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

Arthur J. Gallagher Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Healthcare Provider for Arthur J. Gallagher Arthur J. Gallagher & Co. is a global insurance brokerage and risk management firm that offers various healthcare-related solutions, including employee benefits and health insurance services. Their healthcare practice focuses on assisting businesses with health insurance needs, compliance, and cost management solutions. Healthcare Cost Increases in 2026 As healthcare costs continue to escalate, the outlook for 2026 indicates a troubling trend for consumers seeking coverage through the Affordable Care Act (ACA). With potential premium increases soaring by over 60% in certain states, many individuals may find their out-of-pocket costs rising dramatically. If enhanced federal premium subsidies are not extended, an estimated 92% of ACA marketplace enrollees could face skyrocketing premiums, potentially increasing by more than 75%. This perfect storm of market pressures may leave millions scrambling to secure affordable care as both insurers and policymakers navigate a challenging economic landscape. Click here to learn more

'Arthur J. Gallagher employees approaching retirement should recognize that proactive income and health care planning can make the difference between preserving subsidy eligibility and facing sharply higher ACA premiums.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Arthur J. Gallagher employees planning their retirement should consider how income levels influence ACA subsidies, as even small adjustments in taxable withdrawals can affect future health care affordability.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.
Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.
Practical steps Arthur J. Gallagher professionals can take before enrolling in 2026 Marketplace plans.

by Brent Wolf, CFP®, Wealth Enhancement

As open enrollment for 2026 Marketplace plans begins, many households are seeing dramatic shifts in their renewal letters. Rising base premiums and the possible end of enhanced subsidies after 2025 could mean significantly higher out-of-pocket costs for anyone purchasing coverage through the Affordable Care Act (ACA) exchange.

The Kaiser Family Foundation (KFF) estimates that if Congress does not extend enhanced premium tax credits, average net premium payments could more than double in 2026. ¹

“It feels like a second mortgage to pay this premium.”

Profile: A couple in their early 60s who retired a few years before becoming Medicare-eligible.

What changed: Their ACA premium had been manageable due to increased subsidies. Their renewal now indicates a rise of about $1,000 to $1,200 monthly if enhanced credits expire.

Decision pressure: They faced hard choices—drawing more taxable income from IRAs, going without coverage, or returning to the workforce for employer-based insurance.

Our response: We reworked their income plan to align with the ACA’s income-based subsidy structure. By controlling their Modified Adjusted Gross Income (MAGI) through smaller IRA withdrawals, use of cash reserves, and partial Roth conversions, we kept them eligible for key subsidies. Comparing a Bronze high-deductible plan with a health savings account (HSA) to a Silver plan revealed the Silver plan—thanks to cost-sharing reductions—was more economical given their expected medical treatments.

“I can’t risk losing coverage while battling an illness.”

Profile: A single client in her early 60s undergoing ongoing medical treatment.

What changed: Without enhanced subsidies, her premiums nearly tripled.

Decision pressure: Balancing affordability with the need to keep her care team and prescriptions consistent.

Our response: We prioritized staying with her provider network and controlling her out-of-pocket costs. A dedicated “medical reserve” fund—equal to one year’s maximum out-of-pocket limit—gave her a cushion without liquidating investments during market declines. We also worked with her physicians to identify lower-cost prescriptions through her plan’s formulary.

“The new premiums are hurting our business margins.”

Profile: A self-employed couple—one partner managing asthma and the other a cardiac rhythm condition.

What changed: Without subsidies, their net premiums are expected to rise sharply.

Decision pressure: Continue paying high premiums, choose a plan with a very high deductible, or seek W-2 employment for benefits.

Our response: We compared total annual costs for a Silver plan versus a Bronze option, factoring in frequent specialist visits and prescriptions. Once total medical costs were considered, the Silver plan proved more cost-effective. We also aligned their life and disability coverage and tailored their tax approach to reflect potential changes in premium tax credits.

“I’m young and healthy—do I even need full coverage?”

Profile: An independent contractor in their 20s with minimal expected medical use.

What changed: Premiums for mid- and high-tier plans nearly quadrupled.

Decision pressure: Choosing between a high-deductible Bronze HSA plan and catastrophic coverage.

Our response: We modeled three options—a Bronze HSA-eligible plan, a mid-tier plan, and catastrophic coverage. The Bronze HSA option offered the best mix of lower premiums and long-term tax benefits. Monthly automated HSA contributions build a future medical fund that can later be used for qualified health care expenses or Medicare premiums (excluding Medigap) after age 65.

Five Steps to Take Before You Enroll

1. Evaluate your total annual cost, not just the premium. Factor in deductibles, copays, and the possibility of reaching your out-of-pocket maximum.

2. Manage your MAGI carefully. ACA subsidies depend on income. Coordinate Roth conversions, capital gains, and IRA withdrawals strategically.

3. Verify your doctor and prescription coverage. Always confirm your plan’s provider network and formulary before enrolling.

4. Maintain a medical reserve fund. Hold six to 12 months of premiums plus a portion of your maximum out-of-pocket in cash or short-term Treasuries.

5. Finalize your plan by December 15. Open Enrollment for 2026 coverage ends on December 15, with plans effective January 1.

If Affordability Is a Concern

Choosing to go without insurance can expose you to serious financial strain in case of illness or accident. Consider the most affordable Bronze plan that still meets ACA minimum coverage requirements. If your income decreases during the year, you may become eligible for Medicaid or CHIP and qualify for a Special Enrollment Period. ²

How The Retirement Group Supports Arthur J. Gallagher Professionals

For Arthur J. Gallagher employees approaching or already in retirement, the intersection of rising health care costs and income planning can be complex. The Retirement Group focuses on helping clients navigate ACA subsidy rules, tax-efficient withdrawal strategies, and health care cost planning during retirement transitions.

To speak with an advisor about aligning your retirement income and health care planning, call (800) 900-5867 today.

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Sources:

1. Cox, Cynthia, et al. “ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Expire.” Kaiser Family Foundation (KFF) , 2025, pp. n.p., https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/ .
2. Centers for Medicare & Medicaid Services. ' Understanding Special Enrollment Periods. ' June 2025.
Other resources:
1. “When Can You Get Health Insurance? | Dates & Deadlines.” HealthCare.gov , U.S. Centers for Medicare & Medicaid Services, n.d., https://www.healthcare.gov/quick-guide/dates-and-deadlines/ .
2. Publication 969: Health Savings Accounts and Other Tax-Favoured Health Plans. Internal Revenue Service, 2024, pp. 8–9, https://www.irs.gov/pub/irs-pdf/p969.pdf .
3. “Silver vs. Bronze Plan Selection: Cost-Comparison Scenarios.” Centers for Medicare & Medicaid Services (CMS) , 23 Dec. 2024, pp. 1–3, https://www.cms.gov/files/document/silver-vs-bronze-cost-comparison-scenario-resource.pdf .
4. Murphy, Tom. “Expect Health Insurance Prices to Rise Next Year, Brokers Say.” AP News , Associated Press, 24 Aug. 2025, https://apnews.com/article/health-insurance-drug-costs-2026-rates-c4d865ec09c7088ecc6b55dc520f3566 .

How can Gallagher, Flynn & Company LLP assist employees in understanding the advantages and disadvantages of cash balance retirement plans compared to traditional pension plans, and what factors should employees consider when determining which plan might be more beneficial for their unique financial situations within Gallagher, Flynn & Company LLP?

Understanding the advantages and disadvantages of cash balance plans: Gallagher, Flynn & Company LLP helps employees understand the benefits of cash balance retirement plans by comparing them to traditional pension plans. Cash balance plans offer higher contribution limits and more retirement savings while also reducing tax liability. However, employees must consider that cash balance plans distribute benefits evenly across all working years, which could lead to lower benefits than traditional pension plans that focus on the highest earning years(Gallagher_Flynn_Company…).

As an employee of Gallagher, Flynn & Company LLP, what specific criteria should individuals meet to be eligible for participation in a cash balance retirement plan, and how does Gallagher, Flynn & Company LLP ensure compliance with these criteria to maintain the planâ€™s integrity?

Eligibility for participation in a cash balance plan: Employees at Gallagher, Flynn & Company LLP must meet specific criteria to participate in cash balance retirement plans. These criteria typically involve employer contributions of 5-8% of the employee's salary. The company ensures compliance with contribution regulations by maintaining consistent cash flow to meet the annual contribution requirements(Gallagher_Flynn_Company…).

What are the current IRS contribution limits for cash balance retirement plans in 2024, and how does Gallagher, Flynn & Company LLP implement these limits to maximize the retirement savings of its employees, particularly those nearing retirement age or with higher incomes?

IRS contribution limits in 2024: The IRS contribution limit for cash balance plans in 2024 is over $200,000 for participants aged 60 or over. Gallagher, Flynn & Company LLP implements these limits by allowing employees to contribute significant amounts, especially those nearing retirement, helping them maximize their retirement savings while reducing their tax burden(Gallagher_Flynn_Company…).

In what ways can employees of Gallagher, Flynn & Company LLP expect their retirement benefits to be calculated under a cash balance pension plan, and how do the different factors affecting this calculation impact long-term financial planning for employees?

Retirement benefits calculation under a cash balance plan: Retirement benefits in a cash balance plan at Gallagher, Flynn & Company LLP are calculated based on the percentage of the employee’s salary credited to their account each year, plus an interest credit. This structure allows employees to plan for long-term financial stability, although it may result in lower overall retirement benefits compared to traditional pension plans due to the even distribution of contributions(Gallagher_Flynn_Company…).

What steps does Gallagher, Flynn & Company LLP take to communicate updates or changes in cash balance retirement plan regulations, and how can employees stay informed about their rights and obligations under these plans?

Communication about plan updates: Gallagher, Flynn & Company LLP regularly communicates updates and changes in cash balance retirement plan regulations through company-wide communications and financial advising services. Employees are encouraged to stay informed by contacting the company’s financial advisors or reviewing regulatory updates to understand their rights and obligations(Gallagher_Flynn_Company…).

Can you elaborate on the specific tax benefits associated with cash balance retirement plans that are offered by Gallagher, Flynn & Company LLP, and how these benefits compare to those available through other retirement plans?

Tax benefits of cash balance plans: Cash balance retirement plans at Gallagher, Flynn & Company LLP offer significant tax benefits by allowing for higher contribution limits than traditional 401(k) plans. These higher limits enable employees to lower their taxable income, making these plans advantageous for employees seeking to minimize tax liabilities and increase retirement savings(Gallagher_Flynn_Company…).

How does Gallagher, Flynn & Company LLP support employees who are considering transitioning from a traditional pension plan to a cash balance retirement plan, and what resources are available to facilitate this decision-making process?

Support for transitioning to a cash balance plan: Gallagher, Flynn & Company LLP provides resources and personalized financial advising to employees considering a transition from a traditional pension plan to a cash balance plan. The company ensures that employees understand the benefits and limitations of both plans, offering guidance to facilitate informed decisions(Gallagher_Flynn_Company…).

What strategies does Gallagher, Flynn & Company LLP recommend to employees who are in a position to "catch up" on their retirement contributions, particularly for those over the age of 40, to take full advantage of the higher limits associated with cash balance retirement plans?

Catch-up contributions: Employees over 40 at Gallagher, Flynn & Company LLP can take advantage of catch-up contributions due to the higher contribution limits of cash balance plans. The company recommends that older employees maximize these contributions to enhance their retirement savings and benefit from the associated tax advantages(Gallagher_Flynn_Company…).

How does Gallagher, Flynn & Company LLP determine the annual employer contribution rates for its cash balance retirement plan, and what factors influence the sustainability of these contributions in the long-term financial health of the company and its employees?

Annual employer contribution rates: Gallagher, Flynn & Company LLP determines the employer contribution rates for cash balance plans based on a percentage of employee salaries, typically ranging from 5-8%. These contributions are influenced by the company’s financial stability and commitment to providing robust retirement benefits for long-term employee financial health(Gallagher_Flynn_Company…).

If an employee at Gallagher, Flynn & Company LLP has additional questions about the cash balance retirement plans and needs further assistance, what are the best ways for them to contact Gallagher, Flynn & Company LLP to receive tailored guidance or information?

Contact for further assistance: Employees at Gallagher, Flynn & Company LLP who have additional questions about the cash balance retirement plans can contact the company through their financial advisors or reach out to their local offices for tailored guidance and support. The company’s financial team is available to provide personalized information and assistance as needed(Gallagher_Flynn_Company…).

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

Arthur J. Gallagher recently announced a series of restructuring efforts aimed at streamlining operations and improving efficiency. This includes significant layoffs and changes to employee benefits. Given the current economic volatility and the evolving tax and investment climate, it is crucial to stay informed about these developments to navigate potential impacts on retirement planning and investment strategies.

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