Last year, Michael Taricano faced a...

Last year, Michael Taricano faced a big decision concerning his company's health insurance. The sumptuousness had risen for the past four years, and it was about to rise again for International Manufacturing Solutions, a Nashua, N.H.-based provider of shoe-manufacturing equipment that engages 80 people.

Feeling a heavy responsibility for the company's employee and their families--including any severely ill children--as well as retirees, Chief Executive Officer Taricano knew he had to make a certain quantity of changes. "We had to confirm renewal of Our contract within 30 clays. United Healthcare notified us [that] we had a 52% increase in the