With health care legislation now law, employers are still far from finishing their assessment of how to respond to and implement the necessary changes within the next few years.

To no one’s great surprise, the early adaptors are in the minority.

“Both large and small employers are carefully scrutinizing their options,” says Sally Natchek, senior director of research at the International Foundation of Employee Benefit Plans in Brookfield. “Employers at this point are reacting to the first wave of requirements, knowing they need to make some initial immediate decisions. They are also looking at the next few years and how the timeline of regulations will impact their organizations.”

The International Foundation of Employee Benefit Plans recently conducted a survey of how 1,000 employers are reacting to the health care legislation and the strategies they are implementing within their organizations. Among their findings:

• Only one in five employers plans to immediately extend health care benefits to children up to age 26; 67 percent said they will not extend coverage to dependents up to age 26 until required by law;

• Forty two percent of respondents plan to extend dental plan coverage to adult children in order to match their medical plan requirements; 32 percent plan to extend vision benefits to those adult children. And half (53 percent) are not yet sure what action they will take.

According to the new federal requirements, the new law allows — but does not require — employers to extend vision and dental coverage to children younger than 26 if these plans are offered to employees separately from the medical plan with a separate premium. Employers cannot impose a surcharge of any kind for adult dependents, though they can revisit their premium methodology and adjust costs consistently for dependent coverage.

Moving even further from old coverage requirements, the new law requires coverage of adult children until age 26 without limitations: Full-time student status, marriage restrictions, residency requirements or income limitations no longer apply as long as the adult child is under the maximum age and is a child of the health plan participant.

The only limited exception is that grandfathered plans can exclude coverage for adult children until 2014 if the adult children are eligible to enroll in an employer-sponsored plan other than the plan of either parent. Plans can, however, exclude coverage for a spouse or a child of an adult child.

Natchek notes that many survey respondents have chosen not to make early changes to their health care packages for a simple reason: It’s about dollars.

“Plan changes cost money,” she says. “What many companies are doing right now are looking into what will make them administratively compliant, following the regulations and waiting until their next open enrollment period to implement the new requirements.”

She says that one element that is likely to have been overlooked by the legislators who voted through health care reform are the compliance requirements now needed.

“Bringing all those programs in line for the average business is not an easy task; many do not have the internal staff to do so quickly and efficiently,” she says. “The sheer administration of these new requirements is a challenge for businesses.”

So while the average business is content with the status quo, at least for now, that doesn’t mean that they are avoiding the situation.

Natchek actually believes that smart businesses are taking a more calculated view of the situation.

“We’re getting the feeling that businesses are more interested in putting long-term strategies into effect,” she says. “It’s a big challenge, and they are trying to find the most cost-effective and logical means to ensure correct compliance.”

By Laurie Arendt

Laurie Arendt is editor of CRW. She can be reached at crweditor@crwmag.com