The Affordable Care Act (ACA) established three risk-spreading programs to provide payments to health insurance issuers that cover higher-risk populations and to more evenly spread the financial risk carried by issuers. These programs, which will be effective in 2014, are a transitional reinsurance program, a temporary risk corridor program and a permanent risk adjustment program.

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On Feb. 9, 2012, the Departments of Health and Human Services, Labor and Treasury (Departments) released much-anticipated final guidance on the requirement for health plans and health insurance issuers to provide a summary of benefits and coverageto applicants and enrollees.

As your company has likely experienced, health care costs were expected to rise between 5 and 11 percent in 2011, according to several reputable surveys and research groups.

Several causes were cited, including the slow economic recovery and increased health care utilization; the most notable factor was the cost to implement various health care reform provisions.

Faced with this cost increase and the expectation of continued rising costs, employers shared in these surveys various strategies they were utilizing or considering to control health care costs.