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The passage of the 2010 Patient Protection and Affordable Care Act (‘ACA’ or ‘Obamacare’) has created a paradigm where companies with fewer than 500 full-time equivalent (‘FTE’) employees have an opportunity to realize substantial benefits by replacing their fully insured medical benefits with self-insured plans. The ACA changes the fully insured market substantially beginning in 2014, but most of the changes do not apply to self-insured plans. As of 2013, 83.9% of private-sector employers with 500+ FTE employees were already self-insured, so the impact of the increased risk sharing is particularly acute in the 100-499 and the 50-99 FTE employee segments, as only 25.3% and 13.3% of these companies are self-insured, respectively1.

1. Source: Agency for Healthcare Research and Quality, Center for Financing, Access and Cost Trends. 2013 Medical Expenditure Panel Survey-Insurance Component.