We've been hearing so much about the avalanche of PPACA changes that are about to overwhelm us that it's sometimes difficult to maintain perspective.
At the small end of the marketplace, those changes will truly be disruptive as employers (with more than 50 employees) and all employees (consumers) reorient themselves to the new rules.
In the mid-market, much attention has been focused on the exceptions. Companies that can lower their full-time headcount to avoid expensive PPACA requirements (through reduction in hours, workforce reduction or other arrangements) have gotten a lot of press. Mid-market companies that offer comprehensive medical now are less impacted, although advice from a trusted broker remains vital.
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At the large-case end of the market, brokers and consultants will push their private exchange solutions, often using a defined contribution approach to bring attention to a platform that's often otherwise unremarkable. The title "private exchange" will create interest for a while. But if they aren't being marketed with a DC approach, it's likely they won't turn out to be the Great Oz, just a man behind a curtain.
Still, these private exchanges will lock up some accounts, especially if all ancillary/voluntary products are enrolled only through that mechanism. And for some cases, that might cut out brokers who focused on offering one-off products to large accounts. But for most large cases, change will be incremental and the bulk of large accounts will not be "locked up"—at least not for the immediate future.
So, hype aside, where are we? All employers will need advice, and might need to adjust their benefit plans and approaches. But they'll continue on, adding and improving their ancillary and voluntary offerings and relying on brokers and consultants to assist them. The upheaval will be concentrated in the small/micro cases, exceptional circumstances, and those large cases that choose to lock their offerings into an owned or third-party "private exchange" platform. The bulk of the traditional market will continue to build out their benefit offerings and plans, while relying more heavily on advice from their advisors.
The impact areas get the press and the national attention, but the bread-and-butter cases, the bulk of the traditional benefits marketplace, aren't going away. We need to offer better advice and do a better job of integrating our PPACA-related, core and voluntary consulting approaches. But for those who do, there's opportunity all around us, especially while so many are fixated on the wizard's smoke and flames.
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