When it was enacted, the ACA brought new requirements, including an employer mandate, which has prompted many employers to take a hard look at what they were doing—and paying—for employee benefits. While cost-sharing and cost-shifting are common strategies to cope with overall costs, small and midsize employers have been taking an even bigger plunge into self-funded health care plans, which used to be considered an alternative funding method that was only feasible for big companies. As the industry has continued to evolve, self-funding, especially among small groups, has been slowly and steadily rising.