There's been a lot of talk – and press coverage – over the last couple of years about employer-based health benefits. Where is it going? How much more will it cost? And will reform kill it altogether? From McKinsey to Willis to our very own surveys, the fate of employer-sponsored health care is a hotly debated one these days.

And it's within this climate the Employee Benefit Research Institute drops its latest take on it. And the outlook is decidedly grim, as least based on these numbers.

For starters and maybe not all that surprisingly, the percentage of workers with coverage has been falling pretty steadily over the last decade. Of course, fewer workers have access to begin with, a huge contributor to drop in coverage.

The bottom line, according to EBRI, is that between 1997 and 2010, the rate employers offered benefits fell to 67.5 percent from slightly more than 70 percent while the coverage rate dropped from 60.3 percent to 56.5 percent.

The interesting twist here, though, is that even the rate at which employees actually accept coverage when it's offered has fallen as well, probably a testament to how tight the economy remains on a personal level. From that same time frame, the number or employees decling coverage – based on cost concerns – jumped from 23.2 percent to 29.1 percent.

So perhaps more than ever before, brokers face a dual challenge when selling employee benefits, because getting into the conference room with employees is just half the battle.

It's also worth noting that despite all sound and fury surrounding the Patient Protection and Affordable Care Act, these falling numbers reflect an era that completely predates that legislation.

Instant Insights /

Employer-based coverage falls

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