"I think what employers would really like from the Legislature is more certainty. Not making laws that, to figure out what it means, you have to go to litigation," David A. Rapuano, a partner with Archer & Greiner, said. "To me, and to my clients, it is bad policy to create laws that cannot be figured out unless a court [is involved]."

The lawsuit, filed on behalf of UnitedHealth's 200,000 current and former employees, alleges CFO John Rex interfered with the company's decision to drop "one of the worst-performing target date options in the entire market."

The Cigna paper suggests that physicians, patients, and health plans tend to recognize the good aspects of VBC, but that change has been slow nonetheless in the private sector.

With so much at stake, how can benefits advisors best collaborate with their employer groups to prevent medical billing errors and fraud in the first place?