What impact do you expect to see as employers are faced with the choice of offering health care insurance to employees or paying a required alternate fee?



Val Fields, director of human resources, Associated Industries: Whether loved or loathed by employers, the acronym PPACA (Patient Protection and Affordable Care Act) has certainly become the most recognizable abbreviation of the decade. However, when asked what changes the PPACA will bring to their company, many employers report they have little information on exactly how health care reform will play out.

Some Associated Industries mem-bers say they view upcoming PPACA changes with trepidation. However, most tell us that our country is headed in the right direction. In fact, employers who currently provide adequate benefit coverage and who employ 50 or more mostly full-time workers tell us they have little concern about PPACA's coming changes. "We haven't yet fallen off the fiscal cliff," explains one such employer, "so we will just take things one step at a time."

In its Post-Election Outlook for HR Public Policy for 2013, the Society for Human Resource Management (SHRM) warns that the PPACA has shortcomings, including "inadequate cost containment measures, namely medical liability reform, and other restrictions on employer-sponsored plans that limit employer plan design." Despite such warnings, we hear that employers feel affordable health care for everyone is beneficial and positive.

"Many companies have struggled to keep up with rising health care costs," explains Andrea Morgan, president of INSHRM, the local SHRM chapter. "The impact on employers," she adds, "is great."

Still, monitoring employee benefits and possible increased costs is a concern to some. "This is a function that has been taken care of through our accounting department and is fairly simple to administer," offers one employer. "Now with all this red tape, I'm afraid I'll have to hire someone to manage our benefits to ensure we're making the best choices financially."

Also concerned with PPACA-related costs, another employer of just under 50 employees says he may offer overtime to current employees rather than being forced to jump into the over-50 employees, government-mandated pool. The PPACA is slated to be fully functioning by 2018, requiring employers to have a good grasp of changes and to build "essential benefits" into their plan.

Teri Barros, vice president of support services at the Inland Northwest Blood Center, credits her level of confidence to her insurance broker who provides continuous updates. That's good advice for all employers.



Bryan Fix, vice president of human resources, Ambassadors Group Inc.: Ambassadors Group is a small public company with headquarters in Spokane. The co-mpany provides international stud-ent educational travel experiences under the brands of People to People and Dis-covery Student Adventures. Local-ly, the company employs about 200 individuals at its Airway Heights campus.

The Ambassadors Group seeks to provide an outstanding employment experience where employees have an opportunity to grow the next generation of global citizens. The lead-in on our employment website says it best, "Every day, I get to be a part of shaping tomorrow's leaders. That's a job worth doing!"

We want to provide competitive and comprehensive medical-benefits plans to our employees so that they can focus on the task at hand. As a smalleremployer, compared with other publicly traded companies, we've taken an aggressive stance with a self-funded, comprehensive PPO-style plan. We feel strongly that we must provide the best benefits that we can afford.

In coming years, this will provide challenges in the face of the increasing fees andexpenses introduced by PPACA legislation. We are now introducing various plan designs beyond the traditional full-featured PPO, such as consumer-driven high-deductible health plan (HDHP) options that provide a choice of lower-cost plans to employees. We are also more aggressively asking employees to participate in wellness initiatives. The struggle in coming years will be to provide full-featured plan designs at a reasonable cost to both employer and employee.

There is additional complexity as we are a national employer and have employees across many states, some of whom are already implementing public health care exchanges. In the end, we believe that health care becomes more of a partnership with well-informed consumers, who happen to be our employees. If our employees wanted to go to an exchange-based medical plan, we would not prevent them. However, I don't expect that we'll pay thepenalties and push our employees to the exchange. That would not be consistent with our values as an employer.

With the help of our broker, Mercer, we will be focusing on managing our health and wellness plans to deliver the highest possible value. We'll continue to actively engage our employees in managing the health care expenses of our self-funded plan through ongoing wellness initiatives.



Josh Neblett, CEO, GreenCupboards Inc.: GreenCupboards has experienced rapid growth since its inception in 2008. As a result, we grew to more than 50 employees last year.

One of our competitive advantages is our winning, employee-empowered and fun company culture that is centered around a team of young, passionate, and tenacious individuals. To maintain this advantage, it only made sense to offer health care benefits to our employees.

Rather than waiting for the government's mandate to start in 2014, we opted to start offering health benefits at the start of 2013. While paying a required alternate fee will be a less expensive option next year compared to offering health insurance to our employees, we see the benefit is well worth the added cost.

Offering health insurance is an investment in our team, their future, and our businesses. We hope by offering benefits, employees will feel more comfortable visiting the doctor for checkups and taking the healthy steps to prevent illness. This will decrease our employees' stress level, benefit their health, and increase their happiness.

Not only will this result in more productive employees but it will also maintain our company culture centered around our employee-empowered team.