'MASSMutual 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 MassMutual MassMutual primarily collaborates with a range of healthcare providers through its employee benefits plans but does not operate a dedicated healthcare provider network itself. Instead, MassMutual provides health insurance options to its employees through various partnerships with leading insurance carriers. Projected Healthcare Cost Increases for 2026 As we approach 2026, healthcare costs are anticipated to increase significantly, with potential premium hikes driven largely by the expiration of enhanced federal subsidies for ACA marketplace enrollees. Experts forecast that Americans could face average increases of over 75% in out-of-pocket premium costs due to these subsidy reductions, alongside aggressive rate increases from major insurers, some of which are as high as 66.4% in places like New York. Furthermore, rising medical costs and inflation are compounding the financial strain on consumers, marking 2026 as a challenging year for healthcare affordability. Click here to learn more
'MASSMutual 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 MASSMutual 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 MASSMutual Professionals
For MASSMutual 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 is the primary purpose of the 401(k) plan offered by MASSMutual?
The primary purpose of the 401(k) plan offered by MASSMutual is to help employees save for retirement in a tax-advantaged way.
How can employees at MASSMutual enroll in the 401(k) plan?
Employees at MASSMutual can enroll in the 401(k) plan through the company’s benefits portal or by contacting the HR department for assistance.
What types of contributions can employees make to their MASSMutual 401(k) accounts?
Employees can make pre-tax contributions, Roth (after-tax) contributions, and possibly catch-up contributions if they are age 50 or older.
Does MASSMutual offer a company match for 401(k) contributions?
Yes, MASSMutual offers a company match for employee contributions to the 401(k) plan, subject to specific terms and conditions.
What is the vesting schedule for the company match at MASSMutual?
The vesting schedule for the company match at MASSMutual typically follows a graded vesting schedule, which means employees earn ownership of the match over a period of time.
Can employees at MASSMutual take loans against their 401(k) savings?
Yes, employees at MASSMutual may have the option to take loans against their 401(k) savings, subject to plan rules and limits.
What investment options are available in the MASSMutual 401(k) plan?
The MASSMutual 401(k) plan offers a variety of investment options, including mutual funds, target-date funds, and possibly company stock.
Are there any fees associated with the MASSMutual 401(k) plan?
Yes, there may be fees associated with the MASSMutual 401(k) plan, such as administrative fees and investment management fees, which are outlined in the plan documents.
How often can employees change their contribution amounts in the MASSMutual 401(k) plan?
Employees can typically change their contribution amounts to the MASSMutual 401(k) plan on a regular basis, often at any time during the year.
What resources does MASSMutual provide to help employees manage their 401(k) investments?
MASSMutual provides various resources, including online tools, educational materials, and access to financial advisors to help employees manage their 401(k) investments.
With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
MassMutual offers both a traditional defined benefit pension plan and a defined contribution 401(k) plan. The defined benefit plan includes a cash balance component, where benefits grow based on years of service and compensation, with interest credits added annually. The 401(k) plan features company matching contributions and various investment options such as target-date funds and mutual funds. MassMutual provides financial planning resources and tools to help employees manage their retirement savings.
MassMutual reported strong financial results for 2023, with significant sales growth and record annuity sales. Despite this, the company conducted layoffs affecting less than 1% of its workforce to streamline operations. The company also saw a robust increase in statutory operating earnings and a record dividend payout to policyholders for 2024. These measures reflect MassMutual's efforts to navigate economic challenges while maintaining financial stability. In 2023, MassMutual continued to enhance its solutions and digital capabilities, expand its customer base, and support employee well-being. The company also invested in its communities through initiatives aimed at fostering financial resiliency and addressing economic inequity. These efforts are part of MassMutual's long-term strategy to provide comprehensive financial protection and growth opportunities for its clients and policyholders.
MASSMutual offers both RSUs and stock options to employees. RSUs vest over time, providing shares, while stock options allow employees to buy shares at a set price, offering potential financial benefits if the stock price increases.
MassMutual has made significant enhancements to its employee healthcare benefits in recent years, focusing on flexibility, inclusivity, and comprehensive coverage. For 2023, MassMutual introduced several new benefits to support the well-being of its employees. Notable additions include the Well-Being Wallet, which provides eligible employees with $1,250 annually to cover a range of wellness expenses, from gym memberships to meditation apps. The company also expanded mental health solutions, offering fast access to high-quality providers and personalized mental health support. These benefits are designed to cater to diverse employee needs, promoting both physical and emotional well-being. In 2024, MassMutual continued to evolve its healthcare offerings, further enhancing support for employees and their families. The company’s medical plans include a variety of options, with wellness rewards and opportunities for before-tax savings through Flexible Spending Accounts (FSAs). Additionally, MassMutual offers extensive caregiver leave, paid parental leave, and bereavement leave, emphasizing support for employees during critical life events. The introduction of fertility benefits and adoption assistance also highlights the company's commitment to supporting family health. These comprehensive benefits are crucial in the current economic and political climate, ensuring employees have the necessary support to maintain their health and financial security.
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