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When we surveyed benefits professionals early last year, they remained dubious about the Patient Protection and Affordable Care Act, with roughly two-thirds of them predicting the legislation would be scaled down or overturned altogether. Just 12 months later—12 months that included a Supreme Court ruling in favor of PPACA and an Obama victory at the polls—they’ve changed their tune. Now nearly 80 percent of benefits professionals believe PPACA will be implemented fully sometime next time.

Though the formal launch of the public health care exchanges is still months away, new distribution models (including private exchanges in addition to the promised public ones) already have begun to disrupt the benefits marketplace. Producers are bracing for subsidized exchange marketplaces, rating standards, essential health benefits, and several new insurance taxes and fees, all of which go into effect in 2014.

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