The clock is ticking for Tommy Cain and thousands of other U.S. employers facing deadlines to make changes to the health insurance they offer their employees under the Affordable Care Act.

Mr. Cain has already met one of the law’s key requirements: offer health insurance to at least 70% of full-time staffers by 2015, or face penalties.

Back in January, he put a no-frills plan in place for his 250 employees. His Gulf Coast grocery chain offers to pay 60% of premiums costs, deducting $25 weekly from the paychecks of those who opt for the coverage.

But his dilemma now is figuring out whether that plan is affordable to those employees, as required under the law. The cost cannot exceed more than 9.5% of employees’ annual salaries, the law says.

With just three months to go before 2015, Mr. Cain is worried that he will be penalized next year if the plan doesn’t meet the technical standard.

As part of its “Faces of the Affordable Care Act” multimedia series, the Journal has been following two small businesses—T. Cain Grocery chain, based in Fairhope, Ala., and Ovenly LLC, a Brooklyn, N.Y., retail and wholesale bakery, to see how they are dealing with the changes they face under the law.

A minority of business owners are considering trimming their head counts below the 50 full-time-worker cutoff or reducing their workers’ hours rather than comply with the requirement, which begins in January for companies with 100 or more employees.

Others have run the numbers and concluded that their best financial move is simply to skip the requirement and instead pay penalties, $2,000 for each full-time worker after the first 30.

But most business owners, including Mr. Cain, are expected to comply or already do, consultants say.

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Jeffrey R. Ungvary President