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

Sears Holdings Retirees Face Rising Premiums: Why 2026 Health Care Costs May Challenge Household Budgets

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 facing rising health care costs can benefit from reviewing their broader income and coverage strategies early given that policy changes may create uncertainty.” – Wesley Boudreaux, a representative of The Retirement Group, a division of Wealth Enhancement.

“Sears Holdings employees navigating potential premium increases may find it helpful to reassess their long-term health care and budget plans early, as preparation can provide clearer direction during periods of policy uncertainty.” – Patrick Ray, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How the expiration of enhanced ACA subsidies may affect 2026 premiums.
Why many households are delaying enrollment decisions.
What retirees and pre-Medicare individuals should consider when reviewing coverage options.

Why Many Americans May Have Trouble Paying 2026 Premiums When Health Care Costs Increase

Households that rely on premium subsidies under the Affordable Care Act are preparing for significant changes. Unless Congress acts, the ACA’s enhanced premium tax credits, extended under the Inflation Reduction Act and expanded by the American Rescue Plan, will expire after the 2025 plan year. If these subsidies lapse, estimates show average net premiums may increase by roughly 75–115% in 2026, ¹ creating financial strain for millions of Americans.

“When a household sees its premium rise dramatically, families can be forced into difficult choices about how to allocate limited income,” explains Wesley Boudreaux, a financial advisor at Wealth Enhancement.

Consumer Uncertainty and Enrollment Pressures

Many Sears Holdings households are delaying their 2026 Marketplace enrollment decisions as they wait to see if Congress will renew the enhanced subsidies. Postponing enrollment increases the risk of missing deadlines and entering the new plan year without coverage.

Some states, such as Pennsylvania, estimate that if subsidies end in 2026, nearly one-third of current enrollees may drop coverage. ² These estimates reflect affordability concerns, not confirmed enrollment data.

According to Wesley, households are navigating uncertainty rather than disengaging: “Families must make difficult decisions about their health coverage when premiums rise significantly.”

Less Expensive Options May Have Drawbacks

When premiums climb, some Sears Holdings employees may turn to lower-cost alternatives outside the ACA. However, short-term limited duration insurance and other non-ACA-compliant policies often exclude pre-existing conditions, impose annual or lifetime limits, and may not include guaranteed comprehensive benefits. These gaps may leave individuals exposed to significant medical bills during serious illness.

“Lower premiums only matter if the coverage is there when you need it,” Wesley emphasizes. Many non-ACA policies lack essential health benefits and pre-existing condition protections.

Challenging Decisions for Important Groups

If subsidies are not renewed, households may find themselves evaluating difficult choices:

- Moving to ACA plans with higher deductibles
- Paying substantially more in premiums
- Dropping coverage entirely
- Considering non-ACA options with limited protections

Middle-class families, self-employed individuals, and pre-Medicare retirees may feel the greatest financial pressure if enhanced subsidies disappear.

“Many responsible, hardworking families are severely strained by large premium increases,” observes Wesley.

The Function of Subsidies in a Changing Market

Many households currently benefit from subsidies that may reduce premiums by hundreds of dollars each month. If enhanced subsidies expire, out-of-pocket expenses could increase sharply. Insurers have already priced 2026 plans based on current law, contributing to the “sticker shock” consumers are experiencing, even if Congress ultimately restores subsidies.

In this unsettled environment, reviewing coverage options and planning ahead becomes even more important.

How The Retirement Group Can Assist

For individuals not yet eligible for Medicare—including those leaving the Sears Holdings workforce—health care costs remain a major part of retirement planning.

The Retirement Group can help you review your health insurance choices in the context of your broader retirement income strategy.
Call (800) 900-5867 to speak with someone about preparing for rising health care expenses.

Create a Plan Before Policies Change Again

Marketplace premiums for 2026 reflect a combination of insurer cost increases and legislative uncertainty, and future health care policies may continue evolving. Thoughtful preparation can help households reduce the likelihood of coverage gaps and build a clearer understanding of the alternatives available to them.

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Articles you may find interesting:

Sources:

1. Peterson-KFF. ' How much and why ACA Marketplace premiums are going up in 2026 ,' by J. Ortaliza et al. Aug. 6, 2025.

2. The Hospital and Healthsystem Association of Pennsylvania. “5 Things to Know: Pennie Open Enrollment.” HAP Blog , 30 Oct. 2025, www.haponline.org/News/HAP-News-Articles/HAP-Blog/5-things-to-know-pennie-open-enrollment-1 .

Other Resources:

1. Center on Budget and Policy Priorities. “Five Key Changes to ACA Marketplaces Amid Uncertainty over Premium Tax Credit Enhancements.” Written by Jennifer Sullivan and Nicole Rapfogel, 22 Sept. 2025, www.cbpp.org/research/health/five-key-changes-to-aca-marketplaces-amid-uncertainty-over-premium-tax-credit .

2. Evans, Michael. “2026 Health Insurance Hike Sparks Concern Among Early Retirees: ‘We Cannot Afford This.’” Investopedia , 12 Sept. 2025, www.investopedia.com/2026-health-insurance-hike-sparks-concern-among-early-retirees-we-cannot-afford-this-11808938 .

3. KFF. “Calculator: ACA Enhanced Premium Tax Credit.” KFF, 29 Oct. 2025, www.kff.org/interactive/calculator-aca-enhanced-premium-tax-credit/ .

4. United States Departments of the Treasury, Labor, and Health and Human Services. “Short-Term, Limited-Duration Insurance.” Federal Register , 21 Feb. 2018, www.federalregister.gov/documents/2018/02/21/2018-03208/short-term-limited-duration-insurance .

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.

Additional Articles

Check Out Articles for Sears Holdings employees

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.

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