As the Supreme Court ruled 5-4 to uphold the health care reform law, the various mandates are continuing to move forward, and employers need to be ready for the effects. Specifically, the health care exchange system will be a major change that employers must be ready to deal with, says Lee Doble, CLU, CEBS, managing director of Frank Crystal & Company.

"Smaller employers, which are those with fewer than 50 employees in most states and up to a 100 in other states, will see reduced flexibility in terms of plan offerings and in choices of carriers," Doble says. "This is partially because of the SBC requirement, partially because of the health care exchanges being established and partially because the medical-loss ratio requirement that has caused many insurance carriers that focused on the smaller-employer market to withdraw out of the market altogether."

Large employers could see some implications of the health care exchange system, too, Doble says. In his view, more large employers will offer multiple options. Of these options, the more modest will be designed to promote compliance along with the minimum essential coverage and the affordability requirements.