Employer satisfaction with their health insurers is on the decline, according to a new study from PricewaterhouseCoopers' Health Research Institute.

The report found overall satisfaction among large employers has decreased 5 percent since 2008. Satisfaction among small employers remains steady, but PricewaterhouseCoopers points out the gap between large and small employers is narrowing as large employer satisfaction erodes–large employer satisfaction is at 59 percent, only slightly above the 52 percent indicated by small employers.

The report looks at nearly 250 employers and how they viewed health plans in 2009 in 12 key service areas across four main categories: financial, customer service and claims administration, use of technology and population health management and builds on research started by PricewaterhouseCoopers in 2008.