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

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

Healthcare Provider Update: Healthcare Provider for Consolidated Edison: Consolidated Edison (Con Edison) primarily utilizes Empire BlueCross BlueShield as its healthcare provider for employee health insurance plans. This offers a range of services including medical, pharmaceutical, and behavioral health benefits for its employees and their families. Potential Healthcare Cost Increases for Consolidated Edison in 2026: As the healthcare landscape changes, Consolidated Edison faces potential challenges with rising health insurance premiums expected in 2026. Experts predict that without the continuation of enhanced federal subsidies, individuals enrolled in ACA marketplace plans may see premium increases exceeding 75%. This surge is driven by escalating medical costs, including hospital and drug prices, which are increasing faster than overall inflation. With major insurers seeking double-digit rate hikes and a significant number of enrollees expected to face higher out-of-pocket costs, Consolidated Edison employees may need to prepare for heightened financial pressures related to their healthcare coverage in the upcoming year. Click here to learn more

'Consolidated Edison 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.

'Consolidated Edison 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 Consolidated Edison 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 Consolidated Edison Professionals

For Consolidated Edison 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 Consolidated Edison?

The 401(k) plan offered by Consolidated Edison is a retirement savings plan that allows employees to save a portion of their salary on a tax-deferred basis.

How can employees enroll in the Consolidated Edison 401(k) plan?

Employees can enroll in the Consolidated Edison 401(k) plan by completing the enrollment process through the company’s HR portal or by contacting the HR department for assistance.

Does Consolidated Edison offer a matching contribution to the 401(k) plan?

Yes, Consolidated Edison offers a matching contribution to the 401(k) plan, which helps employees increase their retirement savings.

What is the maximum contribution limit for the Consolidated Edison 401(k) plan?

The maximum contribution limit for the Consolidated Edison 401(k) plan is in line with IRS guidelines, which are updated annually. Employees should check the current limits for the year.

Can employees take loans against their 401(k) savings at Consolidated Edison?

Yes, Consolidated Edison allows employees to take loans against their 401(k) savings, subject to certain terms and conditions.

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

The Consolidated Edison 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.

Is there a vesting schedule for the employer match in the Consolidated Edison 401(k) plan?

Yes, there is a vesting schedule for the employer match in the Consolidated Edison 401(k) plan, which determines how much of the employer contributions employees are entitled to based on their years of service.

How can employees check their 401(k) balance with Consolidated Edison?

Employees can check their 401(k) balance with Consolidated Edison by logging into the retirement plan portal or by contacting the plan administrator.

What happens to the 401(k) savings if an employee leaves Consolidated Edison?

If an employee leaves Consolidated Edison, they have several options for their 401(k) savings, including rolling it over to another retirement account, cashing it out, or leaving it in the Consolidated Edison plan if eligible.

Are there any fees associated with the Consolidated Edison 401(k) plan?

Yes, there may be fees associated with the Consolidated Edison 401(k) plan, which can include administrative fees and investment-related fees. Employees should review the plan documents for detailed information.

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

Consolidated Edison offers a traditional pension plan under the Final Average Pay and CECONY Career Average formulas, which include a Cost-of-Living Adjustment (COLA) to help protect retirement income against inflation. Employees who retired under these formulas receive an automatic COLA, but this does not apply to those under the cash balance formula or hired after June 26, 2005, in certain unions. The pension plan details, including service years and age qualifications, are outlined in the company’s retirement plan documents. Consolidated Edison’s 401(k) plan is managed by Vanguard, offering various investment options. The plan includes employer contributions and is available to all eligible employees. For detailed specifics, refer to the company's 2023 retirement plan documents

Restructuring Layoffs and Company Changes: Consolidated Edison has been actively managing its workforce and financial strategies in response to the evolving energy market. In early 2024, the company announced various structural adjustments, including potential layoffs, to streamline operations and adapt to clean energy initiatives. These actions are critical to address due to the current economic conditions, political pressures to shift towards sustainable energy, and the necessity of maintaining investor confidence amidst market fluctuations. Addressing these workforce adjustments is essential in the current investment climate.

Stock Options: Con Edison provides its employees with stock options, allowing them to purchase shares at a predetermined price. This option becomes valuable if the company's stock price increases over time. The acronym commonly used for these options within the company is ESO (Employee Stock Options). Restricted Stock Units (RSUs): RSUs are awarded to employees as a form of compensation. These units represent a promise to deliver company shares to employees upon meeting certain conditions, such as continued employment over a specific period. The RSUs granted by Con Edison typically vest over a few years, ensuring long-term employee commitment. The RSUs are denoted internally with the acronym RSU.

Healthcare Plans: Con Edison offers comprehensive health benefits through providers like Cigna and CVS Health. For 2024, the Cigna Open Access Plus Copay Plan is a prominent option for retirees under 65 and those who are Medicare-eligible. This plan includes coverage for hospital stays, outpatient services, routine preventive care, and emergency room visits. The benefits also extend to vision care, with coverage for routine eye exams and glasses every 24 months. Cost Management: To manage increasing healthcare costs, especially under Medicare, Con Edison has emphasized the importance of selecting appropriate coverage during open enrollment periods. The company has adjusted its offerings over the years, such as discontinuing the Aetna Non-Medicare plan after 2023 and limiting new enrollments in certain HMOs. Healthcare-Related Acronyms: Specific terms used by Con Edison include "HMO" (Health Maintenance Organization), "PPO" (Preferred Provider Organization), and "FSA" (Flexible Spending Account), which are essential for understanding the various health plan options and associated benefits.

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For more information you can reach the plan administrator for Consolidated Edison at 4 Irving Place New York, NY 10003; or by calling them at (212) 460-4600.

https://www.retirees.coned.com/en/benefits/cost-of-living-adjustment https://www.thelayoff.com/t/ulNi6Yn https://conedison.gcs-web.com/proxy-0 https://pitchbook.com/profiles/company/41385-52 https://www.theretirementgroup.com/featured-article/5448106/how-consolidated-edison-employees-can-manage-healthcare-cost-increases https://www.emparion.com/ https://www6.lifeatworkportal.com/slogin/edison/pdf/GY5_H12_H20_2024_Benefits_Enrollment_Guide_Flex.pdf