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

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Sears Holdings Employees: The Health Care Reality Many Retirees Don’t Expect

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Healthcare Provider Update: Healthcare Provider for Sears Holdings Sears Holdings typically provides healthcare benefits to its employees through various insurance plans, often with national insurers such as Aetna, UnitedHealthcare, or Anthem Blue Cross Blue Shield being among the health carriers they have partnered with. The specific providers can vary by location and employee selection during open enrollment periods. Potential Healthcare Cost Increases in 2026 As we progress into 2026, the healthcare landscape is expected to face significant challenges, particularly for employees of Sears Holdings. Forecasts indicate steep premium hikes, with some states imposing increases of over 60%, largely influenced by rising medical costs and the potential expiration of enhanced ACA premium subsidies. The Kaiser Family Foundation highlights that without congressional intervention, millions of marketplace enrollees could see their out-of-pocket costs surge by more than 75%. This convergence of factors threatens to impose a substantial financial burden on both individuals and employers, necessitating proactive strategies to mitigate rising expenses. Click here to learn more

'Sears Holdings employees approaching retirement are often surprised by the health care costs that can still arise after Medicare begins, which is why it's important to evaluate potential medical expenses early so health care planning becomes a thoughtful part of an overall retirement strategy.' – Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement. 

'Many Sears Holdings employees approaching retirement underestimate how health care expenses may continue even after Medicare begins, underscoring the need to consider health care costs as part of broader retirement planning discussions.' – Brent Wolf, CFP®, a representative of The Retirement Group, a division of Wealth Enhancement. 

In this article, we will discuss:

  1. How Medicare impacts retiree health care planning.

  2. Common coverage gaps and unexpected health care expenses.

  3. Why early retirement health care planning matters.

by Brent Wolf, CFP®, Wealth Enhancement

As retirement approaches, many Sears Holdings employees believe that health care expenses may become easier to manage once they reach Medicare eligibility age. However, this assumption can sometimes overlook the complexity of health care costs later in life.

Medicare plays an important role in the U.S. health care system for retirees. Eligibility generally begins at age 65, although some individuals may qualify earlier due to certain disabilities or medical conditions. Many Sears Holdings retirees rely on Medicare coverage as one component of managing health care expenses during retirement.

However, Medicare does not cover every medical cost. Deductibles, premiums, coinsurance, and certain uncovered services remain part of the program. Because of this, retirees—including those who previously worked for Sears Holdings—may still experience out-of-pocket medical expenses even after enrolling in Medicare.

Health Care Expenses May Still Be High

Health issues later in life can create financial pressure for retirees. Depending on the type of treatment required, out-of-pocket expenses may still arise even for individuals with Medicare and other insurance coverage. Sears Holdings employees approaching retirement may find it helpful to become familiar with these potential health care costs earlier in the planning process.

Certain serious medical conditions may require long-term treatment and ongoing care. For example, cancer treatment often involves hospital stays, specialized therapies, and ongoing medical management. Serious illnesses like these can create financial challenges for individuals and families.

Even when insurance plans cover a portion of these expenses, some health care costs may still fall to the patient. Conditions requiring long-term treatment, therapy, or specialized medical support may result in continued financial strain for retirees.

Coverage Gaps That Retirees Need to Know

While Medicare provides valuable coverage, it was never designed to pay for every health care expense retirees may face. For Sears Holdings employees evaluating retirement readiness, understanding these coverage gaps can be an important consideration.

One example is long-term care. Medicare generally does not cover custodial care when assistance with daily activities—such as eating, dressing, or bathing—becomes the primary need. 1  Many Sears Holdings retirees may eventually encounter situations where this type of support becomes necessary.

Medicare also typically does not cover full-time custodial care or 24-hour home care. 2  Certain home health services may be covered if specific eligibility requirements are met, but many services remain outside Medicare coverage.

Because of these limitations, some health care needs later in life may still require significant out-of-pocket spending. For retirees living on a fixed income, these unexpected medical expenses can create financial stress.

Why Retirement Health Care Planning Is Important

Health care needs often increase with age. Research shows that many individuals who reach age 65 will require some form of long-term support during the remainder of their lives. 3  This is why retirement planning discussions among Sears Holdings employees frequently include health care cost considerations.

Planning ahead for health care expenses can help retirees better understand possible financial scenarios in the future. Considering these costs early can provide greater clarity about how health care may affect retirement income.

Planning for health care does not mean medical issues will occur—or that they can always be prevented. However, it may help individuals and families think through potential financial impacts and consider different possibilities that could arise later in retirement.

Greater Awareness Can Increase Confidence

Retirement planning is not about forecasting the future with certainty. Instead, it focuses on developing strategies that help people navigate uncertainty, including future health care needs. Many Sears Holdings employees find that learning about potential risks can support more informed retirement decisions.

Understanding what Medicare covers—and what it does not—can help retirees evaluate how health care expenses may affect retirement income over time. This awareness can be a helpful step when developing a retirement strategy.

Getting Retirement Planning Assistance

Health care planning is an important part of retirement preparation, but it is only one element of a broader financial strategy. Retirement planning for Sears Holdings employees may also include considerations such as longevity risk, income planning, investment strategies, and maintaining stability throughout retirement.

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The Retirement Group can assist with retirement planning discussions if you would like help reviewing your financial strategy. Speaking with a financial professional may provide insight into how different scenarios could influence your long-term retirement plan.

For more information about retirement planning and to discuss your financial goals, call The Retirement Group at  (800) 900-5867 .

Sources:

1. Centers for Medicare & Medicaid Services.  Medicare & You 2026.  U.S. Department of Health and Human Services, 2026,  https://www.medicare.gov/publications/10050-medicare-and-you.pdf .

2. Social Security Administration.  Medicare.  U.S. Social Security Administration, 2026,  https://www.ssa.gov/pubs/EN-05-10043.pdf.  

3. Administration for Community Living.  How Much Care Will You Need?  U.S. Department of Health and Human Services, 18 Feb. 2020,  https://acl.gov/ltc/basic-needs/how-much-care-will-you-need .

How does the Sears Holdings Pension Plan differentiate between normal retirement, early retirement, and late retirement options for Kmart participants? In what ways do these options influence the retirement planning process for employees of Sears Holdings, and what specific considerations should Kmart employees be aware of when choosing one of these retirement paths, particularly in relation to their vested status?

Differentiation of Retirement Options: The Sears Holdings Pension Plan offers distinct options for normal, early, and late retirement. Normal retirement is available at age 65 or after five years of plan participation, whichever is later. Early retirement can be taken from age 55 but before 65, provided the employee is vested, with benefits subject to actuarial reduction unless certain conditions are met (like having at least 90 points, which is a sum of age and years of credited service). Late retirement pertains to any retirement after the normal retirement age, with pensions recalculated to reflect the delay in benefit commencement.

Considering the frozen status of the Sears Holdings Pension Plan, how does this impact the benefits eligibility for Kmart employees, and what implications does it have for their retirement savings strategies? In what ways should current employees factor in this frozen status when evaluating their overall retirement readiness and potential alternatives outside of the company plan?

Impact of Frozen Status: The freezing of the Sears Holdings Pension Plan on January 31, 1996, means that there have been no new accruals of benefits or participants since that date. For Kmart employees, this impacts their benefits eligibility by capping the pension benefits at levels earned up to the freeze date. Employees need to consider this stagnation in benefits when planning for retirement, potentially seeking additional retirement savings avenues to bridge any shortfall.

What are the essential calculations involved in determining the retirement benefits under the Sears Holdings Pension Plan for Kmart employees? Specifically, how do the Career Average Pay and Final Average Pay formulas come into play, and what factors should employees consider when estimating their future retirement payouts?

Essential Calculations for Retirement Benefits: Pension benefits for Kmart employees under the Sears Holdings Pension Plan are calculated using either the Career Average Pay or the Final Average Pay formulas. These calculations take into account an employee's years of credited service and compensation up to the freeze date. Factors like estimated Social Security benefits and specific formulas (such as a deduction based on Social Security benefits under the Final Average Pay formula) play crucial roles in determining the final pension payout.

How can Sears Holdings employees best navigate the process of applying for benefits under the Pension Plan? What specific steps should participants take to ensure their applications are processed correctly, and what important deadlines should they be aware of to avoid any negative consequences on their retirement benefits?

Navigating the Benefits Application Process: To apply for pension benefits, employees must submit a formal application, ideally 30 to 90 days before the intended commencement date. It is crucial to ensure all personal information, including marital status and spouse details, is up-to-date to avoid delays or inaccuracies in benefit processing. Missing application deadlines can lead to postponed benefit payments or unwanted default options.

In what situations can Kmart employees expect to receive a Deferred Vested Pension, and how is the calculation for this pension affected by their previous employment and vesting service? Employees should be aware of the important factors influencing their eligibility and the steps necessary to maintain their retirement benefits after leaving the company.

Eligibility and Calculation for Deferred Vested Pension: A Deferred Vested Pension is available to employees who leave the company after becoming vested but prior to qualifying for retirement. The calculation mirrors that of a normal retirement pension, with possible early commencement reductions. Understanding the timing of benefit commencement and the potential reductions for early start is vital for planning.

How does the Sears Holdings Pension Plan address tax considerations for employees receiving both monthly payments and lump sum payments upon retirement? What tax implications should Kmart participants be aware of, particularly in relation to IRS rules for distributions and potential penalties for early withdrawal?

Tax Implications of Pension Receipt: Pension payments, whether monthly or lump sum, are subject to federal taxes. Monthly benefits are taxed as ordinary income, while lump sums might be eligible for special tax treatments or rollover options to defer taxes. It’s important for Kmart employees to consider these implications and possibly consult with a tax advisor to optimize tax liability.

What are the rights and protections afforded to Kmart participants under the Employee Retirement Income Security Act (ERISA) as they navigate their retirement benefits with the Sears Holdings Pension Plan? How can employees leverage these rights to ensure they are receiving all the benefits to which they are entitled?

ERISA Rights and Protections: Under ERISA, Kmart employees are entitled to certain rights including the ability to appeal denied benefits, access to plan information, and assurances of fair and equitable treatment of their benefits. Leveraging these protections ensures that employees receive all due benefits.

What steps should Kmart employees take to update their personal information to ensure they continue receiving their benefits without interruption, especially in the context of missing participants or uncashed checks? What resources and contacts at Sears Holdings are available to assist with these updates?

Updating Personal Information: Maintaining accurate personal information with the pension plan is crucial for uninterrupted benefit payments. Employees should promptly update changes such as address, marital status, or beneficiaries to prevent issues with benefit distributions or lost checks.

How does the process of transferring between affiliated employers impact pension benefits for Kmart employees under the Sears Holdings Pension Plan? What considerations should be taken into account concerning Credited Service and Vesting Service during such transfers, and how can employees ensure they do not lose any entitled benefits?

Impact of Transfers Between Affiliated Employers: Transferring between Sears Holdings’ affiliated employers can affect pension benefits differently depending on whether the employer participates in the pension plan. It's essential to understand how such transfers impact credited and vesting service accruals.

For Kmart employees seeking more information about their benefits under the Sears Holdings Pension Plan, what is the best way to contact company representatives? How can they effectively communicate their questions or concerns to ensure they receive accurate and timely information regarding their retirement benefits?

Contacting Plan Representatives: Kmart employees seeking clarity on their pension benefits should contact the Sears Holdings Pension Service Center. Effective communication, including prepared questions and necessary documentation, will aid in obtaining accurate and comprehensive information.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Sears Holdings Corporation's pension plans were taken over by the Pension Benefit Guaranty Corporation (PBGC) following the company's bankruptcy. The two defined benefit pension plans have been frozen since 2005, meaning no new benefit accruals are added. The plans are underfunded by approximately $1.4 billion, with PBGC assuming responsibility to ensure pension payments continue. These plans cover about 90,000 participants who worked for Sears, Roebuck and Co., and Kmart Corporation. Despite the underfunding, PBGC is expected to cover the vast majority of pension benefits owed under these plans. Participants can manage their benefits and verify information through PBGC's online platform or service center.
Bankruptcy and Store Closures: Sears Holdings emerged from bankruptcy with significant store closures, reducing from nearly 700 stores to less than 25. The company has been liquidating its remaining assets and recently announced more store closures in 2024. The focus is on resolving bankruptcy-related issues and managing the liquidation process effectively (Sources: The Layoff, Yahoo Finance).
Sears Holdings offered both RSUs and stock options before its bankruptcy. RSUs vested over time, providing shares, while stock options allowed employees to buy shares at a fixed price.
Sears Holdings, now part of Transformco, has faced numerous challenges in recent years, impacting its ability to provide comprehensive employee healthcare benefits. The strategic transformations initiated since 2017 aimed to improve operational performance and liquidity, which included measures such as obtaining additional loan proceeds and real estate sales. However, the company's financial struggles and store closures have also led to significant changes in employee benefits, including healthcare. As part of its efforts to stabilize and restructure, Sears has focused on reducing outstanding debt and pension obligations, contributing almost $4 billion to its pension plan since 2005 due to prolonged low interest rates. In 2023, Transformco continued to navigate its financial challenges, which have influenced its healthcare benefits offerings. The company has aimed to maintain basic healthcare coverage for its employees despite ongoing restructuring efforts. This includes providing access to medical, dental, and vision plans, although the specifics of these benefits and any enhancements over the past years have been less prominently highlighted compared to the broader financial strategies and operational changes. The focus on financial stability and cost reduction remains critical for Transformco as it seeks to ensure the viability of its employee benefits programs amid economic uncertainties.
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For more information you can reach the plan administrator for Sears Holdings at 3333 beverly road Hoffman Estates, IL 60179; or by calling them at 1-800-697-3277.

https://www.pbgc.gov/sites/default/files/documents/sears-holdings-summary-plan-description.pdf - Page 5, https://88sears.com/documents/pension-plan-2022.pdf - Page 12, https://88sears.com/documents/pension-plan-2023.pdf - Page 15, https://88sears.com/documents/pension-plan-2024.pdf - Page 8, https://www.consultrms.com/documents/sep-2022.pdf - Page 22, https://www.revenue.alabama.gov/documents/defined-benefit-plan.pdf - Page 28, https://www.mayoclinic.org/documents/mayo-pension-plan-2023.pdf - Page 20, https://mycentralstatespension.org/documents/annual-funding-notice-2023.pdf - Page 14, https://frs.fl.gov/documents/frs-pension-plan-2023.pdf - Page 17, https://fppta.org/documents/florida-pension-issues-2024.pdf - Page 23

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