What role do employers play in financing health care coverage? Researchers at the Economic and Social Research Institute first conducted a literature review of writings and research on the employer-based system, which included a review of new designs for the U.S. health care system made by scholars across a broad array of organizations, as well as a review of major national surveys conducted by RAND, the federal government, and others. The literature (and proposals for redesign) on employer financing and contribution policies were also reviewed. The results of the literature review was then used to outline the kinds of issues to address in the employer interview component of the study. The researchers conducted in-depth interviews with 50 to 60 employers to elicit information on what business leaders see as the essential ingredients for reforming the employer based system. They examined questions aimed at understanding how employers view the employer-based system, what problems it creates for them, and how they would respond to a variety of proposals to reform the system, including some that would eliminate the employer’s role. The objectives of the project were to provide policymakers with better information about the strengths and weaknesses of the employer-based system, as well as the implications for the future direction of reform, focusing on whether to repair the current system or replace it with an alternative design.