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'Molina Healthcare 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.
Healthcare Provider Update: Molina Healthcare is a prominent healthcare provider that offers a range of health insurance plans, primarily through the Affordable Care Act (ACA) marketplace. In Florida, Molina is proposing a significant rate increase of approximately 41% for individual plans in 2026, which is the highest among competing insurers. This surge in premiums is part of a broader trend expected across the ACA marketplace, where many participants may face increased costs due to various factors including the potential expiration of enhanced federal premium subsidies and rising medical expenses. If enacted, this could lead to substantial financial strain for a large portion of enrollees, particularly those who are reliant on affordable coverage under the ACA. Click here to learn more
'Molina Healthcare 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.
In this article, we will discuss:
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How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.
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Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.
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Practical steps Molina Healthcare 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 Molina Healthcare Professionals
For Molina Healthcare 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:
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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/ .
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2. Centers for Medicare & Medicaid Services. ' Understanding Special Enrollment Periods. ' June 2025.
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Other resources:
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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/ .
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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 .
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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 .
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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 type of retirement savings plan does Molina Healthcare offer to its employees?
Molina Healthcare offers a 401(k) retirement savings plan to its employees.
Does Molina Healthcare match employee contributions to the 401(k) plan?
Yes, Molina Healthcare provides a matching contribution to the 401(k) plan, helping employees maximize their retirement savings.
What is the eligibility criteria for Molina Healthcare's 401(k) plan?
Employees of Molina Healthcare are generally eligible to participate in the 401(k) plan after completing a specified period of service, which is outlined in the plan documents.
Can Molina Healthcare employees choose how much to contribute to their 401(k) plan?
Yes, employees at Molina Healthcare can choose their contribution amount, subject to IRS limits.
What investment options are available in Molina Healthcare's 401(k) plan?
Molina Healthcare's 401(k) plan offers a variety of investment options, including mutual funds and other investment vehicles, allowing employees to diversify their portfolios.
How can Molina Healthcare employees access their 401(k) account information?
Molina Healthcare employees can access their 401(k) account information through the plan's online portal or by contacting the plan administrator.
Are there any fees associated with Molina Healthcare's 401(k) plan?
Yes, there may be administrative fees and investment-related fees associated with Molina Healthcare's 401(k) plan, which are disclosed in the plan documents.
Can Molina Healthcare employees take loans against their 401(k) savings?
Yes, Molina Healthcare allows employees to take loans against their 401(k) savings, subject to specific terms and conditions outlined in the plan.
What happens to Molina Healthcare employees' 401(k) accounts if they leave the company?
If Molina Healthcare employees leave the company, they have several options for their 401(k) accounts, including rolling over to another retirement account or cashing out, subject to tax implications.
Does Molina Healthcare offer financial education resources for employees regarding their 401(k) plan?
Yes, Molina Healthcare provides financial education resources and tools to help employees make informed decisions about their 401(k) savings.
With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Molina Healthcare offers a competitive benefits package that includes both pension and 401(k) plans for its employees. As of 2022, 2023, and 2024, the Molina Healthcare 401(k) plan allows employees to save for retirement with both pre-tax and Roth options. The company matches 100% of employee contributions up to 4% of their salary. Employees are automatically enrolled at a 4% contribution rate. Eligibility for the company match occurs after one year of service, making Molina's retirement plan accessible to full-time employees.
In addition to the 401(k) plan, Molina Healthcare provides a defined contribution retirement plan for employees. This plan does not specify an exact pension formula but is built around employee and employer contributions rather than a traditional defined benefit structure. Full-time employees working a minimum of 30 hours per week qualify for these retirement benefits. Additionally, the Employee Stock Purchase Plan (ESPP) is available, which allows employees to purchase company stock at a discounted rate, further enhancing retirement savings.
The 401(k) and pension plans are managed with a focus on employee participation and long-term financial wellness. These plans are designed to encourage active savings for retirement while offering the flexibility of both traditional and Roth contribution options. Molina emphasizes the importance of long-term service by vesting employer contributions after one year.
Restructuring Layoffs: In 2023 and early 2024, Molina Healthcare announced multiple layoffs as part of their ongoing restructuring efforts. One significant wave involved a 10% reduction in the corporate and health plan workforce, impacting approximately 1,400 employees. This was part of a larger restructuring initiative aimed at reducing operating expenses and aligning the company with the changing healthcare landscape (Molina Healthcare) (Molina Healthcare). Importance: It is critical to address these layoffs because they are happening in a period of heightened economic uncertainty and shifts in government healthcare funding. These workforce reductions may affect service delivery and the overall financial performance of the company, influencing its stock value and investment outlook in 2024.
Molina Healthcare provides its employees with stock-based compensation, including stock options and Restricted Stock Units (RSUs), to align their interests with those of shareholders and incentivize long-term performance. Molina's Employee Stock Purchase Plan allows eligible employees to buy company stock at a 15% discount. RSUs are granted to key executives and senior employees as part of their compensation package, which vests over a multi-year period based on performance targets and continued employment.
In 2022, 2023, and 2024, Molina Healthcare granted stock options and RSUs through its equity incentive plan. These awards are designed for executives and select employees who meet performance criteria. Stock options are priced at the market value on the grant date, and RSUs are granted based on company performance and employee role. In 2023, Molina reported $115 million in stock-based compensation (Molina Healthcare) (Stock Analysis).
Stock options and RSUs at Molina Healthcare are available to senior management and executives, with eligibility determined by job role and performance metrics. The 2024 Proxy Statement and the 2023 Annual Report provide details on the structure of these equity incentives (page 30, Proxy Statement 2024)
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