'With ACA premiums expected to rise in 2026, Harvard 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, Harvard 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.
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In this article we will discuss:
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The expected premium increases for ACA marketplace plans in 2026 and their potential impact on Harvard employees and retirees.
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The major national insurers and states with the largest requested rate hikes.
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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 Harvard 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:
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New York: UnitedHealthcare requesting up to +66.4% (individual market).
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Arkansas: QualChoice +54.4% , Ambetter (Celtic) +42.5% , statewide average +36.1% .
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Colorado: Western Slope ~+38.8% ; statewide average +28.4% . Rocky Mountain HMO +36.4% , Cigna +29.4% , Anthem +33.6% , Kaiser +15.3% .
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Florida: Molina ~+41% , Florida Blue +27% , Centene Venture +18.73%
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Maine: Anthem (revised) +24.8% ; statewide weighted average +25.9% .
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Washington: 14 insurers; requested average +21.2% .
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Vermont: BCBS Vermont +23.3% .
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Maryland: Requested statewide average +17.1% (individual market).
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Illinois: BCBS Illinois +27% .
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Texas: BCBS Texas +21% .
Major National Insurers and Their 2026 Requests:
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UnitedHealthcare (UnitedHealth Group): Up to +66.4% in New York.
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Elevance Health (Anthem BCBS): +33.6% in Colorado; +24.8% in Maine.
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Kaiser Permanente: +15.3% in Colorado (individual market).
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Centene Corporation (Ambetter/Celtic): +42.5% in Arkansas; +18.73% in Florida.
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Cigna Healthcare: +29.4% in Colorado.
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Molina Healthcare: ~41% in Florida.
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HCSC (BCBS IL, TX): +27% in Illinois; +21% in Texas.
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GuideWell (Florida Blue): +27% in Florida.
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CareFirst BlueCross BlueShield: Maryland requested statewide average +17.1% .
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CVS Health/Aetna: Withdrawing ACA marketplace plans in 17 states in 2026, affecting ~1 million members.
Key Factors Driving the Increases:
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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
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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.
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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
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Pages/Sections referenced:
Article body noting ~1 million exchange members and the 2026 exit (single web page; n. pag.).
What are the key distribution options available to employees at Harvard University upon retirement, and how do these options differ regarding tax implications? Employees should understand both the annuity options and lump-sum distributions available under the Harvard University Retirement Plan, as these can significantly affect their financial outcomes in retirement. Harvard University provides various choices depending on the lump-sum value, and it's essential to analyze each choice carefully to maximize retirement benefits.
Key Distribution Options: Upon retirement, Harvard University employees can choose between a lump-sum distribution, a rollover to another retirement account, or an annuity with different options, including a single-life annuity or joint and survivor annuity(Harvard University Reti…). Lump-sum payments may lead to immediate tax liabilities, while annuity options offer more tax-deferred growth(Harvard University Reti…).
How does the choice of an annuity payment method impact the long-term financial security of retirees at Harvard University? Employees need to weigh the advantages and disadvantages of single life versus joint and survivor annuities, considering not only their own financial needs but also those of potential beneficiaries. The decision can affect monthly income levels and the benefits passed on to surviving partners or dependents.
Impact of Annuity Payment Method: Choosing a single-life annuity maximizes monthly payments but provides no benefits after the retiree’s death. A joint and survivor annuity reduces monthly payments but ensures ongoing income for a surviving spouse or beneficiary, offering more long-term financial security for both parties(Harvard University Reti…).
What specific conditions must be met for a retired employee of Harvard University to elect the Consolidated Harvard Annuity Option (CHAO), and what benefits might this offer? Understanding the eligibility criteria for CHAO and its implications on retirement planning will help employees make informed decisions. The CHAO allows for a potential increase in annuity benefits, but there are specific deadlines and requirements that participants must adhere to.
Consolidated Harvard Annuity Option (CHAO): To elect the CHAO, employees must terminate their employment after April 30, 2006, and have a Basic Retirement Account balance exceeding $1,000. They must elect the CHAO within 60 days of termination to exchange their investment account for a higher annuity(Harvard University Reti…)(Harvard University Reti…).
How can employees at Harvard University ensure that they have properly designated beneficiaries within their retirement plans, and what are the ramifications of failing to do so? The importance of keeping beneficiary designations up to date cannot be overstated, as it impacts how benefits are distributed upon the participant’s death. Employees must familiarize themselves with the required forms and the potential consequences of having outdated or incorrect designations.
Beneficiary Designations: Employees should ensure their beneficiary designations are up to date by completing the appropriate forms. Failure to do so could result in benefits being distributed according to marital status or to unintended recipients(Harvard University Reti…).
In what ways do the spousal consent rules affect the retirement options for married employees of Harvard University, and why is this a critical aspect to consider when planning for retirement? Understanding the spousal consent requirements is vital for retirees since failing to adhere to these regulations can lead to unintended consequences, including issues related to benefit disbursement. Employees should seek to navigate these requirements carefully to secure their desired benefit structure.
Spousal Consent Rules: Married employees must obtain spousal consent, witnessed by a notary or plan representative, if they choose a retirement distribution option that does not provide survivor benefits to their spouse(Harvard University Reti…). Failure to adhere to these rules can result in complications with benefit disbursement(Harvard University Reti…).
How does the $1,000 threshold affect retirement distribution choices for employees retiring from Harvard University, and what specific options are available once this threshold is considered? Employees need to be informed about the options that arise based on the value of their Basic Retirement Account when making distribution decisions. Knowing whether an annuity or lump-sum option is available can significantly influence retirement planning and benefits.
$1,000 Threshold: If an employee's Basic Retirement Account value is $1,000 or less, they must take a lump-sum payment or rollover, as annuity options are unavailable. The lump-sum is subject to tax withholding unless rolled over(Harvard University Reti…).
What steps should employees at Harvard University take if they wish to defer their retirement distributions, and what factors should they consider before making this decision? Deferring distributions can offer various tax advantages and impact retirement income strategies. Employees should evaluate their financial situations, anticipate future needs, and understand the timelines involved in the deferment process to make sound choices.
Deferring Distributions: Employees can defer their distributions until the April 1st following the year they turn 70½. Deferring can offer tax advantages and allow time for the value of retirement funds to grow(Harvard University Reti…).
What are the consequences of electing a lump-sum distribution from a retirement account at Harvard University, particularly in terms of immediate and long-term tax implications? Employees considering a lump-sum distribution must recognize that such options can lead to significant tax liabilities and potential penalties, especially if improperly managed. A thorough understanding of these financial repercussions can aid in making choices that align with retirement goals.
Lump-Sum Distribution Consequences: Opting for a lump-sum distribution can result in substantial tax liabilities, including early withdrawal penalties if under age 59½. However, rolling the distribution into another retirement account can mitigate tax impacts(Harvard University Reti…).
How can employees contact the Harvard University Retirement Center to learn more about their retirement plan options, and what information should they prepare before reaching out? Understanding how to access information and ask the right questions is crucial for employees looking to navigate their retirement options effectively. Having personal details and specific inquiries ready when contacting the Harvard University Retirement Center will facilitate a more productive dialogue.
Contacting the Retirement Center: Employees can reach the Harvard University Retirement Center at 800-527-1398 for information. They should have their pension statement, retirement account details, and any specific questions prepared(Harvard University Reti…).
What should employees at Harvard University consider when choosing whether to roll over their retirement benefits into another employer's retirement plan or an IRA? The decision to roll over retirement benefits comes with various implications, including investment choices, fees, and the overall management of retirement funds. An in-depth understanding of the pros and cons of rollover options will empower employees to make informed decisions that best suit their financial futures.
Rollover Options: Rolling over retirement benefits into another employer’s plan or an IRA allows employees to maintain tax-deferred growth. It is crucial to compare fees, investment options, and withdrawal rules before making a decision(Harvard University Reti…).