What You Need to Know for Open Enrollment 2026
Staff and faculty can enroll in or adjust benefits from Oct. 6-24.
Cigna was selected for its strong performance in a competitive bidding process and positive feedback from other employers that worked with Cigna.
What should covered employees expect because of the change?
The transition to Cigna is intended to be seamless. Existing Duke medical plans—Duke Basic, Duke Select, Duke USA, Duke Options and Cigna Care (formerly called Blue Care)—will remain in place, and Cigna will serve as the single, third-party administrator.
Duke Human Resources Associate Vice President for Total Rewards Joyce Williams. Photo by Travis Stanley.
In addition, a new health plan option, called Duke Advantage, will be added. Duke Advantage is a high-deductible health plan with a health savings account (Duke HSA). The new plan option offers lower monthly premiums but higher out-of-pocket expenses, so it may not be suitable for those with significant healthcare needs.
Decision tools and information will be provided to assist staff and faculty in evaluating their respective health plan choices.
Minimizing provider disruption was a key factor in transitioning to Cigna, and the Cigna network includes nearly all current providers, but some plans may differ.
An online tool will be available on the open enrollment website to allow our staff and faculty to review the provider network to ensure that their provider is already included. Should a favored provider not be listed, there will be additional tools provided to enable employees to request Cigna outreach to their provider.
What broader trends are we seeing nationally that help explain how health insurance costs are evolving for employers and employees?
Contracting with Cigna and Express Scripts helped to moderate the anticipated expenses for 2026. However, the pace of medical and pharmaceutical expenses continues to trend high. Nationally, health care costs are rising by about 10% on average. Some of the main drivers include the growing number and complexity of chronic conditions and the high costs of treating those patients. Nationally, employers are seeing more high-cost claims, especially related to cancer treatment and neonatal care. Add to that medical inflation, rising drug prices, and major—but costly—advances in how we treat serious illnesses.
Each of these factors is contributing to the upward trend in premiums across the country. For 2026, Duke’s monthly premiums for individual health coverage will increase between $4 and $24, depending on the plan selected. Dental premiums will see a modest rise, but there are no changes to copays or deductibles for health, dental, or vision plans, and no increase in vision premiums.
For detailed information about all Duke medical plans and annual open enrollment, visit hr.duke.edu/enrollment2026.