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

HCA Healthcare Employees: Smarter Ways to Manage Taxes on Appreciated Stock

Healthcare Provider Update: Healthcare Provider for HCA Healthcare HCA Healthcare is a large, nationwide health system in the United States, operating over 400 healthcare facilities, including hospitals, outpatient centers, and urgent care clinics. The organization is one of the leading healthcare providers in the U.S., delivering a comprehensive range of healthcare services to millions of patients each year. Potential Healthcare Cost Increases in 2026 In 2026, healthcare costs are expected to rise significantly, potentially affecting millions of Americans. The expiration of enhanced premium subsidies under the Affordable Care Act will likely result in average premium increases upward of 75% for many marketplace enrollees, with some states experiencing hikes exceeding 60%. This steep rise is compounded by continually escalating medical costs and major insurers implementing aggressive rate increases, placing additional financial strain on families and individuals who rely on these essential health services. As HCA Healthcare navigates these changes, it must adapt to the resulting impact on patient care and operational costs. Click here to learn more

'HCA Healthcare employees with concentrated stock positions may benefit from thoughtful tax planning that allows for tax deferral while balancing liquidity, compliance, and long-term compounding,' Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.

'HCA Healthcare employees who hold highly-appreciated stock may want to consider tax-efficient strategies that help mitigate their liabilities while aligning with their overall retirement goals,' Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How taxes can affect investment returns, particularly on concentrated stock positions.
Exchange funds and options-based strategies as methods for tax deferral and diversification.
Alternative planning techniques outside ETFs, including charitable trusts and gifting strategies.

By Carlos Hernandez, Wealth Enhancement advisor

When it comes to driving portfolio returns, many investors aim to keep management fees low by investing in low-cost index funds and exchange-traded funds (ETFs). While fees matter, however, the real culprit for lower-than-anticipated performance is taxes. ¹

Wealth Enhancement advisor Carlos Hernandez explains: 'By losing less to taxes each year, investors have access to more capital that can continue to compound over time. This makes tax deferral an important part of an effective financial plan.' HCA Healthcare employees looking for long-term growth strategies could benefit by understanding how to better manage their investment tax burdens.

Trade Money

One area where taxes can take a toll is on the sale of company stock or other concentrated investment positions. HCA Healthcare professionals looking to diversify could face significant capital gains taxes on an outright sale. One way to diversify without triggering immediate capital gains is through exchange funds. By contributing their highy-appreciated stock to a pooled fund, investors can trade their concentrated holdings for shares in a diverse basket of securities. This method can be used by HCA Healthcare employees who want to diversify while postponing taxable events.

Although this method allows for tax deferral, it also requires investors to hold the exchange fund for a period of time, typically seven years. ² This could create a challenge for investors who require liquidity. Additionally, these funds are often exclusively accessible to wealthy, accredited investors—something HCA Healthcare executives should carefully evaluate.

Funds Based on Options

Another way to mitigate taxes on the sale of highly-appreciated stock is by using options contracts. The idea is to hedge risk with put options while covering the cost of those puts by selling call options—a strategy called 'collaring'. From there, the strategy reverses, with investors selling put options and using the proceeds to buy call option on an equity or bond index. ³ If managed effectively, this helps to diversify a concentrated portfolio while still maintaining liquidity.

Given the complexity of this strategy, meticulous planning is necessary. It's generally recommended that investors work with an experienced financial advisor before pursuing this approach.

Things to Be Aware of

Although these strategies can be beneficial for HCA Healthcare employees who hold highly-appreciated stock, caution is recommended. There are costs associated with these approaches, and potential liquidity risks. Additionally, the IRS may eventually contest such arrangements because their tax status has not been thoroughly examined—something HCA Healthcare retirees should keep top of mind.

'Tax drag reduction strategies can be effective, but they must be assessed through the lens of risk, liquidity, cost, and compliance,' warns Carlos Hernandez. What is appealing in theory must hold up to inspection in the real world.

Alternative Strategies

Although they show promise, investors with highly-appreciated stock or those looking to postpone gains have other alternatives besides exchange funds or options. Other tactics could include:

- Prepaid variable forwards (subject to IRS regulations, contracts to sell at predetermined terms in the future).
- Charitable remainder trusts (CRTs), which allow investors to donate appreciated stock to a charitable trust and receive a stream of regular income in return.
- Donor-advised funds (DAFs), which provide investors with a tax deduction for the fair market value of the appreciated stock they donate.
- Other gifting techniques, such as direct donations to charity or family.
Each has its own set of guidelines, advantages, and disadvantages. To limit unnecessary taxes or violating the constructive sale regulations, careful planning is necessary for HCA Healthcare professionals managing complex portfolios.

The Bottom Line

Although the movement to mitigate the tax burden on investments is not new, the instruments are changing. Both exchange funds and options-based structures offer investors a way to manage tax liabilities, especially for HCA Healthcare employees who hold highly-appreciated stock.

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In the end, taxes are unavoidable. However, with the correct set of instruments, they can be controlled and postponed. 'The real value comes from aligning tax strategy with investment strategy,' summarizes Carlos Hernandez.

Sources:

1. BlackRock Advisor Center. ' Investing for After-Tax Returns ,' 2025.

2. Kiplinger. ' Four Clever and Tax-Efficient Ways to Ditch Concentrated Stock Holdings ,' by Robert Waskiewicz. Sep. 11, 2025.

3. Financial Planning Association. ' Tax-Efficient Ways to Diversify Concentrated Stock Positions ,' by Peter Lazaroff. Oct. 2024.

What is the 401(k) plan offered by HCA Healthcare?

The 401(k) plan offered by HCA Healthcare is a retirement savings plan that allows employees to save a portion of their salary on a pre-tax or Roth after-tax basis.

Does HCA Healthcare match employee contributions to the 401(k) plan?

Yes, HCA Healthcare provides a matching contribution to employee 401(k) accounts, which helps to enhance retirement savings.

How can I enroll in the 401(k) plan at HCA Healthcare?

Employees can enroll in the HCA Healthcare 401(k) plan through the company's benefits portal during the enrollment period or when they first become eligible.

What types of investment options are available in the HCA Healthcare 401(k) plan?

HCA Healthcare's 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and company stock.

Is there a waiting period before I can participate in the HCA Healthcare 401(k) plan?

Yes, HCA Healthcare may have a waiting period for new employees before they can participate in the 401(k) plan, typically based on the employee's start date and eligibility criteria.

How much can I contribute to my 401(k) plan at HCA Healthcare?

Employees at HCA Healthcare can contribute up to the IRS limit for 401(k) contributions, which may change annually.

Can I take a loan against my 401(k) savings at HCA Healthcare?

Yes, HCA Healthcare allows employees to take loans against their 401(k) savings, subject to specific terms and conditions.

What happens to my 401(k) if I leave HCA Healthcare?

If you leave HCA Healthcare, you can choose to roll over your 401(k) balance into another retirement account, cash it out, or leave it in the HCA Healthcare plan if you meet the eligibility requirements.

Can I change my contribution amount to the HCA Healthcare 401(k) plan?

Yes, employees can change their contribution amounts to the HCA Healthcare 401(k) plan at any time, subject to the plan's rules.

Does HCA Healthcare provide financial education regarding the 401(k) plan?

Yes, HCA Healthcare offers resources and financial education to help employees make informed decisions about their 401(k) savings and investments.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.

HCA Healthcare is one of the largest for-profit healthcare providers in the U.S., operating hospitals and surgery centers. The company focuses on delivering high-quality healthcare services across its facilities.

HCA Healthcare offers RSUs and stock options to eligible employees. These incentives vest over time, aligning employee interests with company performance.