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

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

Healthcare Provider Update: Healthcare Provider for Pfizer: Pfizer does not operate as a traditional healthcare provider, but it is a major pharmaceutical company that provides a wide range of medications and vaccines. For healthcare services, Pfizer collaborates with various healthcare organizations, insurers, and providers to distribute its products and support health initiatives. Potential Healthcare Cost Increases in 2026: The healthcare landscape is bracing for significant cost escalations in 2026, driven by a convergence of factors, including the anticipated expiration of enhanced ACA premium subsidies and rising medical costs. Insurers are expected to request steep premium increases, some exceeding 60%, as they cope with surging hospital and prescription drug expenses. Moreover, without congressional action to extend these subsidies, many consumers could see their out-of-pocket costs rise dramatically-some estimates suggest increases of over 75%-making access to affordable healthcare a critical concern for millions. Click here to learn more

'With ACA premiums expected to rise in 2026, Pfizer 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, Pfizer 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 Pfizer 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 Pfizer 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 Pfizer, Inc. approach the management of its Consolidated Pension Plan to ensure the financial stability and long-term sustainability of the benefits promised to its employees? Furthermore, what strategies does Pfizer, Inc. employ to communicate the importance of this plan to its workforce, and how does it equip employees with the knowledge needed to understand their benefits effectively?

Pfizer, Inc. manages its Consolidated Pension Plan with a strong focus on financial stability and long-term sustainability by working with key financial partners like Fidelity Investments for recordkeeping and Northern Trust Company for trustee services(Pfizer_3-9-2015_Pfizer_…). The company ensures proper investment strategies and regular reviews to meet the pension obligations and maintain the health of the fund. To communicate the importance of the pension plan, Pfizer uses various channels to educate employees about their benefits, including workshops, internal communication, and retirement planning tools, ensuring that all employees have a clear understanding of their benefits.

In what ways does Pfizer, Inc. ensure compliance with the latest IRS regulations concerning pension plans, and how frequently does it review and update its pension plan policies to align with changing laws? Additionally, what role does the Pension Plan Administrator play in overseeing these compliance efforts within Pfizer, Inc.?

Pfizer, Inc. stays in compliance with IRS regulations regarding pension plans by frequently reviewing and updating its policies to reflect legal changes. The Pension Plan Administrator at Pfizer plays a vital role in overseeing compliance efforts, ensuring that the company adheres to evolving tax laws and regulations. Regular internal audits and legal consultations help Pfizer maintain the necessary compliance measures(Pfizer_3-9-2015_Pfizer_…).

How does Pfizer, Inc. determine the eligibility criteria for employees to participate in its defined benefit pension plan, and what factors are considered when calculating pension benefits? Furthermore, how does Pfizer, Inc. ensure transparency in communicating these criteria and calculations to its employees?

Eligibility for Pfizer’s defined benefit pension plan is determined by factors such as years of service and employee classification. When calculating pension benefits, Pfizer considers age, salary history, and service duration. The company ensures transparency by providing clear documentation and personalized benefit statements to employees, helping them understand the criteria and calculations affecting their retirement benefits(Pfizer_3-9-2015_Pfizer_…).

What are the potential tax implications for employees of Pfizer, Inc. who choose to retire early and how does this intersect with the company's pension plan offerings? Additionally, what resources does Pfizer, Inc. provide to assist employees in understanding their options and the long-term impact of early retirement on their pension plans?

Employees of Pfizer, Inc. who opt for early retirement may face tax implications such as penalties for early withdrawals or reduced pension payouts. Pfizer provides educational resources, including financial planning tools and access to retirement advisors, to help employees navigate the long-term impacts of early retirement decisions. These resources ensure employees can make informed decisions about their retirement plans(Pfizer_3-9-2015_Pfizer_…).

Can you outline the process that Pfizer, Inc. has in place for employees to appeal decisions related to their pension benefits? What steps are involved, and how does Pfizer, Inc. ensure that this process is accessible and fair to all employees who may wish to challenge a decision regarding their pensions?

Pfizer, Inc. offers a structured process for employees to appeal pension benefit decisions. This process includes filing a formal complaint, undergoing a review by the Benefits Administration team, and potentially escalating to higher management if needed. Pfizer ensures this process is accessible and fair, providing employees with clear guidance on how to challenge pension-related decisions(Pfizer_3-9-2015_Pfizer_…).

How does Pfizer, Inc. integrate career counseling and financial planning resources into the retirement process for employees? Furthermore, what initiatives does Pfizer, Inc. undertake to educate its employees about preparing for retirement beyond the financial aspects, ensuring a holistic approach to the transition into retirement?

Pfizer integrates career counseling and financial planning into its retirement process by offering resources such as access to financial advisors, retirement workshops, and online tools. These initiatives help employees plan for retirement comprehensively, covering not just financial aspects but also lifestyle adjustments and post-retirement career considerations(Pfizer_3-9-2015_Pfizer_…).

What specific benefits does Pfizer, Inc. offer to employees who are nearing retirement age, and how do these benefits differ from those provided to younger employees? Additionally, how does Pfizer, Inc. communicate and promote these benefits to ensure that eligible employees take full advantage of what is available to them as they approach retirement?

Pfizer, Inc. provides specific benefits for employees nearing retirement, such as catch-up contributions to retirement plans and access to enhanced financial counseling. These benefits are communicated through targeted retirement seminars and direct communications to ensure that eligible employees understand the advantages available to them as they approach retirement(Pfizer_3-9-2015_Pfizer_…).

How does Pfizer, Inc. address issues related to underfunding of its pension plan, if applicable, and what measures are taken to mitigate potential risks? What plans does Pfizer, Inc. have in place to ensure that it can meet its pension obligations even in challenging financial environments?

If Pfizer, Inc. faces any underfunding issues in its pension plan, the company takes proactive steps to address the problem by increasing contributions or adjusting plan investment strategies. Pfizer has contingency plans in place to ensure it can meet pension obligations even in financially challenging environments(Pfizer_3-9-2015_Pfizer_…).

In 2024, what key changes to the pension plan within Pfizer, Inc. can employees expect, particularly concerning contribution limits and retirement planning strategies? How does Pfizer, Inc. communicate these changes to its employees to ensure that they are well-informed and able to adjust their retirement planning effectively?

In 2024, Pfizer employees can expect updates to the pension plan concerning contribution limits and retirement strategies, in line with IRS changes. The company communicates these updates through newsletters, online portals, and direct emails to ensure employees stay informed and can adjust their retirement planning accordingly(Pfizer_3-9-2015_Pfizer_…).

If employees at Pfizer, Inc. have questions about their retirement benefits, what is the best way for them to contact the company? Are there specific resources, such as a dedicated help desk, online portal, or contact persons within the Benefits Administration team, that Pfizer, Inc. recommends for providing assistance and further information regarding retirement benefits?

Employees at Pfizer, Inc. who have questions about their retirement benefits can contact the Benefits Administration team directly at the contact details provided. Additionally, Pfizer offers online portals and dedicated help desks, making it easy for employees to get assistance with any retirement-related inquiries(Pfizer_3-9-2015_Pfizer_…).

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

Pfizer provides both a traditional defined benefit pension plan and a defined contribution 401(k) plan. The defined benefit plan includes a cash balance component, where benefits grow based on years of service and compensation, with interest credits added annually. The 401(k) plan offers company matching contributions and various investment options such as target-date funds and mutual funds. Pfizer also provides financial planning resources and tools to help employees manage their retirement savings.

Pfizer provides both RSUs and stock options to employees. RSUs vest over time, providing shares, while stock options allow employees to buy shares at a set price.