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

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

Healthcare Provider Update: Healthcare Provider for Gap Inc. Gap Inc., the global apparel retail company, typically provides employee health benefits through various insurance carriers. As of recent data, they predominantly utilize UnitedHealthcare for their healthcare plans. This partnership offers their employees comprehensive coverage options, including medical, dental, and vision plans. Healthcare Cost Increases for Gap in 2026 As we approach 2026, healthcare costs are expected to rise significantly, impacting Gap's overall employee benefits expenditures. Recent projections indicate that premiums for health insurance plans may increase by an average of 20%, with certain states experiencing jumps of 60% or more, primarily due to heightened medical expenses and the potential loss of federal premium subsidies. Consequently, many employees enrolled in Affordable Care Act (ACA) plans might see out-of-pocket costs surge by over 75%, compelling employers like Gap to reassess and potentially adjust their health benefits strategies to mitigate these financial pressures for their workforce. Click here to learn more

'Gap 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.

'Gap 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 Gap 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 Gap Professionals

For Gap 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 Gap's 401(k) plan?

Gap's 401(k) plan is a retirement savings plan that allows employees to save for their future by contributing a portion of their paycheck before taxes are taken out.

How does Gap match employee contributions to the 401(k) plan?

Gap offers a company match on employee contributions to the 401(k) plan, typically matching a percentage of the employee's contributions up to a certain limit.

What are the eligibility requirements for Gap's 401(k) plan?

Employees at Gap are generally eligible to participate in the 401(k) plan after completing a specified period of service, usually within the first year of employment.

Can Gap employees change their contribution rates to the 401(k) plan?

Yes, Gap employees can change their contribution rates to the 401(k) plan at any time, allowing them to adjust their savings based on their financial situation.

What investment options are available in Gap's 401(k) plan?

Gap's 401(k) plan offers a variety of investment options, including mutual funds, stocks, and bonds, allowing employees to choose investments that align with their retirement goals.

Does Gap provide financial education regarding the 401(k) plan?

Yes, Gap provides resources and financial education to help employees understand their 401(k) options and make informed decisions about their retirement savings.

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

Gap employees can enroll in the 401(k) plan through the company’s HR portal or by contacting the HR department for assistance with the enrollment process.

What happens to my 401(k) plan if I leave Gap?

If you leave Gap, you have several options for your 401(k) plan, including rolling it over to an individual retirement account (IRA) or another employer’s plan, or cashing it out.

Are there any fees associated with Gap's 401(k) plan?

Yes, like many 401(k) plans, Gap's 401(k) plan may have administrative fees and investment-related fees, which are disclosed in the plan documents.

How often can Gap employees change their investment allocations in the 401(k) plan?

Gap employees can change their investment allocations in the 401(k) plan at any time, allowing them to respond to market conditions or personal financial changes.

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: Gap Inc. Pension Plan Years of Service and Age Qualification: Eligibility: Employees are generally eligible for the pension plan if they have at least 5 years of service. The retirement age qualification is typically 65 years, but early retirement options may be available with reduced benefits. Pension Formula: 401(k) Plan Details Name of 401(k) Plan: Gap Inc. 401(k) Plan Eligibility: Eligibility: Generally available to employees who meet the minimum service requirements, which is usually one year of service. The plan allows employees to contribute a portion of their salary pre-tax.

In 2023, Gap Inc. announced a significant restructuring plan as part of its efforts to streamline operations and improve profitability. This included a reduction in its global workforce and the closure of several underperforming stores. These changes are part of a broader strategy to adapt to shifting consumer preferences and economic pressures. It's crucial to monitor these developments due to the current economic climate, which impacts employment stability and corporate financial health. The restructuring aims to position Gap Inc. better amidst evolving market conditions, emphasizing the need for employees and investors to stay informed about these changes.

Gap Inc. offered stock options (SO) and Restricted Stock Units (RSUs) to key executives and senior management in 2022. SO typically allowed for purchase at a set price, while RSUs were granted as a form of performance or retention incentive.

1. Gap Official Website Health Benefits Page: The official Gap website typically contains information on employee benefits, including health insurance plans. Specific terms and acronyms used might include "HMO" (Health Maintenance Organization), "PPO" (Preferred Provider Organization), and "HSAs" (Health Savings Accounts). 2. Glassdoor Employee Reviews: Glassdoor often includes employee reviews and feedback on benefits. Look for terms like "medical insurance," "dental coverage," and "vision benefits." 3. Indeed Company Reviews: Indeed provides employee reviews and sometimes includes details on benefits packages. Key terms might be "401(k) match," "healthcare coverage," and "family leave." 4. LinkedIn Company Page: LinkedIn's company page sometimes features posts about benefits and changes. Acronyms like "FSA" (Flexible Spending Account) and "EAP" (Employee Assistance Program) might be mentioned. 5. Benefit News Websites Recent Articles: Websites focused on employee benefits, such as BenefitsPro or Employee Benefit News, may have articles detailing recent changes or updates in Gap's benefits. Summary of Recent Employee Healthcare News: Healthcare Plans: Gap has been known to offer a variety of healthcare plans including PPO and HMO options. Recent changes in 2023 included enhancements to their telehealth services and expansion of mental health resources. Healthcare Terms & Acronyms: PPO: Preferred Provider Organization HMO: Health Maintenance Organization HSA: Health Savings Account FSA: Flexible Spending Account EAP: Employee Assistance Program Recent Changes: 2023: Introduction of new mental health support services and increased coverage for telemedicine visits. 2024: Possible updates to premium rates and network expansions; specific details will be more apparent as official announcements are made. For the most accurate and up-to-date information, you should visit the official Gap website and check recent employee reviews and benefit articles from reliable sources. If you need further details on any specific aspect, let me know!

Additional Articles

Check Out Articles for Gap employees

For more information you can reach the plan administrator for Gap at , ; or by calling them at .

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