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'With 2026 ACA premiums set to rise, Vistra 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, Vistra 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 Vistra 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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- Corporate Employees: 8 Factors When Choosing a Mutual Fund
- Use of Escrow Accounts: Divorce
- 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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- Corporate Employees: Do NOT Believe These 6 Retirement Myths!
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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.
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…).