Healthcare Provider Update: Healthcare Provider for Duke Energy Duke Energy utilizes a range of health benefits and insurance plans provided through major healthcare organizations, with Aetna being one of the primary providers offering their employee health insurance coverage. Potential Healthcare Cost Increases for Duke Energy in 2026 As 2026 approaches, Duke Energy employees may face significant healthcare cost increases due to a combination of factors impacting the broader health insurance market. Record premium hikes for Affordable Care Act (ACA) marketplace plans, with some states eyeing increases exceeding 60%, could manifest in employer-sponsored plans as well. The potential expiration of enhanced federal premium subsidies, alongside rising medical costs and aggressive rate hikes from insurers, may significantly elevate out-of-pocket expenses for beneficiaries. This perfect storm of factors indicates that employees might need to prepare for substantial healthcare financial burdens in the upcoming year, as many individuals could see their premiums rise by more than 75%. Click here to learn more
'Duke Energy employees preparing for retirement should account for rising health care premiums as a core expense, and build flexibility into their plans today to help reduce the strain of unexpected costs tomorrow.' – Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.
'Duke Energy employees nearing retirement should stress-test their plans for higher 2026 health care costs, review coverage options each year, and—when eligible—fund HSAs to keep cash flow resilient.' – Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article, we will discuss:
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Why health insurance premiums are expected to rise significantly in 2026.
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The unique challenges retirees face before becoming eligible for Medicare.
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Practical strategies to help manage increasing health care expenses.
The Increase in Health Insurance Premiums in 2026: Consequences and Solutions
With over 300 Affordable Care Act (ACA) marketplace providers proposing premium rises of about 18% on average, 1 health insurance costs are set to climb sharply in 2026. For those exiting the workforce before age 65, including Duke Energy employees, this change creates a fiscal gap that calls for thoughtful preparation.
'Health care costs are often the single biggest surprise in retirement,' says Brent Wolf, CFP of Wealth Enhancement. Even the most carefully built retirement plan may be disrupted when premiums go up faster than expected. This highlights the need for Duke Energy retirees to factor in health care expenses when creating retirement scenarios.
Why the Years Before Medicare Are Particularly Difficult
At age 65, most people become eligible for Medicare. People who leave work earlier must find coverage to bridge the gap. Options include:
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- Purchasing ACA marketplace policies
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- Continuing with COBRA payments after leaving employment
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- Using a spouse’s employer-sponsored plan
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- In rare cases, accessing a former employer’s retiree plan
For those who have spent years with Duke Energy, cost becomes the main issue. Premiums tend to rise sharply in the late 50s and early 60s, with ACA rates often based on age. A couple in their early 60s might pay several thousand dollars per month, before deductibles or prescriptions. 2 Rising premiums can put real strain on those planning to retire before Medicare begins.
Important Factors Affecting the 2026 Increases
Several policy and systemic drivers are fueling the expected ~18% jump:
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Ending subsidies: After 2025, the enhanced ACA tax credits that cap premiums at 8.5% of income are due to expire. 2
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Medical inflation: The cost of hospital stays, outpatient care, and doctor visits continue rising faster than general inflation. 3
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Labor shortages: Health care providers are raising pay and benefits to retain staff, increasing the cost of care.
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Drug costs: High-demand prescription drugs increase insurer costs.
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Tariffs and supply costs: Anticipated import taxes on medical supplies may add pressure.
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Reduced risk pool: If subsidies end, healthier people may drop out of the market, leaving higher-cost individuals behind.
As Wolf remarks, “Healthier participants leave the system when subsidies disappear.” For Duke Energy workers nearing retirement, this cycle may mean even steeper rates in the years before Medicare.
The Effect in the Real World
Premium hikes will affect families quickly. By 2026, some who stretched budgets for coverage in 2025 may find it unaffordable altogether. Others may need to draw more from retirement savings, weakening long-run sustainability.
“I’ve seen families who were comfortable in retirement suddenly needing to take on part-time work just to cover insurance,” Wolf explains. For Duke Energy retirees, that reality could require adjusting their retirement lifestyle or rethinking sources of income.
Unexpected medical bills may also force individuals with fixed incomes to cut back on other retirement goals.
Practical Techniques to Control Rising Medical Expenses
While large market forces are beyond individual control, Duke Energy employees approaching retirement can take steps to ease the burden:
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Review coverage annually: Subsidies and plan options change each year. Automatic renewals may lead to paying too much.
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Consider HDHPs: High-deductible health plans tend to have lower premiums and make participants eligible for health savings accounts (HSAs).
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Leverage HSAs: Contributions grow tax-free and can be used to pay medical costs later.
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Stay in-network: Using approved providers helps reduce out-of-pocket costs.
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Prioritize preventive care: Routine screenings and healthy habits may reduce the chance of large medical bills in future.
The Need to Plan in Advance
Health care costs must now be assumed higher than in many past retirement plans. With subsidies expiring and inflation pressure rising, Duke Energy retirees should expect bigger expenses.
“My advice is to assume higher health care costs in every scenario,” suggests Wolf. If subsidies continue, that will help, but conservative planning can help avoid surprises.
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Health care planning has become a central pillar of retirement preparation. The 2026 premium jump highlights the importance of adaptability, careful cost estimation, and taking action early.
According to recent data, a record 24.2 million consumers selected or were auto-re-enrolled in ACA marketplace plans in 2025, 4 with fewer older registrants than in prior years. This shift means Duke Energy employees who are not yet Medicare-eligible could grapple with harder budget choices as premiums climb.
In 2026, higher insurance costs will feel like unmarked tolls on the path to Medicare at 65. The road still exists, but detours—expiring subsidies, inflation, costly new drugs—may drain retirement funds faster than many expect. By using tools like health savings accounts and reviewing plan options each year, retirees can get a better handle on their medical expenses to avoid depleting their resources.
Sources:
1. KFF. “ How Much and Why ACA Marketplace Premiums Are Going Up in 2026 ,” by J. Ortaliza et al, 6 Aug. 2025 .
2. KFF. ' ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Explire ,' by Justin Lo et al, September 30, 2025.
3. American Hospital Association, ' The Cost of Caring: Challenges Facing America’s Hospitals in 2025 ,' Apr. 2025.
4. CMS.gov, ' Over 24 Million Consumers Selected Affordable Health Coverage in ACA Marketplace for 2025 ,' Jan. 17, 2025.
How does the Duke Employees' Retirement Plan calculate benefits at normal retirement age, specifically for employees who reach the age of 65? In what circumstances might an employee consider retiring before reaching this age, and how would the benefits differ if they choose this option?
Benefit Calculation at Normal Retirement Age: Duke Employees' Retirement Plan calculates benefits for employees who retire at age 65 by applying a formula that includes 1.25% of their average final compensation for the first 20 years of credited service and 1.66% for any additional years. If an employee retires before 65, they can do so after age 45 with 15 years of service, but their benefits will be reduced based on how early they retire, resulting in lower payments due to a longer payout period.
What considerations should an employee keep in mind regarding their unused sick leave or carry-over bank hours when calculating benefits under the Duke Employees’ Retirement Plan? How does Duke utilize these factors to enhance an employee's credited service for the purpose of benefit calculation?
Impact of Unused Sick Leave and Carry-Over Bank Hours: Unused sick leave and carry-over bank hours are converted into additional credited service, which can enhance the calculation of retirement benefits. Employees who have accumulated these hours can see their credited service extended, leading to higher pension benefits at retirement.
In what situations would an employee's benefits under the Duke Employees' Retirement Plan be automatically paid in a lump sum? How does the Plan determine the value of benefits that fall below the threshold for monthly payouts, and what implications does this have for retirement planning?
Lump-Sum Payments for Small Benefits: If the value of an employee's benefit is $5,000 or less, Duke Employees' Retirement Plan automatically pays it as a lump sum. For benefits between $5,000 and $10,000, employees can choose between a lump-sum payment or a monthly pension. This can significantly impact retirement planning, especially for employees weighing whether to take a smaller upfront amount or spread it over time.
How does the Duke Employees' Retirement Plan handle benefit adjustments for employees who continue to work beyond their normal retirement age? What factors influence how these adjustments are calculated, and what implications might this have for future financial planning for employees nearing retirement?
Benefit Adjustments for Postponed Retirement: Employees who continue working beyond their normal retirement date will see their benefits increased annually (by no less than 10%) to account for the shorter period during which they will receive payments. The plan recalculates benefits based on the employee’s continued service and compensation after age 65.
What options are available to employees of Duke University regarding payment forms when they retire, and what are the long-term implications of choosing each option? How do these choices affect both the retiree's monthly income and survivor benefits for a spouse or other beneficiary?
Payment Form Options and Implications: At retirement, employees can choose various payment options such as a single life annuity, joint and survivor annuities, or a lump-sum payment. These choices affect the amount received monthly and any survivor benefits for a spouse or beneficiary. Employees should carefully consider their long-term financial needs and the needs of their beneficiaries when selecting a payment option.
What specific protections does the Duke Employees' Retirement Plan provide for spouses in the event of an employee's death, and how does this influence the choice of payment options? What steps must an employee take to ensure that their spouse's rights are upheld under the Plan?
Spousal Protections: The Plan provides protections for spouses in the event of an employee's death. A surviving spouse can receive 50% of the employee's reduced monthly benefit through a joint and survivor annuity. Employees must take steps to ensure spousal rights are protected by selecting the appropriate payment option and ensuring the necessary documentation is completed.
How can employees of Duke University ensure that they are informed about their rights under ERISA while participating in the Employees' Retirement Plan? What resources and tools does Duke provide to help employees understand and assert these rights?
Employee Rights Under ERISA: Duke provides resources for employees to understand their rights under ERISA, including access to plan documents and assistance in filing claims. Employees are encouraged to use Duke's available tools to assert their rights and ensure they are fully informed about the benefits available to them under the Plan.
In what ways can employees at Duke University navigate the complexities of reemployment after retirement, and how does their choice of retiree status affect their benefits? What regulations govern how benefits are recalculated if they choose to return to work at Duke?
Reemployment After Retirement: Employees who return to work at Duke after retiring can continue to receive their pension if they work fewer than 1,000 hours per year. However, if they exceed 1,000 hours, their payments will be paused and recalculated based on additional service and earnings when they retire again. This provides flexibility for employees considering reemployment after retirement.
What impact do legislative changes, such as those introduced by the IRS, have on the Duke Employees' Retirement Plan’s structure and benefits? How should employees approach understanding these changes in the context of their personal retirement strategies?
Impact of Legislative Changes: Changes introduced by the IRS or other regulatory bodies can impact the structure of the Duke Employees' Retirement Plan and its benefits. Employees should stay informed about these changes and how they affect personal retirement strategies, particularly regarding tax laws and pension calculations.
How can employees at Duke University contact the Retirement Board for questions or clarifications regarding their retirement benefits? What is the best approach for reaching out to ensure that they receive timely and accurate information?
Contacting the Retirement Board: Employees can contact Duke's Retirement Board for any questions or clarifications regarding their retirement benefits. The Retirement Board is responsible for managing the Plan, and employees are encouraged to reach out directly for timely and accurate information to address any concerns about their retirement.



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