Let's be clear that there is no lawfully present individual in the country that is not affected by health care reform. That includes all individuals (both insured and uninsured) and employers of all sizes (both insured and uninsured).
It is true that employers with fewer than 50 full-time equivalent employees are not subject to the employer mandate and, for those employers, there is no consequence if they decide not to offer insurance.

HOWEVER, if they do offer insurance, as 87% of NJ employers do, they do have to comply with the insurance market reforms to offer a compliant plan.

Some of the highlights of these reforms are:
-No waiting period in excess of 90 days
-Dependent to 26 coverage
-SBC distribution
-No pre-existing condition exclusions
-No coverage rescissions
-Coverage of preventive health services without cost-sharing
-Comprehensive health insurance coverage (Essential Health Benefits requirement)

In the small group market, most of these requirements are handled by the insurance companies. Employers must also make sure they are holding up their end of the bargain. They must be sure to distribute the SBCs, they may not remove essential health benefits (i.e. Pediatric Dental) without replacing them, etc.
There has been a lot of confusion about pediatric dental. Employers offering non-grandfathered small group policies must offer ACA compliant pediatric dental coverage to their employees to be in compliance. To that end, Horizon has recently changed their administration of this benefit to require an employer to show proof of a replacement ACA compliant dental plan before they can remove pediatric dental from the medical offering.

Failure to comply can trigger penalties (under 4980D) to employers of all sizes of $100/day/employee or $36,500 per year, per employee!

There are pediatric dental solutions outside of the medical plans which can be a better value for your groups. We can help you quote those plans with carriers like MetLife. Met's offerings include coverage for adults and braces for kids, both of which are generally excluded from the medical plans' pediatric dental offerings. Also, the rates are generally lower for richer benefits! Since employers have to offer this coverage, we should certainly make sure they are getting the best value.