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

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

Healthcare Provider Update: Ensign Group Healthcare Provider The Ensign Group primarily operates skilled nursing facilities, assisted living facilities, and memory care services. They are known for providing a diverse range of healthcare services, including rehabilitation and care for patients with chronic conditions. Their operating model emphasizes patient-centered care, and they often partner with various healthcare providers to ensure comprehensive service delivery to their residents. Potential Healthcare Cost Increases in 2026 As the landscape of healthcare continues to evolve, significant premium hikes are anticipated in 2026, particularly for Affordable Care Act (ACA) marketplace plans. With some states forecasting increases exceeding 60%, the loss of enhanced federal premium subsidies could lead to average out-of-pocket costs spiking by over 75% for the majority of policyholders. This surge is attributed to rising medical costs and the record profits reported by major insurers, creating a perfect storm for healthcare consumers facing steep financial challenges ahead. As consumers prepare for 2026, proactive financial strategies will be essential to mitigate the impact of these escalating costs. Click here to learn more

'Ensign Group 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.

'Ensign Group 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 Ensign Group 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 Ensign Group Professionals

For Ensign Group 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 primary purpose of the 401(k) plan at Ensign Group?

The primary purpose of the 401(k) plan at Ensign Group is to help employees save for retirement by allowing them to contribute a portion of their salary on a tax-deferred basis.

Who is eligible to participate in Ensign Group's 401(k) plan?

All full-time employees of Ensign Group who meet the eligibility requirements, such as age and service time, are eligible to participate in the 401(k) plan.

How can employees enroll in the 401(k) plan at Ensign Group?

Employees can enroll in the 401(k) plan at Ensign Group by completing the online enrollment process through the designated benefits portal.

Does Ensign Group offer a company match for 401(k) contributions?

Yes, Ensign Group offers a company match for employee contributions to the 401(k) plan, which enhances the overall retirement savings.

What is the maximum contribution limit for the 401(k) plan at Ensign Group?

The maximum contribution limit for the 401(k) plan at Ensign Group is subject to IRS regulations, which are updated annually. Employees should refer to the latest guidelines for specific limits.

Can employees change their contribution percentage in Ensign Group's 401(k) plan?

Yes, employees can change their contribution percentage at any time during the year by accessing their account through the benefits portal.

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

The Ensign Group 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and other investment vehicles to suit different risk tolerances.

How often can employees make changes to their investments in the Ensign Group 401(k) plan?

Employees can make changes to their investment allocations in the Ensign Group 401(k) plan on a regular basis, typically daily, depending on the plan's rules.

Is there a vesting schedule for the Ensign Group 401(k) company match?

Yes, Ensign Group has a vesting schedule for the company match, meaning employees must work for the company for a certain period before they fully own the matched contributions.

What happens to my 401(k) account if I leave Ensign Group?

If you leave Ensign Group, you have several options for your 401(k) account, including rolling it over to another retirement account or withdrawing the funds, subject to applicable taxes and penalties.

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

Ensign Group offers a 401(k) Savings Plan for its employees, which includes both pre-tax and Roth after-tax contribution options. The eligibility criteria for the plan requires that all full-time and part-time employees aged 18 and above can join the plan on the first of the month following 90 days of service. Employees can contribute up to 90% of their pay on a pre-tax or Roth basis, with the annual IRS contribution limit set at $23,000 for 2024. For employees aged 50 and above, an additional "catch-up" contribution of $7,500 is allowed. Ensign Group matches 25% of the first 2% of compensation contributed by employees, with a vesting schedule of 25% per year of service, reaching full vesting after four years. The plan includes various investment options through Fidelity, including target-date funds tailored to retirement timelines.

Restructuring and Layoffs: In early 2023, Ensign Group announced a restructuring plan aimed at streamlining operations and reducing costs. This move included the consolidation of some facilities and a reduction in workforce, primarily affecting administrative and support roles. The company stated that these changes were necessary to improve efficiency and operational agility.

Ensign Group offered stock options (SO) and RSUs to its employees as part of its compensation package. The company's SO and RSU plans are designed to attract and retain key talent by aligning employee interests with shareholder value. For 2022, the stock options and RSUs were granted to executives and other key employees based on their performance and role within the company.

Ensign Group: Health Benefits Information 1. Official Website Ensign Group Benefits Overview: Ensign Group's official website often outlines employee benefits, including healthcare options. You can usually find detailed information under their "Careers" or "Employee Benefits" sections. Key Terms: Health Savings Account (HSA), Flexible Spending Account (FSA), Preventive Care, Employee Assistance Program (EAP). 2. Glassdoor Benefits Review: Reviews from employees on Glassdoor often highlight the specifics of healthcare benefits, such as health insurance plans, coverage details, and employee satisfaction. Key Terms: Health Insurance Coverage, PPO, HMO, Deductibles, Co-pays. 3. Indeed Employee Reviews: Indeed provides employee reviews and salary information, including insights into healthcare benefits and any recent changes. Key Terms: Medical, Dental, Vision Insurance, Coverage Options, Wellness Programs. 4. LinkedIn Company Updates: LinkedIn can offer updates and posts related to Ensign Group's employee benefits, including any new health initiatives or changes in benefits. Key Terms: Wellness Benefits, Health and Wellness Programs, Employee Health Plans. 5. News Articles Recent News: Look for recent news articles on healthcare benefits or changes at Ensign Group. These articles might discuss new policies, cost changes, or improvements in health benefits. Key Terms: Benefit Enhancements, Policy Changes, Healthcare Coverage Updates. Summary of Recent Employee Healthcare News for Ensign Group: 2022 Updates: Ensign Group has been working on enhancing its healthcare benefits, including improving access to preventive care and expanding wellness programs. They’ve been emphasizing mental health support and telehealth services as part of their comprehensive healthcare offerings. 2023 Developments: In 2023, Ensign Group continued to evolve its health benefits by introducing new flexible spending account options and expanding employee assistance programs. There has been a focus on providing more comprehensive coverage and better support for chronic conditions. 2024 Changes: For 2024, Ensign Group has made adjustments to its health insurance plans, including updates to deductible levels and premium costs. They have also introduced additional wellness incentives and resources to support employee health and well-being.