So, if you were to ask an insurance broker to prioritize their response to the ACA for 2014, what would they say?

I recently did exactly that, asking four of my colleagues at Gregory & Appel for one idea each for employers in general, and for employers larger than 100 employees in particular. Their responses, in no particular order:

Explore a self-funded plan. Plan flexibility is harder to design with the ACA. Self-funding has significant new advantages in 2014 and beyond, as it means your health plan is not subject to the ACA's community rating requirements, therefore giving firms more flexibility in how you respond to state regulations. This tactic can restore some room to be creative, room that is being removed via the many regulations faced in the fully insured marketplace. Just understand that self-funding (by definition) means you are assuming more risk, and that needs to be a part of your overall risk management strategy.