'With 2026 ACA premiums set to rise, University of Chicago employees approaching early retirement should integrate health care cost projections into their broader income planning to help maintain long-term financial stability.' – Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.
'Given the anticipated ACA premium hikes in 2026, University of Chicago employees considering early retirement should evaluate how health care expenses fit within their retirement budget to support a sustainable financial plan.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article we will discuss:
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The proposed2026 ACA premium increases and the states facing the steepest hikes.
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Key economic and policy factors influencingthese premium changes.
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Strategies retirees can use to help manage rising health care costs before Medicare eligibility.
Following recent changes to the Affordable Care Act (ACA), millions of Americans covered by ACA marketplace insurance may be set to see a sharp rise in their annual premiums. Preliminary estimates place the median national increase at 18%, 1 with many states anticipated to exceed this level. Early filings cite the planned expiration of enhanced subsidies, ongoing medical inflation, the rising cost of specialty drugs, and broad policy and market pressures as contributors to premium jumps that could increase by as much as 30% in certain areas. 2
States With the Biggest Increases Under Consideration
While changes vary by insurer and plan, early filings identify five states with some of the steepest expected increases:
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Projected → Anticipated increase of about 24%. UnitedHealthcare, for example, requested a 66.4% increase for specific ACA policies.
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Colorado: Insurers report statewide average increases in the high teens to 20% range, with some geographic areas facing hikes above 33%.
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Illinois: Blue Cross & Blue Shield of Illinois has filed for an almost 27% increase for 2026, placing the state among those with the highest expected rate changes.
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Rhode Island: Rate-review report shows a weighted average request in the low to high 20% range, depending on carrier.
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Washington: Fourteen individual-market insurers requested an average statewide increase of 21.2% for 2026.
Final approved rates will be determined later in the year following each state’s review process. However, the data so far indicates 2026 will be challenging for those on ACA coverage before Medicare eligibility. Nationwide, most planned increases fall between 12% and 27%, with many topping 20%.
Factors Contributing to the 2026 Increase
Several converging factors are influencing these rate hikes:
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1. Expiration of Enhanced ACA Premium Subsidies: Without new legislation, temporary premium tax credits will end in 2026, raising monthly costs and potentially reducing enrollment among healthier individuals—worsening risk pools and pushing rates up.
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2. Medical Inflation and Provider Pricing: Hospitals and health care providers are negotiating higher reimbursement rates to offset increased labor, supply, and inflationary costs.
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3. High-Cost Pharmaceuticals: Specialty drugs, including GLP‑1 therapies for diabetes and weight management, are driving higher payouts, with expenses being pushed back to consumers.
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4. Supply Chain Costs and Tariffs: Delays and tariffs on health care equipment and imports are contributing to insurers’ cost forecasts.
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5. Risk Pool Deterioration: Rising rates may cause healthier enrollees to exit the market, raising the average cost for those remaining.
Ways to Manage Rising ACA Premium Costs
Financial planning professionals, including Brent Wolf and Paul Bergeron of Wealth Enhancement, note that proactive, tax-aware strategies can help University of Chicago retirees mitigate these increases:
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Adjust Retirement Timing: Delaying retirement until closer to Medicare eligibility could reduce years of elevated ACA coverage costs.
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Manage Modified Adjusted Gross Income (MAGI): Strategic Roth conversions or income‑efficient withdrawals can help preserve eligibility for premium support.
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Contribute to a Health Savings Account (HSA): Full HSA funding offers pre‑tax contributions, tax‑deferred growth, and tax‑free withdrawals for qualified medical expenses.
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Compare Plans During Open Enrollment: Reviewing network access, cost-sharing, and prescription coverage across carriers can help identify more budget‑friendly options.
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Evaluate COBRA vs. ACA Coverage: Depending on age, health needs, and location, COBRA continuation may be cost effective for a limited time after leaving employer coverage.
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Use Special Enrollment Periods: Income or household changes may qualify enrollees for updated subsidies.
Particular Considerations in New York
New York’s ACA marketplace offers one of the most diverse plan selections nationwide, and rate requests vary widely. The Department of Financial Services releases carrier-level tables showing proposed changes. Significant hikes from carriers like United Healthcare and Oxford have attracted attention; 3 final approvals will be announced later this summer.
Looking Ahead
While rate increase reports remain preliminary, it appears that ACA enrollees may face substantial premium increases in 2026. For some households, rate hikes of 20–30% could mean hundreds more per month. For Fortune 500 employees considering retiring early, incorporating health care costs into broader tax and income planning will be vital.
According to Avalere Health and AARP’s Public Policy Institute, nearly five million adults aged 50–64 may experience average annual premium increases exceeding $4,000 if enhanced ACA subsidies lapse, and some could lose eligibility altogether. 4
With national rates expected to go up by a median of 18%—and more in specific states—retirees will need to adopt targeted planning. Thoughtful plan comparison, HSA contributions, and income management can offer some relief ahead of Medicare eligibility.
Retiring early before Medicare can be likened to setting sail toward an approaching storm. In 2026, the winds of expiring subsidies, medical inflation, and costly new treatments could make for turbulent conditions. By adjusting income strategies, funding HSAs, and choosing plans carefully, retirees may navigate these waters much like a seasoned captain charts a steady course through rough seas.
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- Medicare Open Enrollment for Corporate Employees: Cost Changes in 2024!
- Stages of Retirement for Corporate Employees
- 7 Things to Consider Before Leaving Your Company
- How Are Workers Impacted by Inflation & Rising Interest Rates?
- Lump-Sum vs Annuity and Rising Interest Rates
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Sources:
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1. KFF. ' 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. 2025.
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2. Fierce Healthcare. ' KFF analysis finds a median ACA premium hike of 18% for 2026 ,' by Paige Minemyer. 8 Aug. 2025.
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3. ACASignups.net. ' 2026 Rate Changes - New York: +13.2% Avg ,' New York Department of Financial Services. 2 June 2025.
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4. AARP. ' Expiring Tax Credit Threatens Affordable Health Coverage for Midlife Adults ,' by Jan Sung and Olivia Dean. 4 April 2025.
What are the eligibility criteria for participation in the SEPP plan for employees of The University of Chicago, and how can factors like years of service and age impact an employee's benefits under this plan? Discuss how these criteria might have changed for new employees post-2016 and what implications this has for retirement planning.
Eligibility Criteria for SEPP: Employees at The University of Chicago become eligible to participate in the SEPP upon meeting age and service requirements: being at least 21 years old and completing one year of service. For employees hired after the plan freeze on October 31, 2016, these criteria have been crucial in determining eligibility for newer employees, impacting their retirement planning as they do not accrue benefits under SEPP beyond this freeze date.
In what ways does the SEPP (Staff Employees Pension Plan) benefit calculation at The University of Chicago reflect an employee's years of service and final average pay? Examine the formulas involved in the benefits determination process, including how outside factors such as Social Security compensation can affect the total pension benefits an employee receives at retirement.
Benefit Calculation Reflecting Service and Pay: The SEPP benefits are calculated based on the final average pay and years of participation, factoring in Social Security covered compensation. Changes post-2016 have frozen benefits accrual, meaning that current employees’ benefits are calculated only up to this freeze date, affecting long-term benefits despite continued employment.
How can employees at The University of Chicago expect their SEPP benefits to be paid out upon their retirement, especially in terms of the options between lump sum distributions and annuities? Analyze the advantages and disadvantages of each payment option, and how these choices can impact an employee's financial situation in retirement.
Payout Options (Lump Sum vs. Annuities): Upon retirement, employees can opt for a lump sum payment or annuities. Each option presents financial implications; lump sums provide immediate access to funds but annuities offer sustained income. This choice is significant for financial stability in retirement, particularly under the constraints post the 2016 plan changes.
Can you elaborate on the spousal rights associated with the pension benefits under the SEPP plan at The University of Chicago? Discuss how marital status influences annuity payments and the required spousal consent when considering changes to beneficiary designations.
Spousal Rights in SEPP Benefits: Spouses have rights to pension benefits, requiring spousal consent for altering beneficiary arrangements under the SEPP. Changes post-2016 do not impact these rights, but understanding these is vital for making informed decisions about pension benefits and beneficiary designations.
As an employee nearing retirement at The University of Chicago, what considerations should one keep in mind regarding taxes on pension benefits received from the SEPP? Explore the tax implications of different types of distributions and how they align with current IRS regulations for the 2024 tax year.
Tax Considerations for SEPP Benefits: SEPP distributions are taxable income. Employees must consider the tax implications of their chosen payout method—lump sum or annuities—and plan for potential tax liabilities. This understanding is crucial, especially with the plan’s benefit accrual freeze affecting the retirement timeline.
What resources are available for employees of The University of Chicago wishing to understand more about their retirement benefits under SEPP? Discuss the types of information that can be requested from the Benefits Office and highlight the contact methods for obtaining more detailed assistance.
Resources for Understanding SEPP Benefits: The University provides resources for employees to understand their SEPP benefits, including access to the Benefits Office for personalized queries. Utilizing these resources is essential for employees, especially newer ones post-2016, to fully understand their retirement benefits under the current plan structure.
How does The University of Chicago address benefits for employees upon their death, and what provisions exist for both spouses and non-spouse beneficiaries under the SEPP plan? Analyze the specific benefits and payment structures available to beneficiaries and the conditions under which these benefits are distributed.
Posthumous Benefits: The SEPP includes provisions for spouses and non-spouse beneficiaries, detailing the continuation or lump sum payments upon the death of the employee. Understanding these provisions is crucial for estate planning and ensuring financial security for beneficiaries.
What factors ensure an employee remains fully vested in their pension benefits with The University of Chicago, and how does the vesting schedule affect retirement planning strategies? Consider the implications of not fulfilling the vesting criteria and how this might influence decisions around employment tenure and retirement timing.
Vesting and Retirement Planning: Vesting in SEPP requires three years of service, with full benefits contingent on meeting this criterion. For employees navigating post-2016 changes, understanding vesting is crucial for retirement planning, particularly as no additional benefits accrue beyond the freeze date.
Discuss the impact of a Qualified Domestic Relations Order (QDRO) on the SEPP benefits for employees at The University of Chicago. How do divorce or separation proceedings influence pension benefits, and what steps should employees take to ensure compliance with a QDRO?
Impact of QDROs on SEPP Benefits: SEPP complies with Qualified Domestic Relations Orders, which can allocate pension benefits to alternate payees. Understanding how QDROs affect one’s benefits is crucial for financial planning, especially in the context of marital dissolution.
How can employees at The University of Chicago, who have questions about their benefits under the SEPP plan, effectively communicate with the Benefits Office for clarity and assistance? Specify the various communication methods available for employees and what kind of information or support they can expect to receive.
Communicating with the Benefits Office: Employees can reach out to the Benefits Office via email or phone for detailed assistance on their SEPP benefits. Effective communication with this office is vital for employees to clarify their benefits status, particularly in light of the post-2016 changes to the plan.