The median deductible for individual coverage under the most popular type of health plan doubled in the past year to $1,000, according to a study of job-based health care costs released Wednesday.

The $1,000 median deductible finding refers to traditional preferred provider organization plans, which cover more than two-thirds of employees enrolled in health plans, Mercer's annual National Survey of Employer-Sponsored Health Plans found.

The finding is surprising because it doesn't include high-deductible plans where a deductible of anywhere from $1,150 to $5,800 is required in order to deposit tax-free money in a Health Savings Account, or HSA.

"The introduction of the HSA may have changed employers' thinking on just how high a deductible can go without causing employees to revolt," said Christopher Watts, head of Mercer's Denver health and benefits business. "Raising the deductible has become the fallback for employers faced with cost increases they can't handle."

The Mercer nationwide survey of 2,900 public and private employers with 10 or more employees found that the total health plan cost per employee rose by 6.3 percent in 2008, in line with annual cost increases for the past three years.

Employers expect costs to rise about 6.4 percent next year, according to the survey, although companies made those projections in August and September before the the financial meltdown began in earnest. Health care costs for employers typically spike during economic downturns because workers worried about their job security often rush to get health care that they otherwise might delay.

Adding to the squeeze, hospitals and health providers must search for ways to recoup losses on investments in the market and the swelling ranks of uninsured patients who can't pay bills.

Higher employee cost-sharing measures like the $1,000 deductible might help stanch that trend this time, Watts said. The PPO deductible tends to be highest among small to midsize employers. In firms with 500 or more employees, the median deductible for individual coverage is $300 and for family coverage is $800.

The survey also found that early-retiree medical coverage is becoming increasingly rare, with just 27 percent of large employers offering it to new hires, compared with 46 percent 15 years ago. The survey data suggest that offering early retirement coverage influences employee retirement decisions: In organizations that offer a retiree medical plan, the average retirement age is three years younger than in those that don't.

"The slowing economy makes the lack of retiree coverage a bigger issue," Watts said. "Companies that hope to reduce their work force through attrition rather than layoffs may find older workers hanging on longer because they don't want to lose health benefits."

Survey findings

$1,000median deductible for individual coverage in PPO plans in 2008, up from $500 last year and $250 in 2000

80% of employers imposed a deductible for PPO coverage this year, up from half of employers in 2000.

6.3% amount the average total health care plan costs per worker rose for employers in 2008

20% of large employers in 2008 offered a high-deductible health savings account or health reimbursement arrange- ment, up from 14 percent

9% of employers with fewer than 500 workers offered an HSA or HRA, up from 7 percent