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

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

Healthcare Provider Update: Healthcare Provider for MetLife: MetLife partners with a variety of healthcare providers and networks to deliver its health insurance products. These generally include extensive networks of hospitals, physicians, and specialists under the MetLife brand, often incorporating regional healthcare systems to ensure members have access to a broad range of services. Specific providers may vary based on the plan and location chosen by the member. Potential Healthcare Cost Increases for 2026: As healthcare costs continue to rise, projections indicate that premiums for Affordable Care Act (ACA) plans could increase sharply in 2026, with the median hike estimated at 18%-the largest seen since 2018. This surge is fueled by factors such as escalating medical expenses, the looming expiration of enhanced federal premium subsidies, and recent aggressive rate hikes from major insurers like MetLife. Without these subsidies, many enrollees could face even steeper out-of-pocket costs, potentially exceeding 75%, underscoring the urgent need for consumers to prepare financially for the upcoming changes. Click here to learn more

'With ACA premiums expected to rise in 2026, MetLife 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, MetLife 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 MetLife 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 MetLife 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 the MetLife Retirement Plan structure benefits differently for salaried versus commissioned employees, and what specific factors go into calculating the retirement benefits for each type of employee as detailed in the MetLife plan documents?

Salaried vs. Commissioned Employees: MetLife structures benefits for salaried employees based on their base salary and Annual Variable Incentive Plan, while commissioned employees' benefits are calculated using 42% of commissions from Company proprietary products and services. The benefit formula takes into account eligible pay, Social Security Wage Base, and credited service(MetLife_Retirement_Plan…).

For employees considering early retirement from MetLife, what factors should they weigh in terms of financial security and expected benefits, and how does the MetLife plan accommodate early retirement for participants who may be eligible?

Early Retirement Considerations: Employees considering early retirement should weigh the reduction in benefits due to early retirement factors. Eligibility requires at least 15 years of service and being at least 55 years old. Early retirement benefits are reduced according to specific factors based on age and service(MetLife_Retirement_Plan…)(MetLife_Retirement_Plan…).

What are the implications of the recent changes to the MetLife Retirement Plan regarding the freeze on the Traditional Formula benefits, and how does this impact employees who have been accruing benefits under this system?

Changes to Traditional Formula Benefits: The Traditional Formula was frozen as of December 31, 2022. All future benefit accruals are under the Personal Retirement Account (PRA) formula, which impacts those who were accruing under the Traditional Formula by transitioning them to the PRA(MetLife_Retirement_Plan…).

How does MetLife ensure that employees are fully informed of their rights under the Employee Retirement Income Security Act (ERISA), and what resources does the company provide for employees to understand their pension benefits?

ERISA Rights and Resources: MetLife ensures employees are informed of their ERISA rights through plan documents, the MetLife HR Global Compensation and Benefits Department, and the Retirement Benefits Service Center. Participants can access detailed plan information, their benefits, and contact the plan administrator for legal issues(MetLife_Retirement_Plan…).

In the event of resignation or transitioning to another role within MetLife, what provisions does the retirement plan offer regarding preserved benefits, and how can employees navigate this process to secure their retirement funds?

Preserved Benefits after Resignation: Employees leaving MetLife retain preserved benefits if vested. These benefits can be claimed at retirement age, and employees can opt for different forms of payment, including lump sums or annuities, depending on the value of their preserved benefits(MetLife_Retirement_Plan…).

What measures are in place for employees at MetLife to reach out for support and clarification about their retirement benefits, and how can they utilize those resources effectively to address any concerns they might have?

Support for Retirement Benefit Queries: Employees can seek support through the Retirement Benefits Service Center or the online portal. These resources provide answers to any queries about benefits and can be used to resolve discrepancies in benefit calculations or account information(MetLife_Retirement_Plan…).

As MetLife employees, what strategies can individuals implement to maximize their pension benefits throughout their careers, including understanding the impact of factors like final average pay and years of credited service?

Maximizing Pension Benefits: Employees can maximize pension benefits by understanding the impact of final average pay, credited service, and the Social Security Wage Base. Maintaining consistent employment and maximizing eligible pay are key strategies for increasing retirement benefits(MetLife_Retirement_Plan…).

Can you explain the eligibility criteria for participation in the MetLife Retirement Plan and how an employee can determine their eligible pay throughout the duration of their employment with the company?

Eligibility for MetLife Retirement Plan: To participate in the plan, employees must complete at least one year of service with 1,000 hours and be 21 years old. Eligible pay is determined by the employee's base salary or a percentage of commissions for commissioned employees(MetLife_Retirement_Plan…).

What steps should MetLife employees take if they notice discrepancies or unusual activity in their retirement accounts, and what resources are available to assist them in resolving these issues?

Addressing Discrepancies in Accounts: If employees notice discrepancies, they should contact the Retirement Benefits Service Center immediately. There are procedures in place for filing claims, and employees must report errors within a reasonable timeframe(MetLife_Retirement_Plan…).

How can MetLife employees obtain further information about their pension rights and benefits, and what specific documentation or communication channels should they utilize to ensure they have accurate and comprehensive information? These questions are designed to assist employees in navigating their retirement benefits with MetLife.

Obtaining Further Information: Employees can access comprehensive information on their pension rights and benefits through the online portal or by contacting the plan administrator. The portal provides personalized benefit details, and written requests can be submitted for official plan documents(MetLife_Retirement_Plan…).

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

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