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Private Equity in Select Medical Holdings 401(k) Plans: What Employees Should Know

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Healthcare Provider Update: Healthcare Provider for Select Medical Holdings: Select Medical Holdings operates primarily through its network of specialized rehabilitation hospitals and outpatient rehabilitation clinics. Their healthcare services focus on providing rehabilitation services for critical illness, physical therapy, and long-term acute care hospitals, making them a significant player in the healthcare sector. Potential Healthcare Cost Increases in 2026: As we approach 2026, significant increases in healthcare costs are anticipated, primarily driven by expected record hikes in Affordable Care Act (ACA) premiums. With states facing premium increases exceeding 60%, many individuals may experience out-of-pocket premium hikes of up to 75%, drastically affecting affordability. Contributing factors include the potential expiration of federal premium subsidies and rising medical costs from hospitals and providers. This perfect storm of financial pressures underlines the urgent need for consumers to prepare for the impending increase in healthcare expenses. Click here to learn more

'Select Medical Holdings employees should carefully weigh transparency, costs, and flexibility when evaluating new 401(k) options, as thoughtful planning today can make a meaningful difference in retirement outcomes.' — Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

'Select Medical Holdings employees navigating evolving 401(k) choices should focus on understanding fees, liquidity, and long-term impact to help align their retirement strategies with their personal goals.' — Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. The opportunities and risks of private equity’s entry into 401(k) retirement plans.

  2. The impact of fees, transparency, and liquidity on long-term retirement outcomes.

  3. Key considerations Select Medical Holdings employees should weigh before adding private equity to their portfolios.

For several years, private equity firms have been seeking access to corporate retirement plans, which could affect the investment choices available in 401(k) accounts. Traditionally, these alternative investments have been limited to wealthy and institutional investors, who provide private equity firms with funds they can use to buy equity stakes in unlisted private companies. Under the Employee Retirement Income Security Act (ERISA), however, private equity funds have been excluded from most workplace retirement plans due to their high fees, limited liquidity, and opaque reporting requirements. 1

New federal guidelines may be shifting this landscape. In an Executive Order issued in August 2025, the Trump administration supported access to alternative assets for 401(k) investors. 2  While these changes may broaden diversification opportunities, they also raise questions about appropriateness, costs, and transparency for Select Medical Holdings employees planning their retirement. 'It's a historic change in access, but it's also a time that calls for caution,' said Neva Bradley of Wealth Enhancement. Although private equity may offer diversification benefits, a higher risk profile and less transparent pricing require careful consideration.

Juggling Promise and Risk

Private equity funds have historically delivered strong long-term returns, 3  but more recent conditions have narrowed the edge over traditional stock indexes. 4  Rising interest rates and volatile markets have made performance less consistent, which is an important factor for Select Medical Holdings workers evaluating retirement strategies. While opportunities for gains remain, the trade-off in volatility cannot be ignored.

Fee structures complicate matters further. Compared to low-cost index funds, private equity investments involve multiple layers of expenses. According to Bradley, 'the fee structures and volatility can significantly reduce those gains over time.' Select Medical Holdings employees should note that these fees can be ten times higher than standard 401(k) options, 5  which can diminish long-term compounding.

Challenges of Transparency

One of the largest differences between mutual funds and private equity is reporting. Mutual funds tend to publish daily prices and transparent performance updates, while private equity reports are typically quarterly and valuations are often based on estimates. 1  This lack of standard benchmarks can make it difficult for even seasoned investors to evaluate performance consistently. For Select Medical Holdings participants, this means private equity may feel less straightforward than traditional investment choices.

The Cost Aspect

Private equity is also known for its high fees. Typical structures include a 1% to 2% annual management charge plus performance-based incentives, compared to about 0.25% for many mutual funds. 1  Over decades, these higher costs compound, especially for retirement accounts where long-term growth is important. As Bradley points out, 'those costs compound over decades,' underscoring the need to weigh fees against potential returns.

Important Things to Consider for Retirement Planning

For Select Medical Holdings employees who may encounter private equity options in their 401(k), here are some key considerations:

  • Liquidity:  Investments are often locked in for years with limited access.

  • Costs:  Carefully review and compare fee structures.

  • Timeline:  Private equity may lack the flexibility needed closer to retirement.

  • Diversification:  If included, it should represent only a small portion of the portfolio.

Bradley summarized, 'Private equity is not a panacea, but it can contribute to complex portfolios.' Select Medical Holdings participants should evaluate transparency, fees, and personal risk tolerance before making decisions.

One notable development is that target-date funds that include private equity and private credit holdings have been shown to potentially boost retirement income by 5% to 15% over 40 years, 6  provided top-tier managers are selected. For Select Medical Holdings employees, this underscores both the opportunity and the complexity of integrating private equity into a long-term plan.

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Sources:

1. Investopedia. ' Private Equity is Coming for Your 401(k): How to Protect Yourself ,' by Daniel Liberto. 17 Jan. 2025.

2. The White House, Presidential Actions. ' Democratizing Access to Alternative Assets for 401(k) Investors ,' Executive Orders. 7 Aug. 2025.

3. Institutional Investor. ' Why Private Equity Wins ,' by Dawson Partners. 24 Mar. 2025.

4. Morningstar. ' How Attractive Is Private Equity? ' by Jack Shannon. 11 June 2025.

5. Investopedia. ' Private Equity Explained With Examples and Ways To Invest ,' by James Chen. 2 Sep. 2025.

6. BlackRock Advisor Center. ' How private markets could improve retirement outcomes ,' by BlackRock Retirement Perspectives. 26 Jun. 2025.

What is the 401(k) plan offered by Select Medical Holdings?

The 401(k) plan offered by Select Medical Holdings is a retirement savings plan that allows employees to save a portion of their paycheck before taxes are taken out.

Does Select Medical Holdings match employee contributions to the 401(k) plan?

Yes, Select Medical Holdings provides a matching contribution to employee 401(k) accounts, subject to certain limits and conditions.

What is the eligibility requirement to participate in Select Medical Holdings' 401(k) plan?

Employees of Select Medical Holdings are typically eligible to participate in the 401(k) plan after completing a specified period of service, as outlined in the plan documents.

How can employees of Select Medical Holdings enroll in the 401(k) plan?

Employees can enroll in the Select Medical Holdings 401(k) plan by completing the enrollment process through the designated online portal or by contacting the HR department for assistance.

What types of investment options are available in the Select Medical Holdings 401(k) plan?

The Select Medical Holdings 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and other investment vehicles, allowing employees to choose based on their risk tolerance.

Can employees of Select Medical Holdings take loans against their 401(k) savings?

Yes, Select Medical Holdings allows employees to take loans against their 401(k) savings, subject to the terms and conditions of the plan.

What happens to the 401(k) plan if an employee leaves Select Medical Holdings?

If an employee leaves Select Medical Holdings, they have several options for their 401(k) savings, including rolling over the balance into an IRA or a new employer's plan.

Are there any fees associated with the Select Medical Holdings 401(k) plan?

Yes, there may be administrative fees and investment-related fees associated with the Select Medical Holdings 401(k) plan, which are disclosed in the plan documents.

How often can employees change their contribution rates to the Select Medical Holdings 401(k) plan?

Employees can typically change their contribution rates to the Select Medical Holdings 401(k) plan at any time, subject to the plan's guidelines.

Does Select Medical Holdings provide financial education regarding the 401(k) plan?

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

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