Healthcare Provider Update: Offers medical, dental, vision, life, disability, telemedicine, and TRICARE supplement plans, plus HSAs and FSAs 8. With ACA subsidies expiring, Vistras benefitsincluding 100% employer-paid optionsoffer significant financial advantages over marketplace plans. Click here to learn more
'With ACA premiums expected to rise in 2026, Vistra 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, Vistra 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 Vistra 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 Vistra 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.).
How does the eligibility criteria for participation in the Vistra Operations Company pension plan differ for represented and non-represented employees? Specifically, what factors should an employee of Vistra Operations Company consider in understanding whether they qualify for the PRB Structure of the Plan based on their employment agreements and status?
Eligibility Criteria for Represented and Non-Represented Employees: The Vistra Operations Company pension plan has distinct eligibility criteria for represented and non-represented employees. Non-represented employees hired or rehired on or after January 1, 2019, are not eligible to participate in the plan, as their benefits were frozen effective December 31, 2018. Represented employees are subject to their collective bargaining agreements, and their participation may vary depending on the terms of those agreements(Vistra_Operations_Compa…).
What steps should an employee at Vistra Operations Company take if they wish to contest a denial of benefits they believe they are entitled to under the plan? Please outline the procedures outlined in the document that the employees must follow to ensure their rights under the Employee Retirement Income Security Act are upheld.
Contesting a Denial of Benefits: Employees must file a written claim for benefits if they believe they were denied benefits under the plan. The plan administrator reviews the claim, and if it is denied, the employee has the right to request a review of the denial within 60 days. Employees can provide additional documentation and will receive a final decision within 60 to 120 days depending on circumstances. If the claim is denied after review, the employee has the right to file a civil action under ERISA(Vistra_Operations_Compa…)(Vistra_Operations_Compa…).
For employees of Vistra Operations Company who are nearing retirement age, what options do they have concerning their pension benefits, and how can they make the most informed decision regarding the form of payment they choose? What factors specific to their circumstances and relation to the plan should they consider, such as marital status or previous employment benefits?
Options for Employees Nearing Retirement: Employees nearing retirement have several options for receiving their pension benefits, including single life annuity or joint and survivor annuity payments. Factors such as marital status, existing benefits, and personal financial circumstances will affect their decision. For instance, married employees may elect a joint and survivor annuity, which provides reduced monthly payments during their lifetime and continues to pay a portion to their spouse after their death(Vistra_Operations_Compa…)(Vistra_Operations_Compa…).
In what ways does the Vistra Operations Company pension plan accommodate employees transitioning from another employer's retirement plan, particularly with frozen benefits under an acquired plan? Employees should consider how these changes could impact their retirement outcomes and what steps are needed to integrate these benefits.
Transitioning from Another Employer’s Retirement Plan: Employees who transition from another employer’s retirement plan, especially those whose benefits have been frozen under an acquired plan, may still be eligible for interest credits on their account balances. The plan allows these employees to continue receiving interest credits while their account remains in the plan, preserving the value of their retirement savings(Vistra_Operations_Compa…)(Vistra_Operations_Compa…).
How can employees of Vistra Operations Company name a beneficiary in relation to their retirement benefits, and what specific requirements must be met to ensure that the designation is legally valid? Discuss the implications for both the employees and their chosen beneficiaries, including any necessary consents or notarizations.
Naming a Beneficiary: Employees can designate a beneficiary for their pension benefits, and if they are married, their spouse must provide notarized consent if they choose someone else as their beneficiary. It is important to update this information following life changes, such as marriage or divorce, to ensure benefits are distributed according to their wishes(Vistra_Operations_Compa…).
What provisions are in place within the Vistra Operations Company pension plan for employees who become disabled before reaching retirement age? Employees should understand how disability benefits interact with their retirement benefits and what criteria they must meet to access these provisions.
Provisions for Disabled Employees: Employees who become disabled before reaching retirement age may still be eligible for 100% vesting in their pension benefits. The plan recognizes disability as a qualifying event for full vesting if the employee receives Social Security disability benefits(Vistra_Operations_Compa…).
How does the annual interest crediting rate for defined benefit plans apply to employees of Vistra Operations Company, and what recent adjustments have been implemented that might affect their retirement savings? Review the specifics in relation to current economic indicators affecting these plans.
Annual Interest Crediting Rate: For defined benefit plans, the interest crediting rate is based on the 30-year Treasury securities rate, which can affect employees’ retirement savings. Represented employees may be subject to minimum interest credit rates depending on their collective bargaining agreements, while non-represented employees' interest credits continue even after benefits were frozen(Vistra_Operations_Compa…).
What are the implications of being classified as a non-represented employee under the Viesta Operations Company pension plan, especially considering the plan was frozen for them starting January 1, 2019? Employees should evaluate how this classification impacts their retirement planning and options moving forward.
Impact of Being a Non-Represented Employee: Non-represented employees had their benefits frozen as of December 31, 2018. This freeze means they no longer accrue new benefits, but they may still receive interest credits on their existing frozen benefit. Employees in this classification should evaluate alternative retirement savings options moving forward(Vistra_Operations_Compa…).
Could you explain the importance of the “normal retirement age†and how it affects the pension benefits for participants in the Vistra Operations Company pension plan? Illustrate how this age plays a significant role in defining eligibility and benefit calculations.
Importance of "Normal Retirement Age": The normal retirement age under the plan is 65. This age is critical because it affects when employees become eligible for their full pension benefits without reduction, which plays a significant role in the calculation and payment of benefits(Vistra_Operations_Compa…).
What are the best ways for employees of Vistra Operations Company to contact the Plan Administrator to obtain additional information about their pension benefits and claims? Provide details on the resources available and the recommended channels for reaching out effectively, particularly regarding any changes in address or personal details affecting their benefits. These questions are designed to guide employees through the retirement process and help them navigate the specifics of their pension plan under Vistra Operations Company.
Contacting the Plan Administrator: Employees can contact the Vistra Pension Center for information regarding their pension benefits. They can reach the center at 1-855-568-4146 or online at http://ypr.aon.com/Vistra for assistance with questions or changes to their personal details(Vistra_Operations_Compa…)(Vistra_Operations_Compa…).