Despite all the hullaballoo about health care reform and public health insurance exchanges, less than four in 10 employees at large corporations surveyed even know the exchanges exist. And about 60 percent of those surveyed are unfamiliar with the basics of the Patient Protection and Affordable Care Act.

The survey, conducted on behalf of the National Business Group on Health, was intended to gauge employee knowledge about the reform act. Knowledge was spotty, and, overall, results indicated that big company employees think health care reform will increase their cost for company-sponsored insurance and decrease their coverage over time.

On the plus side, the results suggest that more workers are gaining confidence about their ability to navigate the new health care landscape. Increasingly, the emerging private health insurance exchanges are being viewed as a viable alternative for coverage by the nation's workers.