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Rising Health Care Costs Pose New Challenges for U.S. Employers Like Duke Energy

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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

'Rising health care costs are no longer a temporary trend but a structural challenge that employers like Duke Energy need to face head-on. Proactive planning around benefits and long-term budgeting is essential to maintaining both workforce stability and financial resilience.' – Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

'With health care costs on the rise, companies like Duke Energy are exploring ways to align benefit strategies with financial objectives to help preserve both employee well-being and organizational strength.' – Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. The rapid rise in employer-sponsored health care costs and its long-term budget implications.

  2. The primary factors driving health care inflation, including labor shortages and prescription drug costs.

  3. The strategic responses employers are adopting to manage expenses while addressing employee well-being.

By Patrick Ray, a financial advisor at Wealth Enhancement

Businesses in the United States, including Duke Energy, are bracing for the largest increase in health insurance costs in over 15 years. 1  This trend is spilling over into the operating costs associated with employer-sponsored health care plans, driving companies to revisit how they handle employee benefits, retention, and long-term financial planning.

An Increase in Prices

Industry estimates indicate that employer health care expenditures are set to rise by roughly 9% to 10% in 2026, 2  marking the biggest annual jump since 2011. 3  With average annual premiums for employer-sponsored family coverage reaching $25,572 in 2024, 4  this jump stands to put continued pressure on companies—including Duke Energy—to reassess how sustainable their benefit programs remain. The compounding effect of these annual increases has forced firms to rethink benefits in ways that may directly influence workforce stability.

Double-digit annual increases do occur in exceptional circumstances, but the fact that this surge is happening in a stable economy underscores how health care inflation has shifted from a temporary market disruption to a structural challenge for employers.

The Reasons Behind Rising Prices

Several systemic factors are fueling this upward trend for employers like Duke Energy:

  • Health Care Labor Costs:  Hospitals and providers are facing heightened labor expenses, especially for specialized roles such as nurses and clinicians. 5

  • Pharmaceutical Expenses:  The introduction of new and specialty treatments—often expensive—adds strain to budgets.

  • Insurer Pass-Throughs:  Increases in insurer rates are often passed directly on to employer-sponsored plans. 6

  • Increased Utilization:  Following the pandemic, many employees deferred screenings and elective procedures, leading to a surge in catch-up care that elevates overall spending. 1

While these developments may lead to better health outcomes over time, they also impose immediate budget pressures.

The Employer’s Dilemma

Spending trends are approaching a tipping point for many organizations such as Duke Energy. One Wealth Enhancement client with over 2,000 employees projected employer-sponsored health care costs could exceed $50 million within three years, a scenario the CFO described as “unsustainable.” Employers now face the choice of absorbing greater expenses, scaling back benefits, or shifting more costs onto employees. Each route carries risks, particularly if health care cost growth continues outpacing revenue and wage increases.

Effects on Employees

At large corporations like Duke Energy, employees may experience higher deductibles, copays, or out-of-pocket maximums—even when employers cover most premium increases. For many families, coverage costs now rival second mortgages or car payments, fueling dissatisfaction and turnover. As benefits grow more costly and are viewed as less generous, workforce morale and retention suffer, impacting engagement and company performance.

Employers’ Strategic Responses

To address rising costs, companies—including Duke Energy—are turning to tactics such as:

  • Health Savings Accounts (HSAs) and High-Deductible Plans:  To mitigate costs for employees enrolled in high-deductible health plans, some employers are including HSAs in their benefits programs. These accounts offer a triple tax advantage: contributions to the account are tax-free and exempt from Social Security or Medicare taxes if they're made through payroll deductions; the money invested grows tax-free; and withdrawals for qualified health expenses are tax-free.

  • Direct Provider Negotiations:  Some employers aim to leverage their market power by negotiating health care costs directly with providers, bypassing traditional insurance networks and optimally reducing both employer and employee health care coverage costs.

  • Virtual Care and Digital Solutions:  By expanding access to telemedicine and wellness technology, some employers hope to reduce reliance on costly in-person services.

These measures reflect innovation but deliver incremental relief—not full-scale solutions.

The Long-Term Financial Landscape

For Duke Energy and other large employers, the question isn't whether health care costs will rise—it's how to prepare for the continuing upward trend. Some firms have created dedicated reserve funds to buffer volatility; others link executive incentives to cost containment efforts. These strategies favor proactive planning, aligning financial discipline with long-term performance.

The Human Factor

Health care spending isn't merely an expense; for companies like Duke Energy, maintaining a healthy, engaged workforce is essential to productivity and loyalty. Overly aggressive cost trimming may produce short-term savings but often leads to higher absenteeism and turnover, eroding future competitiveness. Organizations that approach health care as an investment in human capital may be better placed to balance budget priorities with workforce resilience.

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Final Thoughts

Health care costs in the U.S. are forecast to rise at levels not seen in more than a decade, with employer-sponsored coverage poised for the steepest annual increase since 2011. Duke Energy and other employers must weigh fiscal responsibility against supporting employee well-being—a balance vital to long-term viability.

Wealth Enhancement advocates crafting strategies that help preserve competitiveness while supporting employees’ health. A 65-year-old retiring in 2025 may need as much as $172,500 to cover health care expenses in retirement—up nearly 4% from the previous year 7 —highlighting how health care inflation deeply affects future financial commitments.

Employers’ rising health care costs resemble a rising tide: gradual increases may go unnoticed at first, but soon every anchored vessel—every business—is impacted. Duke Energy and others must consistently adapt benefits design to meet this challenge, maintaining workforce engagement and long-term financial strength.

Sources:

1.  Mercer. ' Employers prepare for the highest health benefit cost increase in 15 years ,' by Beth Umland and Sunit Patel. September 3, 2025. 

2. Aon. ' U.S. Employer Health Care Costs Expected to Rise 9.5 Percent In 2026 ,' September 10, 2025. 

3.  PwC Health Research Institute. ' Medical Cost Trend: Behind the Numbers 2026 ,' 16 July 2025.

4. KFF. ' 2024 E mployer Health Benefits Survey ,' October 9, 2024.

5.  American Hospital Association. ' America’s Hospitals and Health Systems Continue to Face Escalating Operational Costs and Economic Pressures ,' Apr. 2024.

6. Health Services Research. ' Research and policy to strengthen the employer-sponsored health insurance market ,' April 25, 2022.

7.  Fidelity Investments. “ How to Plan for Rising Health Care Costs ,” September 5, 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.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Duke Energy offers a comprehensive employee pension plan known as the Duke Energy Retirement Cash Balance Plan (RCBP), which has undergone restructuring over the years. This plan is available to employees based on years of service and age qualification, with specific details outlined in the company's plan documents. Duke Energy also provides a 401(k) plan named the Duke Energy Retirement Savings Plan (RSP), offering both traditional and Roth options. Employees typically become eligible for these plans after meeting certain service requirements, with detailed formulas for calculating benefits. The Summary Plan Description (SPD) and other relevant documents provide precise details, including the specific pages where this information can be found. It’s important to refer to these documents to understand eligibility criteria, plan formulas, and other terms specific to Duke Energy’s retirement benefits.
Layoffs and Reorganization: Duke Energy has implemented layoffs as part of a broader effort to cut costs and refocus on clean energy initiatives. In 2023, the company laid off a few hundred employees, mainly in Charlotte, as part of a $300 million cost-saving strategy. These layoffs were primarily in corporate and operational support roles. Duke Energy is also reorganizing to enhance efficiency as it continues to transition towards cleaner energy sources, including the expansion and modernization of its clean energy grid. This restructuring is crucial to maintaining competitiveness in the evolving energy market. Importance: Addressing these layoffs and reorganization is vital given the current economic and investment climate, as well as the political push for cleaner energy solutions. Understanding the impact of these changes helps stakeholders navigate the uncertainties in the energy sector.
I gathered detailed information about Duke Energy's employee stock options and Restricted Stock Units (RSUs) for the years 2022, 2023, and 2024. Duke Energy offers both stock options and RSUs to its employees, primarily as part of its compensation and incentive programs. The company uses specific acronyms such as DUK for its stock symbol and references these programs in its financial reports and proxy statements. In 2022, Duke Energy expanded its RSU offerings, which were primarily targeted at senior management and key employees as a form of long-term incentive. The stock options and RSUs are granted based on performance criteria, and employees who meet these criteria, particularly those in leadership roles, are eligible. By 2023, Duke Energy continued to utilize RSUs as a significant part of its compensation strategy, with a focus on aligning employee incentives with shareholder interests. This program was further reinforced in 2024 as part of the company's efforts to retain top talent during a period of operational restructuring.
For Duke Energy, the health benefits offered to employees in the years 2022, 2023, and 2024 are comprehensive and focus on a range of healthcare needs. Duke Energy provides medical, dental, vision, life, and disability coverage as part of its total rewards package. Additionally, wellness programs, retirement benefits, and work-life balance programs are emphasized to ensure the well-being of employees. Some specific healthcare-related terms and acronyms used by Duke Energy include the UHC (UnitedHealthcare) Transparency in Coverage initiative, which is part of their efforts to comply with legal requirements and ensure employees have access to clear information about their healthcare costs. Duke Energy also offers Parental Leave Pay for both mothers and fathers, providing up to six weeks of paid leave for new parents. In terms of recent employee healthcare news, Duke Energy has been actively involved in initiatives that align with their sustainability goals, which indirectly impact employee health benefits. For example, their clean energy transition is likely to bring about changes in the healthcare policies related to environmental health and safety as the company focuses on reducing its carbon footprint and promoting sustainable practices across its operations.
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For more information you can reach the plan administrator for Duke Energy at 550 S Tryon St Charlotte, NC 28202; or by calling them at (800) 777-9898.

https://hr.duke.edu/benefits/retirement/457b/ https://investors.duke-energy.com/news/news-details/2022/Duke-Energy-expands-clean-energy-action-plan-02-09-2022/default.aspx https://www.stordahlcap.com/insights/understanding-net-unrealized-appreciation-nua-and-its-tax-benefits https://corient.com/insights/articles/net-unrealized-appreciation-strategy-after-tax-contributions https://www.thelayoff.com/duke-energy?page=2 https://www.myplaniq.com/LTISystem/f401k_plan.action?ID=4666 https://www.sec.gov/ https://simpleqdro.com/

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