NU Online News Service, Jan. 15, 12:37 p.m. – Some big companies may attack skyrocketing health insurance costs by getting tougher on employees’ spouses and children, according to a survey by Hewitt Associates L.L.C., Lincolnshire, Ill.

When Hewitt researchers surveyed personnel executives at 500 large U.S. employers, they found that 94% said their companies’ top executives were “significantly” or “critically” concerned about health care costs.

Thirty-seven percent of the companies surveyed might cope by making workers pay a higher percentage of the cost of covering spouses and children, and 31% might require working spouses to elect any health coverage available from their own employers.

Twenty-eight percent of the companies might charge workers more if working spouses fail to accept coverage available from the other employers.

The Hewitt survey also found that 72% of companies would consider adopting “custom design” health plans, which give employees the ability to choose between richer, more expensive benefits and leaner, cheaper benefits, if the plans reduce health coverage expenses or hold them steady.

Another 46% of the employers would consider adopting defined-contribution health plans, which combine high-deductible catastrophic insurance coverage with employee-paid health reimbursement accounts that workers can use to cover the cost of routine medical expenses.