Employees who participate in employer-sponsored health-insurance plans can expect a 14 percent increase in costs as companies continue to shift the expense of insurance onto the workers, according to the survey, by Towers Perrin, a global human-resources and consulting firm.

Workers can also expect a 2 percent erosion in benefits along with higher co-pays, premiums and deductibles.

Meanwhile, the companies surveyed reported they have been able to shave 2 percent off their average employee cost by negotiating insurance offerings and even changing insurance companies.

The survey of 200 of the nation's largest employers, which covers 4.5 million employees, retirees and dependents, found that workers also will pay more for out-of-pocket costs - that is, medical needs not covered by policies.

The survey included about 20 Ohio companies, which said they anticipate increases in costs per employee of about 9 percent, said Ernie Smith, principal at Towers Perrin, a New York firm that has an office in downtown Cincinnati .

Ohio workers at those companies will shoulder 7 percent increases, about half the national average. The survey did not identify the Ohio companies.

"It's tough to generalize why those Ohio workers will only see a 7 percent increase," Smith said. "Twenty companies may not be statistically significant."

The projected 14 percent increase in health costs in the survey mirrors a report in June from Hewitt Associates that shows HMO rates will increase next year by about 13.7 percent.

That estimate was based on survey results from 1 million employees at 160 companies.

"A lot of usual suspects are driving these costs," Smith of Towers Perrin said.

"Prescription drugs may be the No. 1 perpetrator. It's going up in double digits."

Other factors he cited were increasing use of expensive medical tests, such as MRIs, and rising malpractice insurance costs.

Towers Perrin expects more employer plans in 2005 to reduce their costs by encouraging the use of generic and over-the-counter drugs.

Joseph A. Hinson, president and chief executive of West Chester Chamber Alliance, a regional chamber of commerce based in Butler County, recognizes that executives and workers fret over health-insurance trends:

"There are four key areas that continue to be brought up again and again and again.

"In no particular order, it's transportation, economic development, jobs that are going overseas and the rising cost of health care. It doesn't matter what group of people I talk with, it's the same over and over again. Health care is a huge topic."

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E-mail jeckberg@enquirer.com