and disability insurance, health savings accounts, and wellness services such as biometric screenings and fitness reimbursements, aligning with industry standards(Gilead_2016_Company_Peo…).

In what ways does Gilead's professional development program contribute to the personal and career growth of its employees? How does Gilead gauge the effectiveness of these development initiatives, and what feedback mechanisms are in place to continually improve the offerings?

Gilead’s professional development program contributes to employees' personal and career growth through extensive training opportunities, leadership development programs, and an MBA program in partnership with Golden Gate University. Gilead monitors the effectiveness of these initiatives through completion metrics, feedback surveys, and by tracking career progression. A continuous feedback loop ensures that employee development programs evolve based on participants’ experiences and business needs(Gilead_2016_Company_Peo…).

Gilead emphasizes a pay-for-performance model in its compensation structure. How does this model operate in practice, and in what ways are performance metrics tied to employee compensation at Gilead? Moreover, how does the company ensure transparency and fairness in its pay practices?

Gilead operates a pay-for-performance model, where employee compensation is directly tied to individual performance evaluations and business results. Regular reviews ensure that compensation remains fair and competitive, with transparency maintained through structured performance assessments. Gilead promotes pay equity, regularly reviewing compensation practices to ensure fairness and alignment with market conditions(Gilead_2016_Company_Peo…).

Given the unique challenges associated with employee parental leave, how does Gilead support employees who are navigating this transition? Furthermore, how are Gilead's policies aligned with or surpassing industry standards regarding parental leave and adoption benefits?

Gilead supports employees during parental leave transitions by offering 12 weeks of paid leave for new parents in the U.S., along with adoption benefits and reimbursements of up to $5,000. This benefit, extended to both U.S. and international employees, ensures legislative compliance and alignment with market standards, often surpassing industry norms(Gilead_2016_Company_Peo…).

With the increasing importance of mental health support in the workplace, how does Gilead's Employee Assistance Program (EAP) address the diverse wellness needs of its employees? In what ways does Gilead promote the utilization of these services to ensure engagement and effectiveness?

Gilead’s Employee Assistance Program (EAP) addresses a broad range of wellness needs, including mental health support, counseling, and legal or financial assistance. The company promotes these services through internal communications and wellness campaigns, ensuring employees are aware of and engage with these offerings, which are designed to provide confidential and comprehensive support(Gilead_2016_Company_Peo…).

How does Gilead foster an inclusive work environment that values diversity? What specific programs and initiatives are in place to promote inclusion, and how does Gilead measure the success of these diversity initiatives?

Gilead fosters an inclusive work environment through Employee Resource Groups (ERGs) and diversity initiatives aimed at professional development and community engagement. The company measures the success of its inclusion efforts through employee feedback, participation in diversity programs, and performance management processes that now include “inclusion” as a core value(Gilead_2016_Company_Peo…).

Considering Gilead's Employee Stock Purchase Program (ESPP), how do the company's policies encourage employee investment in Gilead? What benefits do employees gain from participating in the ESPP, and how does it contribute to their overall financial well-being?

Gilead’s Employee Stock Purchase Program (ESPP) encourages investment by offering U.S. employees the ability to contribute 1-15% of their pay to purchase Gilead stock at a 15% discount. This program helps employees build financial security and aligns their interests with the company's success, contributing to overall financial well-being(Gilead_2016_Company_Peo…).

What role does volunteerism play within Gilead's corporate culture, and how does the company facilitate employee engagement in community service initiatives? Additionally, how does participation in these programs impact employee satisfaction and retention rates?

Volunteerism is integral to Gilead’s corporate culture, with the company supporting employee involvement in community service through its Gilead Volunteer Community. These activities align with Gilead’s mission and values, and participation positively impacts employee satisfaction and retention by fostering a sense of purpose and community engagement(Gilead_2016_Company_Peo…).

How does Gilead ensure that its benefits package remains competitive within the biotechnology industry? What strategies does Gilead employ to regularly assess and enhance its offerings to meet the evolving needs of its workforce?

Gilead ensures its benefits package remains competitive by regularly reviewing and benchmarking against industry standards. The company adjusts offerings to meet evolving employee needs, particularly in areas like health and wellness, retirement plans, and work-life balance, ensuring that its benefits are both market-competitive and supportive of long-term employee well-being(Gilead_2016_Company_Peo…).

For employees seeking more information about Gilead's benefits and retirement options, what are the best channels to contact Gilead? How does Gilead ensure that employees have access to clear and timely information regarding their benefits, and what resources are available to assist them during the retirement process?

Employees seeking more information about Gilead’s benefits and retirement options can access resources through the company’s HR portals, internal communication channels, or by contacting HR directly. Gilead provides clear, timely information and offers comprehensive resources such as retirement planning consultations and financial wellness programs to assist employees during the retirement process(Gilead_2016_Company_Peo…).

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

Name of Pension Plan: Gilead Sciences does not appear to have a traditional defined benefit pension plan as of the latest information for 2022, 2023, and 2024. Instead, the company emphasizes its 401(k) plan as a primary retirement benefit. Pension Formula and Qualification: Since there is no traditional defined benefit pension plan, there are no specific formulas or age/service qualifications related to a pension plan. Name of 401(k) Plan: Gilead Sciences 401(k) Plan 401(k) Plan Eligibility: Employees are eligible to participate in the Gilead Sciences 401(k) Plan upon meeting certain criteria, including a minimum period of employment which is typically 30 days. Contribution Details: Gilead Sciences offers a matching contribution to the 401(k) Plan, with the company matching a percentage of employee contributions up to a specific limit.

Restructuring and Layoffs: In 2023, Gilead Sciences announced a significant restructuring plan aimed at optimizing its operational efficiency. This included a reduction of approximately 5% of its workforce. The company stated that these changes were part of a broader strategy to streamline operations and better position itself for long-term growth amidst evolving market conditions. Source: Business Insider. Importance: Given the current economic volatility and changes in the investment landscape, understanding these developments is crucial for stakeholders to assess the impact on company performance and stability. The restructuring is also relevant due to its potential effects on employee benefits and overall corporate strategy.

Gilead Sciences Stock Options and RSUs Stock Options and RSUs Overview: Gilead Sciences has offered stock options and Restricted Stock Units (RSUs) as part of its compensation package. For Gilead Sciences, stock options are typically granted to executives and key employees based on individual performance and company goals. RSUs at Gilead Sciences are generally awarded to a broader range of employees, including those in key roles, to align their interests with shareholder value.

1. Company Official Website Gilead Sciences Official Website: Gilead Sciences Benefits Summary: Gilead Sciences offers a comprehensive benefits package including medical, dental, and vision coverage. They provide options for both HMO and PPO plans, and there are additional wellness programs and resources for employees. 2. Glassdoor Gilead Sciences on Glassdoor: Glassdoor - Gilead Sciences Benefits Summary: Employees on Glassdoor report strong health benefits including generous health insurance coverage, wellness programs, and an Employee Assistance Program (EAP). The company also offers flexible spending accounts (FSAs) and health savings accounts (HSAs). 3. Indeed Gilead Sciences on Indeed: Indeed - Gilead Sciences Benefits Summary: Indeed highlights that Gilead Sciences provides extensive healthcare benefits including medical, dental, and vision insurance, with coverage options for family members. Employees appreciate the company's focus on health and wellness. 4. Employee Benefits News Employee Benefits News - Gilead Sciences: Employee Benefits News Summary: Recent news indicates that Gilead Sciences has been updating its benefits packages to include more mental health support and telemedicine services. They are also expanding their wellness programs to address holistic health needs. 5. HR Dive HR Dive - Gilead Sciences Benefits: HR Dive Summary: HR Dive reports that Gilead Sciences has introduced new benefits in response to the evolving healthcare landscape. This includes enhanced telehealth options and increased coverage for mental health services.

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For more information you can reach the plan administrator for Gilead Sciences at , ; or by calling them at .

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