The cost of health care coverage seems to know no bounds.  Year-to-year premium increases are often dramatic.  In an effort to attract and retain employees, employers often absorb the larger portion of these increases, passing through as little as possible to their employees.  Even though employers are typically able to deduct the cost of group medical coverage as an allowable business expense, they continue to see erosion in the affordability of quality coverage.  Despite the “before tax” treatment of group health care expenses, drastic measures—such as cost shifting, benefit reductions, and budget reallocations—are becoming increasingly necessary.   Simply put, the “old way” is giving way.  “Managed Care” has largely run its course and has proven relatively ineffective in the face of health care reform.  A new value-based system is desperately needed, whereby employees are empowered to help employers contain costs and maintain benefit levels.  Education and incentives to maintain wellness are the keys to make a successful transition to this “new initiative”.