A survey on 791 U. S. employers has revealed that the latest health reform, which will impose an excise tax on high-cost health plans with the enforcement of Patient Protection and Affordable Care Act, has added to their worries.

The employers do not have any idea as to how the act will affect the benefit costs. As the rule will not come into effect until 2018, the concern s of the employers have doubled.

This year, the first two reform directives will be enforced. They are: expansion of coverage for child dependents up to age 26 and prohibition of the use of lifetime benefit dollar limits in individual plans. These two mandates have raised concerns only in one-fifth of the employees observed.

Of the 791 employers being surveyed, 236 employers have less than 500 employees, 354 have 500 to 4,999 employees, and 196 have more than 5,000 employees.

The Government has not provided any details on the "affordable coverage mandate" for all employees working for more than 30 hours per week.

One out of 10 employers said that recent directive is a serious concern. On the whole, one-fifth of them said that they would like to go in for a change in work portfolio in order to reduce the number of people working for more than 30 hours in a week.