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 should recognize that rising health care costs in 2026 highlight the importance of reviewing benefits closely during open enrollment and budgeting carefully for higher out-of-pocket expenses.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.
'Duke Energy employees facing the steepest health insurance increases in over a decade can benefit from proactively comparing plan options and aligning coverage with long-term health care needs during enrollment.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article, we will discuss:
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Why group health insurance costs are expected to rise sharply in 2026.
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How employers may shift health care expenses to employees through plan changes.
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Key steps individuals can take during open enrollment to manage higher costs.
The cost of group health insurance is expected to rise at the fastest pace in 15 years, 1 creating significant challenges for both companies and their employees. Duke Energy employees may soon see higher co-payments, larger deductibles, and greater payroll deductions. Employers across the country are also preparing to make structural adjustments to their health plans, which could mean less prescription drug coverage or tighter provider networks. With Baby Boomers working later into their careers and medical costs continuing to rise, these changes reflect a broader transformation in the American health care system.
According to Brent Wolf, CFP of Wealth Enhancement, “the biggest increase in health insurance costs in over ten years is about to hit both employers and employees. This affects almost everyone and is structural and demographic in nature; it is not just about inflation.”
Factors behind rising prices
While cost hikes in employer-sponsored health insurance have generally been modest, forecasts for 2026 point to a sharp rise. Average benefit costs per employee are expected to grow by over 6.5%, the steepest jump since 2010. 1 This rise is being driven by several key elements:
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An aging workforce: Many Baby Boomers are working well into their 60s and 70s. Their growing medical needs—from advanced oncology treatments to cardiac care—place heavy cost pressure on employer health plans.
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High-cost claimants: Roughly 20% of employees generate over 80% of health care expenses, 2 concentrating costs and making them hard to manage.
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Medical inflation: New therapies, industry consolidation, and complex billing practices are fueling rising medical inflation.
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Regulatory changes: Recent legislation such as the “One Big Beautiful Bill” adds complexity and unpredictability for employer planning.
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Increased utilization and postponed care: Many delayed care during the pandemic. As people return for elective procedures, overall costs have surged.
Wolf observes, “This is a triple whammy. Employers have few options to control costs, medical costs are climbing, and older workers are using more care.”
Employers’ cost management tactics
Nearly 60% of companies are expected to adjust health plan designs in 2026 to help with rising costs 1 —a much larger share than in prior years. For Duke Energy employees, these modifications may translate into a higher out-of-pocket load, particularly if companies pursue cost cutting strategies such as:
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Increased payroll deductions: Premium contributions may go up about 6% to 7%, 1 leading to larger deductions from wages.
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Higher out-of-pocket costs: Changes to deductibles, copayments, and coinsurance will raise what individuals pay when getting care.
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Narrower provider networks: Employers might limit access to certain doctors or prescription medications.
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Plan design shifts: A move toward high-deductible health plans is expected, placing more load on employees to make cost-conscious choices.
According to Wolf, “Employers may quietly reduce benefits because they don't want to annoy employees with premium hikes.” The result is the same: higher household costs.
Getting ready for enrollment
As open enrollment season approaches, careful planning will be very important. Wolf suggests a few key actions:
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- Track open enrollment dates so you don’t miss your chance to make selections.
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- Review all details beyond the monthly premium, including prescription lists, provider networks, and out-of-pocket maximums.
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- Match coverage with personal health needs—chronic conditions may justify higher premiums, while healthier people might prefer high-deductible plans.
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- Use tax-advantaged accounts like flexible spending account (FSAs) or health savings accounts (HSAs) to help offset costs with pre-tax funds.
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- Take advantage of wellness programs that promote preventive care and healthier lifestyles.
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The broader context
The demographic reality of an aging workforce will keep pushing health care costs higher for employers and employees alike. Duke Energy employees, like others across the workforce, will feel these changes beyond 2026.
Wolf emphasizes, “This is not a one-year story.” The cycle of rising costs will affect employers, employees, and retirees for years to come. Planning ahead, budgeting for cost increases, and making informed enrollment choices will be essential.
In addition, Medicare costs are projected to rise significantly in 2026: the Part B monthly premium is expected to climb 11.6%, from $185 in 2025 to $206.50. 3 Part D premiums are forecast to go up 6%, from $36.78 to $38.99, while deductibles increase to $615. 4 The Part B deductible is also set to go up nearly 12%, from $257 to $288. 3
Employer-sponsored plans overall are expected to see employee health benefit costs rise by about 6.5% in 2026, the most rapid climb in 15 years. 1 For Duke Energy employees, the combination of higher copays, deductibles, and premiums mirrors the national trend driven by medical inflation, expensive therapies, and regulatory shifts.
An analogy for what lies ahead
Dealing with these changes is much like planning for a road trip where fuel prices suddenly jump, tolls multiply, and detours force you onto costlier routes. The journey still has to happen, but it now demands more foresight, budget planning, and careful choice-making. Employees will need to carefully evaluate their open enrollment options, just as travelers must adapt their maps and decisions to reach their destination under changed conditions.
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. Employee Benefit Research Institute (EBRI). Fast Facts: A Small Number of Workers Account for Most Health Costs . 4 Sept. 2025.
3. AARP. ' Medicare Part B Premium Expected to Top $200 a Month in 2026 ,' by Tony Pugh. September 9, 2025.
4. KFF. ' A Current Snapshot of the Medicare Part D Prescription Drug Benefit ,' by Juliette Cubanski. Oct. 7, 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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