Health insurance costs will go up again next year, though not the double-digit hikes we saw earlier in this decade. Once again, some of the costs will come out of workers' pockets. The cost of health benefits has been going up about six percent in the last few years, and HR benefits experts Mercer in its preliminary forecast for 2009 predicts a slightly lower increase next year, 5.7 percent, the lowest in more than a decade.

"It's a relief to see cost growth trending down, even slightly," Blaine Bos, a senior Mercer health and benefits consultant based in Minneapolis, said in a statement released by the company. "But this is not an unqualified success story. While some employers are holding down cost growth with innovative methods of improving health care quality and efficiency, more typically employers struggling with increases they can't handle resort to the tried and true method of shifting cost to employees."

That means higher deductibles, copayments, coinsurance and out-of-pocket spending for workers. From 2003 to 2007, the median family deductible for in-network services in a PPO (the type of plan offered by the most employers) rose from $1,000 to $1,500.

About one in five said they will add a consumer-directed health plan (CDHP), which is a high-deductible plan with an employee-controlled spending account in an attempt to bring down costs.