Health care premiums for large employers will increase 15 percent on average in 2003 — the biggest year-over-year jump since Towers Perrin began conducting the survey in 1989.

"Employees will be paying more out-of-pocket this year," says Ron Fontanetta, a Towers Perrin principal. "Cost sharing will come in the form of increased monthly contributions, as well as higher deductibles and copayments."

NOTE: There were 268 responses to the survey of mostly Fortune 1000 companies, conducted in August and September 2002.

SOURCE: TOWERS PERRIN, 2003 HEALTH CARE COST SURVEY

Average cost increases: 1993-2003

Great year for some forms of health insurance

Meanwhile, the health insurance industry, as a whole, had a great year last year, according to Weiss Ratings. The companies recorded a 25 percent increase in profits for 2001, earning $4.1 billion for the year, compared to $3.3 billion for 2000. In the map below, Weiss Ratings' estimates of industry profits by state are combined with state population estimates to reveal where insurers were most successful and where they found a more challenging business climate.

HMOs are the exception

The nation's 573 HMOs did not fare so well, posting a 6.87 percent decline, from $1.08 billion in 2000 to $1.01 billion in 2001. It will be interesting to see if consumers will be able to differentiate between HMOs and the rest of the industry when, as Towers Perrin's Fontanetta predicts, they'll be asked to pony up more of their own money.

SOURCE: WEISS RATINGS, WWW.CENSUS.GOV

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