Enterprise level employers generally have integrated the requirements of the Patient Protection and Affordable Care Act into their benefits packages. But small businesses continue to struggle with providing health insurance for employees in the Obamacare era.

A survey of more than 800 small businesses found that fewer small firms offer health coverage today than was the case a year ago, and costs of coverage are rising, sometimes at alarming rates.

The survey, released by the National Small Business Association, revealed high degrees of confusion over details of the law among small business owners.

“Unfortunately, the smallest businesses are in worse shape today than they were just one year ago,” said NSBA President and CEO Todd McCracken. “Just 41 percent of firms with five or fewer employees offer health benefits, down from 46 percent one year ago — less than half that of their counterparts with 20 or more employees.”

Among survey findings:

• Overall offer rates among all small firms fell to 65 percent from 70 percent in 2014;

• 90 percent of respondents reported increases in their health plan premiums;

• 20 percent said the increase exceeded 20 percent;

• 9 percent said they plan to purchase health insurance through the Small Employer Health Options Program (SHOP exchange) or an individual exchange, down from 14 percent last year;

• The average small business owner is now spending as much as 13 hours a month to comply with PPACA.

“We need to focus on growing our businesses, but the increased costs and compliance burden the ACA puts on us only makes that much more difficult,” said NSBA Chair Timothy Reynolds, president of Tribute, Inc. in Hudson, Ohio.