The Cadillac is coming. Employers who aren't getting up to speed on this funding vehicle for the Patient Protection and Affordable Care Act had best start their engines immediately.

That's the word from consulting firm Towers Watson, which predicts that about half of large U.S. employers will get stuck paying the Cadillac tax, the 40 percent excise tax on their health plans, if they don't begin to look for alternatives now. And that number could nearly double by 2023.

Alternatives do exist, experts say, although they may not fit in with the corporate recruitment/retention strategy. It's one of those pick-your-poisons situations: you can radically redesign the benefits plan, you can make modifications — or you can choose life as usual and just cut a check to the IRS.

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Dan Cook

Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.