Healthcare Provider Update: Healthcare Provider Information for Aetna Aetna, part of the CVS Health family, has been a key player in the Affordable Care Act (ACA) marketplace, providing health insurance plans to individuals and families. However, significant changes are on the horizon for 2026, as Aetna will exit the ACA marketplace in 17 states, impacting approximately 1 million members. This withdrawal is attributed to the company's challenges in maintaining competitiveness and providing value in a rapidly evolving healthcare landscape. Potential Healthcare Cost Increases in 2026 As the healthcare landscape shifts, substantial premium hikes are anticipated for those enrolled in ACA marketplace plans, with projections of up to 75% increases in out-of-pocket costs due to the potential loss of enhanced federal subsidies. In some states, insurers have filed for rate increases exceeding 60%, driven by surging medical costs and the expiration of premium tax credits established under the American Rescue Plan. For Aetna's former members, this change further complicates their healthcare landscape as they seek new insurance options amid heightened financial pressures. Click here to learn more
'Rising health care premiums and the potential loss of ACA subsidies highlight the importance for Aetna employees to begin reviewing budgets and planning ahead for how these costs may affect both household expenses and long-term retirement goals.' – Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.
'With ACA subsidies set to expire and premiums projected to climb, Aetna employees should proactively evaluate their health care costs so they can adapt their household budgets without compromising long-term retirement planning.' – Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.
In this article, we will discuss:
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Why health care premiums are expected to rise sharply in 2026.
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How the expiration of ACA subsidies will affect families and employees.
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Ways households can get ready for these cost changes.
By Wealth Enhancement's Michael Corgiat
In recent weeks, many Aetna employees have begun preparing for potential changes in 2026 health insurance premiums. The Affordable Care Act’s (ACA) expanded subsidies have played a key role in helping households keep monthly costs manageable. These subsidies are set to lapse at the end of this year, creating the possibility of serious budget strains.
Currently, many families pay only a few hundred dollars a month for full coverage. Beginning January 1, those same households may see premiums jump to $1,800 or more per month. 1 Premiums would rise even higher for families whose incomes exceed 250% of the federal poverty level (FPL). 1 For Aetna households, this shift could bring new difficulties in balancing income, health coverage, and retirement contributions.
Why Premiums Are Increasing
The enhanced ACA subsidies were first introduced in 2021 through the American Rescue Plan, then extended by the Inflation Reduction Act through 2025. These provisions were aimed at middle-class families earning too much to qualify for traditional subsidies but still facing rising health care costs. Unless new law is passed, these benefits will end this year.
At the same time, insurers are preparing to raise their base rates for 2026. A report from the Kaiser Family Foundation (KFF) shows the median proposed increase is 18% nationwide. 2 For Aetna employees, losing subsidy support while also seeing higher base rates may impose extra strain in planning out their budgets.
Effect on Individuals
For households, the issue is deeply personal. One couple reported their premium will rise from under $300 to nearly $1,800 next year, 3 forcing hard decisions like cutting back on food, dental care, or other essentials. Aetna families may face comparable trade-offs as premiums climb.
Parents have voiced concern about their children’s coverage, especially as recent policy changes roll back Medicaid expansions. Choices made assuming children remain healthy would need to shift in the event of unexpected illness. This uncertainty makes it hard for families—including those in Aetna households—to plan for the future.
The Broader Picture
This issue is large in scale. In 2025, over 90% of ACA participants made use of enhanced subsidies, with more than 24 million Americans covered through the ACA marketplace. 4 Many in states with high enrollment depended heavily on the extra assistance.
Analysts estimate that if subsidies expire, about 4.8 million Americans could lose coverage in 2026. 1 In some states, for Aetna employees earning around $113,000 per year, a plan that now costs about $112/month with subsidies could cost about $1,600/month without them—nearly $18,000/year. 5
Ways to Get Ready
While what happens in Washington is still uncertain, Aetna employees might consider taking steps now:
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1. Consider High-Deductible Health Plans (HDHPs): Some of these have lower base premiums and, when paired with a Health Savings Account (HSA), provide tax benefits and a way to put aside funds for medical costs.
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2. Revisit Emergency Funds: A robust cash reserve can help cover unexpected medical bills without derailing retirement saving.
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3. Emphasize Preventive Care in 2025: Getting dental work, screenings, and exams done now while subsidies remain in force could reduce costs later.
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4. Adjust Household Budgets: Rising premiums may mean reallocating expenses or finding ways to bring in more income.
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5. Stay Alert When Enrollment Opens: Notices arrive in October, with open enrollment starting November 1. Careful comparison of health plan choices is very important for Aetna households.
Ripples in Other Areas
Higher premiums don’t just affect health coverage—they also ripple into retirement contributions, lifestyle decisions, and overall household resilience. For many Aetna families, higher health care costs may mean cutting back on retirement contributions, changing saving habits, or limiting discretionary spending.
The possible end of enhanced subsidies highlights how fragile the balance is between health care costs and longer-term plans. For many, this is not just about insurance but about preparing for a stable retirement.
Looking Ahead
There is still a chance Congress could extend subsidies and provide relief for millions. Until then, the best path is to plan for increased expenses. As one client said: “It feels like we’re going backward. The ACA made insurance affordable for years, but now we risk losing that progress.” Aetna employees, along with millions of others, are watching as decisions in Washington may heavily impact their household budgets.
Conclusion
The expected 18% increase in base premiums, combined with the end of ACA subsidies, underscores the strong link between health care costs and household budgeting. With over 24 million Americans enrolled in ACA coverage, many—including Aetna families—may face substantial pressure on their finances.
Taking action now through preventive care, comparing plan options, and adjusting budgets may soften the blow. Studies show that adults aged 50 to 64 will be among those hardest hit: close to 5 million people in that age group may see average annual health insurance cost increases of more than $4,000 if premium tax credits lapse. 6
The end of enhanced tax credits feels much like reaching the final stretch of a long journey just as gas prices double. The health plan is still the same vehicle, but every mile now costs more. Aetna households, like millions across the country, may need to rethink how they move forward under these new cost pressures.
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Sources:
1. Urban Institute. ' 4.8 Million People Will Lose Coverage in 2026 If Enhanced Premium Tax Credits Expire ,' by Buettgens, Matthew, Michael Simpson, Jason Levitis, Fernando Hernandez-Lepe, and Jessica Banthin. September 17, 2025.
2. Kaiser Family Foundation (KFF). ' How Much and Why ACA Marketplace Premiums Are Going Up in 2026 ,' by Jared Ortaliza, Matt McGough, Kaitlyn Vu, Imani Telesford, Shameek Rakshit, Emma Wager, Lynne Cotter, and Cynthia Cox. 6 Aug. 2025.
3. KFF Health News. ' Considering a Life Change? Brace for Higher ACA Costs ,' by Julie Appleby. August 12, 2025.
4. KFF Quick Takes. ' More Than 3 in 4 Marketplace Enrollees Live in States Won by President Trump in 2024 ,' by Emma Wager. October 3, 2025.
5. NBC News. ' Families on Obamacare brace for higher health care premiums next year ,' by Berkeley Lovelace Jr.. September 13, 2025.
6. AARP. ' Enhanced Premium Tax Credit Expiration Threatens Affordable Health Coverage for Nearly 5 Million Midlife Adults Ages 50 to 64 ,' by Jane Sung and Ollivia Dean. April 2025.
How does Aetna Inc.'s frozen pension plan affect employees' eligibility for benefits, and what specific criteria must current employees meet to qualify for any benefits from the Retirement Plan for Employees of Aetna Inc.?
Eligibility for Benefits: Aetna Inc.'s pension plan has been frozen since January 1, 2011, meaning no new pension credits are accruing. Employees who were participants before this date remain eligible for benefits but cannot accrue additional pension credits. To qualify for benefits, participants need to have been vested, which generally occurs after three years of service(PensionSPD).
In what ways can employees at Aetna Inc. transition their pension benefits if they leave the company, and what implications does this have for their tax liabilities and retirement planning?
Transitioning Pension Benefits: If employees leave Aetna, they can opt for a lump-sum distribution or an annuity. Employees can roll over their lump-sum payments into an IRA or other tax-qualified plans to avoid immediate taxes. However, direct rollovers must follow the tax-qualified plan's rules. If not rolled over, employees are subject to immediate tax and potential penalties(PensionSPD).
What steps should an Aetna Inc. employee take if they become disabled and wish to continue receiving pension benefits, and how does the company's policy on disability impact their future retirement options?
Disability and Pension Benefits: Employees who become totally disabled and qualify for long-term disability can continue participating in the pension plan until their disability benefits cease or employment is terminated. No additional pension benefits accrue after December 31, 2010, but participation continues under the plan until employment formally ends(PensionSPD).
Can you explain the implications of the plan amendment rights that Aetna Inc. retains, particularly concerning any potential changes in the pension benefits and what this could mean for employee planning?
Plan Amendment Rights: Aetna reserves the right to amend or terminate the pension plan at any time. If the plan is terminated, participants will still receive benefits accrued up to the date of termination, protected by ERISA. Any future changes could impact employees' planning and retirement options(PensionSPD).
How does the IRS's annual contribution limits for pension plans in 2024 interact with the provisions of the Retirement Plan for Employees of Aetna Inc., and what considerations should employees keep in mind when planning their retirement contributions?
IRS Contribution Limits: The IRS sets annual contribution limits for pension plans, including defined benefit plans. In 2024, employees should ensure that their pension contributions and tax planning strategies align with these limits and the provisions of Aetna's pension plan(PensionSPD).
What are the options available to Aetna Inc. employees regarding pension benefit withdrawal, and how can they strategically choose between a lump-sum distribution versus an annuity option?
Withdrawal Options: Aetna employees can choose between a lump-sum distribution or various annuity options when withdrawing pension benefits. The lump-sum option allows for immediate access to funds, while annuities provide monthly payments over time, offering a more stable income stream(PensionSPD).
How does Aetna Inc. ensure compliance with ERISA regulations concerning the rights of employees in the retirement plan, and what resources are available for employees to understand their rights and claims procedures?
ERISA Compliance: Aetna complies with ERISA regulations, ensuring employees' rights are protected. Resources are available through the Plan Administrator and myHR, providing information on claims procedures, plan rights, and how to file appeals if necessary(PensionSPD).
What documentation should employees of Aetna Inc. be aware of when applying for their pension benefits, and how can they ensure that they maximize their benefits based on their years of service?
Documentation for Benefits: Employees should retain service records and review their benefit statements to ensure they receive the maximum pension benefits. They can request additional documents and assistance through myHR to verify their years of service and other relevant criteria(PensionSPD).
How do changes in interest rates throughout the years affect the annuity payments that employees at Aetna Inc. might receive upon retirement, and what strategies can they consider to optimize their retirement income?
Impact of Interest Rates on Annuities: Interest rates significantly affect annuity payments. Higher interest rates increase the monthly annuity amount. Employees should consider the timing of their retirement, especially at the end of the year, when interest rates for the following year are announced(PensionSPD).
If employees want to learn more about their pension options or have inquiries regarding the Retirement Plan for Employees of Aetna Inc., what are the best channels to contact the company, and what specific resources does Aetna provide for assistance?
Contact for Pension Inquiries: Employees can contact myHR at 1-888-MY-HR-CVS (1-888-694-7287), selecting the pension menu option for assistance. Aetna also provides detailed resources through the myHR website, helping employees understand their pension options and benefits(PensionSPD).



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