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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