Health care reform planning checklist.

* Watch the congressional debate to determine whether participation in health care purchasing groups will be required for some employers based on the size of their work forces. Assess the pros and cons of joining the purchasing groups or self-insuring.

* Assess the impact of creating a new benefits package. Compare the cost of your client's or employer's current benefits package with that of the proposed plans. Assess the potential impact of premiums calculated using a community-rating approach. Examine your client's or employer's benefits policies and project any new liability for spouses or dependents.

* Determine the effect of a possible revision of the rules for classifying workers as either employees or independent contractors. Consider whether it makes economic sense to change the work status of some employees (possibly by increasing the percentage of full-time workers compared with part-time workers).

* Examine your client's or employer's human resource and tax department needs. Determine changes in staffing and administrative procedures needed to satisfy new data reporting requirements. Consider the need for and cost of general employee communications, education and implementation.

* Analyze the potential loss of section 125 plans. How would losing the ability to fund medical costs with pretax dollars under cafeteria plans or flexible spending accounts affect other benefits? Could your client or employer continue to offer other pretax benefits, such as dependent care? Might employees demand better health benefits, with lower deductibles and copayments?

* Review the effect of proposed subsidies for early retirees. Does your client or employer have a major retiree liability that could be affected by health care reform proposals? Assess the effect of the government's assumption of early retiree costs--especially on your client's or employer's liability under Financial Accounting Standards Board Statement no. 106, Employers' Accounting for Postretirement Benefits Other Than Pensions. Assess the impact of early retirees' purchasing coverage from regional purchasing groups.

* If your client or employer has operations in several states, consider the impact of possible changes to the Employee Retirement Income Security Act that would weaken the federal preemption of state provisions. Such changes could include permitting states to impose new administrative and tax burdens on self-insured plans and are most likely to be made in states working on their own versions of health care reform.

* Assess the impact of proposals to disallow a portion of employers' deductions for the costs of employee health benefits. Is your client or employer's health plan substantially more costly than a local health maintenance organization plan? If so, the difference may become nondeductible under some health care reform proposals.