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'American Family 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: Healthcare Provider for American Family American Family Insurance offers health insurance primarily through its partnership with HealthPartners and other regional health systems, depending on specific plan availability and state regulations. They provide a range of health coverage options, including individual and family plans as part of their broader insurance portfolio. Brief on Potential Healthcare Cost Increases in 2026 As the healthcare landscape evolves, significant rises in Affordable Care Act (ACA) premiums are expected in 2026, with average increases projected at around 20%. This surge is attributed to various factors, including escalating medical costs, the potential expiration of enhanced federal premium subsidies, and aggressive rate hikes from major insurers like UnitedHealthcare, which is requesting increases as high as 66.4% in certain states. Consequently, if these subsidies are not extended, many consumers could experience a staggering 75% increase in their out-of-pocket premiums, pricing out a substantial segment of middle-income families from adequate coverage. As a result, 2025 becomes a crucial year for consumers to proactively strategize to mitigate the financial impacts of skyrocketing healthcare costs. Click here to learn more
'American Family 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 American Family 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 American Family Professionals
For American Family 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 American Family offer to its employees?
American Family offers a 401(k) retirement savings plan to its employees.
Does American Family match employee contributions to the 401(k) plan?
Yes, American Family provides a matching contribution to employee contributions made to the 401(k) plan, subject to certain limits.
What is the eligibility requirement for American Family employees to participate in the 401(k) plan?
Employees of American Family are typically eligible to participate in the 401(k) plan after completing a specified period of service.
Can American Family employees choose how to invest their 401(k) contributions?
Yes, American Family employees can choose from a variety of investment options within the 401(k) plan to tailor their investment strategy.
What is the maximum contribution limit for American Family's 401(k) plan?
The maximum contribution limit for American Family's 401(k) plan is determined by IRS regulations, which may change annually.
Does American Family allow for catch-up contributions in the 401(k) plan?
Yes, American Family allows employees aged 50 and older to make catch-up contributions to their 401(k) plan.
How often can American Family employees change their contribution amounts to the 401(k) plan?
American Family employees can typically change their contribution amounts to the 401(k) plan on a quarterly basis or as specified in the plan documents.
Are loans available from the 401(k) plan at American Family?
Yes, American Family's 401(k) plan may allow employees to take loans against their vested balance, subject to specific terms and conditions.
What happens to my 401(k) balance if I leave American Family?
If you leave American Family, you can choose to roll over your 401(k) balance to another retirement account, cash out, or leave it in the plan if allowed.
Does American Family offer financial education resources for employees regarding the 401(k) plan?
Yes, American Family provides financial education resources 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.
American Family Insurance provides a defined contribution 401(k) plan with company matching contributions. Employees can contribute pre-tax or Roth (after-tax) dollars, and American Family matches a percentage of eligible compensation. The plan includes various investment options, such as target-date funds and mutual funds. Financial planning resources and tools are available to help employees manage their retirement savings.
Layoffs and Restructuring: In October 2023, American Family Insurance confirmed staff reductions aimed at increasing efficiencies across its operations. The layoffs affected various positions, including leadership roles, as the company consolidates areas that provide similar functions across its multiple insurance brands (Sources: Insurance Journal, The Insurer). Financial Performance: The company reported a significant underwriting loss of $1.5 billion in 2022, attributed to inflation and high catastrophe claims. Despite these losses, American Family maintains a strong financial position with plans to reinvest in products and services (Sources: Carrier Management, AM Best). Operational Changes: The restructuring aligns with American Family's strategy to streamline processes and improve cost management, which is essential for sustaining long-term growth and delivering value to customers (Sources: Insurance Journal, The Insurer).
American Family Insurance grants RSUs that vest over time, providing shares upon vesting. Stock options are also part of their compensation, allowing employees to buy shares at a fixed price.
American Family Insurance has consistently enhanced its employee healthcare benefits to adapt to the evolving needs of its workforce. For 2023, the company maintained comprehensive medical, dental, and vision plans. These plans offer a range of services including preventive care, major dental work, and vision care, which covers eye exams, lenses, and frames. Mental health support is also a significant part of the benefits package, with access to counseling services and wellness programs designed to support employees' mental and emotional well-being. These offerings are designed to ensure that employees have access to quality healthcare, promoting a healthier work environment and improving overall productivity. In 2024, American Family Insurance continued to refine its healthcare benefits, placing a greater emphasis on flexibility and comprehensive coverage. The company introduced enhancements such as expanded mental health resources and wellness programs aimed at managing chronic conditions and preventive care. This is particularly important given the current economic and political climate, where healthcare costs are rising and the need for robust employee support systems is critical. The company also provides various options for employees to manage healthcare costs through Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs). By continuously updating its benefits offerings, American Family Insurance ensures that its employees are well-supported in maintaining their health and well-being.
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