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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 Workers Prepare for Sharp Health Care Cost Increases 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

'With health care costs rising, Eli Lilly employees should take time to review their coverage and align it with their broader retirement income goals,' — Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.

'Eli Lilly employees can stay ahead of rising health care expenses by proactively evaluating benefits and incorporating future medical costs into their long-term retirement strategy,' — Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. Why health insurance premiums may rise in 2026.

  2. How these changes could affect Eli Lilly employees and retirees.

  3. Steps to help prepare for higher health care costs.

Millions of Americans, including employees at Eli Lilly, are learning that health insurance premiums could increase significantly in 2026. Depending on the state, income, and whether federal subsidies are offered, monthly premiums for many people may jump by double-digit percentages. 1

Insurers are sending out letters to Affordable Care Act (ACA) marketplace plans nationwide, detailing significant rate increases that could impact Eli Lilly households who rely on supplemental or early retirement coverage. In many cases, people’s monthly premiums will go up by hundreds of dollars in the upcoming year. 2

Health policy researchers have collected new data suggesting average increases for marketplace plans could range from 10% to more than 20%. 1  Many subscribers, including Eli Lilly retirees using marketplace plans, may see payments more than quadruple if expanded government subsidies disappear. 1

Those purchasing insurance on the exchanges are not the only ones facing higher costs. Employer-sponsored plans used by many Eli Lilly families are also facing rising expenses as medical spending rebounds. In 2026, businesses anticipate an average cost increase of approximately 9%. 3

Reasons for Increasing Premiums

The main drivers behind premium hikes, according to insurers, include an aging population, rising medical costs, and increased health care usage post-pandemic—trends likely to impact Eli Lilly retirees.

In addition, unless Congress intervenes, the expanded ACA subsidies implemented during the pandemic are scheduled to expire after 2025, a potential concern for former Eli Lilly workers who rely on this support before Medicare eligibility. Without these subsidies, many middle-class families could see costs surge immediately.

More than 90% of ACA subscribers receive some government assistance with their premiums, 4  and analysts warn that if the expanded subsidies end, millions—including some who retired from Eli Lilly early—could lose coverage entirely by 2027. 4  

The Individual Effect

Every statistic reflects a personal challenge impacting families. Small business owners, independent contractors, and early retirees are already reporting premium increases from $250 to $700 per month in several states. 5

Some households losing subsidies could face monthly premiums of $2,000 or more 4 —far above the $300–$400 range typical today—creating greater strain for Eli Lilly retirees trying to manage health care expenses.

Those living with chronic conditions face even harder decisions, since routine care and medications remain essential.

Getting Ready for 2026

Advisors recommend reviewing health plan options thoroughly during upcoming enrollment seasons, especially for those nearing retirement. This includes checking subsidy eligibility, comparing multiple coverage options, and evaluating whether a spousal or employer-sponsored plan could offer better value.

Professionals approaching retirement may want to consider tax-efficient health care savings tools like Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) to help manage higher costs. It is also important to account for health care inflation when forecasting post-employment income.

A Monetary Urge to Act

Rising health care expenses can disrupt long-term goals for individuals and families, including those with many years of service at Eli Lilly. Medical coverage decisions should tie to retirement income strategies, tax planning, and asset preservation.

From retirement income and tax strategies to insurance and budgeting, The Retirement Group can help you evaluate how these changes may impact your future. Before open enrollment ends, call The Retirement Group at (800) 900-5867 to review retirement planning options and strategies to help navigate rising health care costs.

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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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