We've been hearing so much about the avalanche of PPACA changesthat are about to overwhelm us that it's sometimes difficult tomaintain perspective.

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At the small end of the marketplace, those changes will truly bedisruptive as employers (with more than 50 employees) and allemployees (consumers) reorient themselves to the new rules.

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In the mid-market, much attention has been focused on theexceptions. Companies that can lower their full-time headcount toavoid expensive PPACA requirements (through reduction in hours,workforce reduction or other arrangements) have gotten a lot ofpress. Mid-market companies that offer comprehensive medical noware less impacted, although advice from a trusted broker remainsvital. 

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At the large-case end of the market, brokers and consultantswill push their private exchange solutions, often using a definedcontribution approach to bring attention to a platform that's oftenotherwise unremarkable. The title “private exchange” will createinterest for a while. But if they aren't being marketed with a DCapproach, it's likely they won't turn out to be the Great Oz, justa man behind a curtain.

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Still, these private exchanges will lock up some accounts,especially if all ancillary/voluntary products are enrolled onlythrough that mechanism. And for some cases, that might cut outbrokers who focused on offering one-off products to large accounts.But for most large cases, change will be incremental and the bulkof large accounts will not be “locked up”—at least not for theimmediate future.

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So, hype aside, where are we? All employers will need advice,and might need to adjust their benefit plans and approaches. Butthey'll continue on, adding and improving their ancillary andvoluntary offerings and relying on brokers and consultants toassist them. The upheaval will be concentrated in the small/microcases, exceptional circumstances, and those large cases that chooseto lock their offerings into an owned or third-party “privateexchange” platform. The bulk of the traditional market willcontinue to build out their benefit offerings and plans, whilerelying more heavily on advice from their advisors.

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The impact areas get the press and the national attention, butthe bread-and-butter cases, the bulk of the traditional benefitsmarketplace, aren't going away. We need to offer better advice anddo a better job of integrating our PPACA-related, core andvoluntary consulting approaches. But for those who do, there'sopportunity all around us, especially while so many are fixated onthe wizard's smoke and flames.

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