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

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Eli Lilly Employees: Expect Rising Health Insurance Costs in 2026

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Healthcare Provider Update: Eli Lilly's primary healthcare provider initiatives are often tied to their pharmaceutical products and drug distribution networks, which include partnerships with a variety of healthcare systems and organizations to ensure that patients have access to their medications and therapies. Looking ahead to 2026, the healthcare landscape is expected to witness significant cost increases, particularly in health insurance premiums for Affordable Care Act (ACA) marketplace plans. With some states projecting hikes exceeding 60%, many individuals could see their out-of-pocket costs soar by over 75% if enhanced federal premium subsidies are not extended. This surge is driven by a combination of rising medical costs, including both hospital and prescription drug expenses, and the profitability pressures on insurers, prompting them to request substantial rate increases. As a result, consumers, especially those relying on ACA coverage, might face unprecedented financial strain in their quest for adequate healthcare. Click here to learn more

'Rising health care costs underscore the importance for Eli Lilly employees to regularly review their benefits and long-term financial strategy,' says Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'With health care expenses climbing faster than wages, Eli Lilly employees should proactively evaluate their coverage options to help protect their long-term financial well-being,' says Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. Why health insurance costs may rise in 2026.

  2. What changes could impact Affordable Care Act and employer plans.

  3. How to review your options during open enrollment.

Health insurance expenses may soon climb even higher for millions of households, including those of Eli Lilly employees. Some people have even received advance notice of increases through 2026, adding to concerns that affordable insurance options are becoming more limited.

If you are one of the approximately 24 million Americans enrolled in an ACA marketplace plan, 1  be aware that significant shifts could occur soon. If enhanced ACA premium tax credits expire after 2025, the average family premium could rise 114%, jumping from $888 in 2025 to $1,904 in 2026. 1

Rising expenses are also impacting those covered through employer plans, including employees at Eli Lilly. Surveys indicate that employer-sponsored health insurance costs are estimated to go up by 6% to 9% in 2026—the biggest increase in more than 15 years. 2  As companies continue shifting more of these expenses to workers, payroll deductions and out-of-pocket costs are on the rise. Health care cost growth is even outpacing wage growth, 3  adding pressure on family budgets.

Why Are Prices Increasing?

Many factors contribute to the upward trend, 3  including:

  • - A surge in medical visits delayed during the pandemic

  • - The growing number of older Americans requiring ongoing care

  • - Continued high incidence of chronic illnesses such as diabetes and heart disease

  • - Shortages and rising labor costs in the health care workforce

  • - Higher demand for services combined with fewer workers

  • Competitive differences across regions also influence costs—some markets have many insurance options, while others have only one or two participating carriers.

What to Do During Open Enrollment

  • Review your current health care usage. If you typically use fewer services, a high-deductible plan paired with a Health Savings Account might lower monthly premiums and offer certain tax advantages.

  • Plan ahead for anticipated medical needs. If you expect more care next year, a plan with higher monthly payments but lower deductibles may help spread costs more evenly.

  • Explore additional coverage options. Depending on eligibility, Medicaid, CHIP, or catastrophic plans may help if employer or marketplace premiums increase sharply.

  • Stay flexible while enrollment is open. You can modify your plan through the end of open enrollment if your situation or subsidy rules change.

The Bigger Picture

Health care decisions are playing a larger role in long-term planning for Eli Lilly households. Rising medical costs can influence both current spending and future retirement readiness.

At The Retirement Group, we assist individuals in planning for health care costs both before and after retirement. To talk about available plan types and tax-advantaged options as open enrollment approaches, call (800) 900-5867.

Want Assistance Reviewing Your Options?

Health plan decisions affect more than just next year—they may also shape your future income expectations, especially if you’re planning to leave Eli Lilly in the near future.

You don’t need to navigate this alone. Before open enrollment deadlines end, The Retirement Group can help you examine your health care strategy alongside your retirement plan.

Want Assistance Reviewing Your Options?

Health plan decisions affect more than just next year—they may also shape your future retirement income needs, especially for those leaving Eli Lilly in the coming years.

You don’t need to sort through this alone. Before open enrollment deadlines end,  The Retirement Group  can help you assess your health care strategy and retirement plan.
Call  (800) 900-5867  to get started.

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Sources:

1. Lo, Justin, and Larry Levitt.  Early Indications of the Impact of the Enhanced Premium Tax Credit Expiration on 2026 Marketplace Premiums . Kaiser Family Foundation, Sept. 2025,  www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire .

2. Mercer Insights Team. “Employers Prepare for the Highest Health Benefit Cost Increase in 15 Years.”  Mercer , 3 Sept. 2025,  www.mercer.com/en-us/insights/us-health-news/employers-prepare-for-the-highest-health-benefit-cost-increase-in-15-years

3. “Why Are Healthcare Costs Rising?”  Marsh McLennan Agency , 5 Sept. 2025,  www.marshmma.com/us/insights/details/rising-health-care-costs.html .

4. “Five Key Changes to ACA Marketplaces Amid Uncertainty Over Premium Tax Credits.”  Center on Budget and Policy Priorities , 2025,  www.cbpp.org/research/health/five-key-changes-to-aca-marketplaces-amid-uncertainty-over-premium-tax-credit .

5. Health Care Workforce Shortages. NIHCM Foundation, 4 Mar. 2025, nihcm.org/newsletter/rising-healthcare-workforce-shortage.

What is the 401(k) plan offered by Eli Lilly?

The 401(k) plan at Eli Lilly is a retirement savings plan that allows employees to save a portion of their salary on a tax-deferred basis.

How does Eli Lilly match employee contributions to the 401(k) plan?

Eli Lilly offers a matching contribution up to a certain percentage of the employee's salary, which helps to boost retirement savings.

Can employees at Eli Lilly choose how their 401(k) contributions are invested?

Yes, employees at Eli Lilly can select from a variety of investment options for their 401(k) contributions, including stocks, bonds, and mutual funds.

What is the eligibility requirement for Eli Lilly's 401(k) plan?

Employees at Eli Lilly are typically eligible to participate in the 401(k) plan after completing a specific period of employment, usually within the first year.

How can Eli Lilly employees enroll in the 401(k) plan?

Eli Lilly employees can enroll in the 401(k) plan through the company’s online benefits portal or by contacting the HR department for assistance.

What are the contribution limits for Eli Lilly's 401(k) plan?

The contribution limits for Eli Lilly's 401(k) plan are set according to IRS guidelines, which can change annually. Employees should refer to the latest IRS limits for specifics.

Does Eli Lilly offer a Roth 401(k) option?

Yes, Eli Lilly provides a Roth 401(k) option that allows employees to make after-tax contributions, which can grow tax-free.

What happens to my Eli Lilly 401(k) if I leave the company?

If you leave Eli Lilly, you have several options for your 401(k), including rolling it over to another retirement account, cashing it out, or leaving it in the Eli Lilly plan if allowed.

Are there any fees associated with Eli Lilly's 401(k) plan?

Yes, there may be administrative fees or investment-related fees associated with Eli Lilly's 401(k) plan, which are disclosed in the plan documents.

How often can I change my contribution amount to the Eli Lilly 401(k) plan?

Employees at Eli Lilly can typically change their contribution amounts at any time, subject to the plan's rules and guidelines.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Eli Lilly offers comprehensive employee retirement benefits, including both pension plans and 401(k) plans. The Lilly Pension Plan is a Defined Benefit (DB) plan, where the pension is determined by an employee's earnings and years of service at the company. This pension plan has been updated over the years, with specific attention to tax and regulatory changes. Employees qualify based on their length of service and meet eligibility requirements outlined in Eli Lilly’s internal documents. The Lilly Pension Plan uses a final average pay formula to calculate the pension, meaning the pension is based on an employee's earnings during their final years of employment​ (SEC.gov). Eli Lilly also provides a 401(k) plan known as The Lilly Employee 401(k) Plan. This plan was established to help employees save for retirement, incorporating both employer contributions and employee savings. As of January 1, 2006, it was amended to include an Employee Stock Ownership Plan (ESOP) within the 401(k). Eligibility for the 401(k) plan includes all regular, full-time employees of Eli Lilly, as well as its subsidiaries and affiliates​ (SEC.gov). The company matches contributions and offers vesting schedules based on years of service. For instance, employees become fully vested after completing five years of service, as outlined in their official documentation​ (SEC.gov). The pension and 401(k) plan information for Eli Lilly has been extensively documented in their official filings with the SEC, where the detailed structure of the plans is outlined, including the qualifications for participation and vesting. Specific sections such as those covering mergers and eligibility requirements for different types of employees, including those under subsidiary plans, are found in their formal pension and 401(k) documentation​ (SEC.gov)​ (SEC.gov).
Restructuring and Layoffs: In 2023, Eli Lilly announced significant restructuring efforts, including the reduction of 3,500 jobs globally. This move is part of their strategy to save $500 million annually, with half of the savings aimed at product launches and R&D efforts. The layoffs are primarily focused on early retirement programs, site closures in New Jersey and Shanghai, and the consolidation of manufacturing locations​ (FiercePharma). This news is critical to address due to the current economic climate, where inflationary pressures and cost-cutting measures are widespread. The political environment also affects the pharmaceutical industry, making it crucial to track how companies like Eli Lilly adjust their workforce to stay competitive​ (FiercePharma).
Eli Lilly provides its employees with both stock options and Restricted Stock Units (RSUs) as part of its long-term incentive compensation. These RSUs are issued to employees and are subject to a vesting schedule, typically staggered over a period of time such as one, two, or three years. The goal is to retain employees by ensuring they receive full ownership of the stock only after they have fulfilled a specified period of service with the company​ (BusinessOwnerAdvisor). Stock options at Eli Lilly grant employees the opportunity to purchase company stock at a predetermined price, typically at the market value on the grant date. These options often vest over several years, with employees being able to exercise them once they are vested. RSUs, on the other hand, provide employees with company shares once they are fully vested, and these shares are taxed as ordinary income at the time of vesting. Employees are responsible for deciding whether to sell the shares immediately or hold onto them, which involves considering factors like tax implications and portfolio diversification​ (Eli Lilly and Company)​ (Eli Lilly and Company). RSUs and stock options at Eli Lilly are available to a broad group of employees, typically those in management and other key roles. The availability of these stock-based compensation forms reflects Eli Lilly's commitment to aligning employee incentives with company performance, and they play a crucial role in employee retention​ (BusinessOwnerAdvisor).
Eli Lilly has been making significant strides in its healthcare offerings, particularly through the launch of its digital platform, LillyDirect. This platform focuses on providing support for patients with chronic illnesses such as obesity, diabetes, and migraines. By enabling patients to access telehealth services and facilitating direct home delivery of certain medications, Eli Lilly has made healthcare more accessible and streamlined for patients dealing with these conditions. Additionally, LillyDirect offers educational resources and digital pharmacy solutions, making it easier for patients to refill prescriptions and receive medications at home. This initiative is crucial as it caters to a growing need for convenient healthcare, especially in light of the current economic pressures and the healthcare industry's shift towards digital solutions​ (PYMNTS.com)​ (PYMNTS.com). In the broader context of Eli Lilly's healthcare initiatives, the company's focus on digital healthcare aligns with current trends in healthcare delivery. The importance of platforms like LillyDirect is underscored by the economic and political pressures on the healthcare system, particularly as patients seek cost-effective and accessible treatments. Moreover, the growing political discourse around healthcare reform, coupled with tax implications for pharmaceutical benefits, further highlights the relevance of Lilly's approach. By offering services such as telehealth and home delivery, Eli Lilly is positioning itself at the forefront of healthcare innovation, which is critical for ensuring patient satisfaction in a competitive market​ (PYMNTS.com)​ (HealthCare ME&A Magazine).
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For more information you can reach the plan administrator for Eli Lilly at Lilly Corporate Center Indianapolis, IN 46285; or by calling them at (317) 276-2000.

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