Average annual premiums for employer-sponsored health insurance grew just 3% this year for family coverage, but employees' share of those costs surged 14%, according to a survey released last week.

The 12th annual Kaiser Family Foundation/Health Research & Educational Trust “Employer Health Benefits” survey found that employee contributions for single coverage grew 15% compared with the 5% increase in annual employer premiums.

As a result, employees paid an average of $3,997 toward the $13,770 cost of family coverage and $899 toward the $5,059 cost of single coverage this year. By comparison, employees last year paid an average $3,515 toward the $13,275 cost of family coverage and $779 toward the $4,824 cost of single coverage.

Since 1999, the share of health care premiums paid by employees has increased 159%, while the cost of employer-sponsored health care benefits has grown 138%, according to the study.

Drew Altman, president and CEO of the Washington-based Henry J. Kaiser Family Foundation, attributed the recent surge in employee health care coverage contributions largely to the recession, saying that many employers—Kaiser included—are asking employees to take on a greater share of the health care cost burden so their firms can continue to afford to offer the coverage and perhaps avoid layoffs.

“I think it is a recession survival tactic,” he said during a Thursday news conference in Washington.

“The continued economic downturn is leading to more burden for employees in terms of what they have to pay for their health insurance,” Gary Claxton, vp and director of the Health Care Marketplace Project at KFF, said during the news conference.

Because significant cost-sharing still is permitted under the Patient Protection and Affordable Care Act, Mr. Claxton said he expects the trend of greater health benefit cost-sharing with employees will continue in the next few years.

The survey, however, was unable to gauge the effects of PPACA on employer-sponsored health benefit costs because much of it was conducted before the reform measure became law earlier this year, he said.

While employee contributions to the cost of coverage grew significantly, the scope of that coverage eroded somewhat, Mr. Altman noted.

In particular, the percentage of employees enrolled in plans with deductibles of $1,000 or more grew to 27% this year from 22% last year, while the percentage with deductibles of $2,000 or more for single coverage grew to 10% this year from 7% last year.

“Insurance in this country is gradually changing, becoming less comprehensive, so that what workers get today is less comprehensive than what their parents got,” Mr. Altman said.

In a first during the 2010 survey, respondents were asked whether they review performance indicators on health plans' clinical and service quality. While 34% of employers with 200 or more employees said they reviewed such performance indicators, only 5% of small employers did so.

Megan McHugh, director of research at HRET, described the numbers as “troubling.”

“Employers are not holding health plans accountable for the quality of care” their employees are receiving, Ms. McHugh said. “Firms might simply be choosing health plans based on price.”

Experts also were pessimistic about the findings.

“These data illustrate a trend that has been coming and will only get worse,” Helen Darling, president of the Washington-based National Business Group on Health, said in an e-mail. “Employers' costs are still rising and most of them still pay for 75% to 80% of employees' health benefits and way more than half of their dependents' costs as well.”

“Until all of us drive down the costs of medical care together, including by taking care of ourselves so we don't need so much care, we will have these challenges, and we will not have sustainable job growth either in the private or the public sectors,” she wrote.

“The strong shift in premium contributions reflects increasing desperation on the part of employers to address rising health insurance premiums,” Paul Ginsburg, president of the Center for Studying Health System Change in Washington, wrote in an e-mail. “Despite a relatively small premium increase, the trend of health care becoming less and less affordable continues,” he wrote.

Andrew Webber, president and CEO of the National Business Coalition on Health in Washington, said in an e-mail that the study shows continuation of “a trend that started well before the current recession. The more central issue for employers is not whether increasing cost-sharing for employees continues, but how to do this in a thoughtful way through value-based insurance design strategies.”

Other findings include:

• The percentage of firms offering health care coverage grew to 69%. The increase was the greatest among firms with three to nine workers, growing to 59% from 46% last year. While on the surface this appears to be good news, researchers said the increase was an aberration that could be attributed to the fact that only firms still in business were interviewed, and that most of those that went out of business during the recession did not offer health care coverage.

• Although preferred provider organization plans still dominate with 58% of employees enrolled in them, the percentage of employees enrolled in high-deductible health plans has grown to 13%. Meanwhile, enrollment in health maintenance organizations shrunk to 19%, while point-of-service plan enrollment fell to 8% and traditional indemnity plan enrollment held at 1%.

• Thirty-four percent of employers with 1,000 or more workers offer high-deductible health plans compared with 21% of those with 200 to 999 workers and 15% of those with three to 199 workers.

• The percentage of firms with 200 or more active workers offering retiree health benefits dropped to 28% in 2010 from 30% in 2009.

• Thirty-one percent of employers with 50 or more workers changed their mental health benefits in response to the Mental Health Parity and Addiction Equity Act.

The survey, which was conducted between January and May of 3,143 randomly selected nonfederal public and private employers, is available at www.kff.org/ insurance/8085/index.cfm.