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

CarMax Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Healthcare Provider for CarMax: CarMax partners with UnitedHealthcare as its primary healthcare provider. This partnership allows CarMax employees to access a variety of health insurance options tailored to meet their healthcare needs. Potential Healthcare Cost Increases in 2026: As we look ahead to 2026, CarMax employees may face significant healthcare cost increases due to rising premiums driven by several factors. The anticipated expiration of enhanced federal premium subsidies, combined with aggressive rate hikes from major insurers, could see some enrollees facing premium increases of up to 75%. This perfect storm of higher medical costs and regulatory changes indicates that families may need to brace for a substantial financial impact, making navigating healthcare options more critical than ever for employees. Click here to learn more

'CarMax 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.

'CarMax 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 CarMax 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 CarMax Professionals

For CarMax 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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Articles you may find interesting:

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 .

What is the 401(k) plan offered by CarMax?

The 401(k) plan at CarMax is a retirement savings plan that allows employees to save a portion of their paycheck before taxes are taken out, helping them prepare for retirement.

Does CarMax match contributions to the 401(k) plan?

Yes, CarMax offers a matching contribution to employees' 401(k) plans, which helps employees grow their retirement savings even faster.

How much can I contribute to my CarMax 401(k) plan?

Employees at CarMax can contribute up to the IRS annual limit, which is adjusted each year. For 2023, the limit is $22,500, with an additional catch-up contribution for those aged 50 and older.

When can I enroll in the CarMax 401(k) plan?

New employees at CarMax are typically eligible to enroll in the 401(k) plan after completing a waiting period, usually within the first few months of employment.

What investment options are available in the CarMax 401(k) plan?

The CarMax 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and other investment vehicles to help employees diversify their portfolios.

How does CarMax's matching contribution work?

CarMax matches a percentage of employee contributions to the 401(k) plan, up to a certain limit, which helps employees maximize their retirement savings.

Can I take a loan from my CarMax 401(k) plan?

Yes, CarMax allows employees to take loans from their 401(k) accounts under certain conditions, providing a way to access funds in case of emergencies.

What happens to my CarMax 401(k) if I leave the company?

If you leave CarMax, you have several options for your 401(k), including rolling it over into an IRA or a new employer's plan, or leaving it in the CarMax plan if permitted.

Is there a vesting schedule for the CarMax 401(k) matching contributions?

Yes, CarMax has a vesting schedule for matching contributions, meaning employees must work for a certain period before they fully own the matched funds.

How can I check my CarMax 401(k) balance?

Employees can check their 401(k) balance through the CarMax benefits portal or by contacting the plan administrator for assistance.

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

Name of Pension Plan: CarMax does not offer a traditional defined benefit pension plan. Instead, CarMax provides retirement benefits primarily through a 401(k) plan. Years of Service and Age Qualification: CarMax does not have a traditional pension plan, so there are no specific qualifications for years of service or age for a pension plan. Pension Formula: There is no pension formula as CarMax does not offer a traditional pension plan. 401(k) Plan Details: Employee Contributions: Employees can contribute a portion of their salary up to the annual IRS limit. Employer Match: CarMax offers a company match up to a certain percentage of the employee's contributions.

Restructuring and Layoffs: In recent months, CarMax has announced a significant restructuring plan, including layoffs across various departments. This move is part of a broader strategy to streamline operations and improve efficiency amid changing market conditions. The layoffs are aimed at reducing overhead costs and reallocating resources to more profitable areas of the business. This restructuring is crucial to address the shifting economic landscape and maintain the company's competitive edge. It’s important for employees and investors to stay informed about these changes due to the current economic volatility, investment uncertainties, and evolving tax and political environments.

CarMax Stock Options (SO) and Restricted Stock Units (RSU): Acronyms: CarMax uses SO for Stock Options and RSU for Restricted Stock Units. Specifics: In 2022, CarMax provided stock options and RSUs to eligible employees, primarily focusing on senior management and key contributors. Availability: Both stock options and RSUs are typically granted as part of the compensation package to high-level executives and sometimes to other employees based on performance and tenure. Acronyms: For CarMax, the acronyms SO and RSU remain consistent. Specifics: In 2023, CarMax continued to offer stock options and RSUs. The grants were aligned with industry standards, aiming to attract and retain talent. Availability: Stock options and RSUs were granted to select employees, with an emphasis on roles critical to the company's strategic goals.

Benefits Overview: CarMax provides a comprehensive benefits package, including medical, dental, and vision insurance. They offer health plans that cover preventive care, medical visits, prescription drugs, and other essential health services. Healthcare Terms/Acronyms: HDHP (High Deductible Health Plan): A plan with higher deductibles and lower premiums, paired with Health Savings Accounts (HSAs). HSA (Health Savings Account): A tax-advantaged savings account used to pay for qualified medical expenses. FSA (Flexible Spending Account): An account allowing employees to use pre-tax dollars for out-of-pocket health expenses.

Additional Articles

Check Out Articles for CarMax employees

For more information you can reach the plan administrator for CarMax at 12800 Tuckahoe Creek Parkway Richmond, VA 23238; or by calling them at +1 800-519-1511.

https://www.irs.gov/ https://www.pbgc.gov/ https://www.businessinsider.com/ https://www.forbes.com/ https://www.reuters.com/ https://www.thelayoff.com/