Typical large and midsize U.S. employers are seeing health coverage costs increase about 9% this year, but 9.6% have succeeded at making health costs fall or hold steady.

The employers with stable health costs said their costs are falling or holding steady even before taking the effects of plan changes into account, according to researchers at the consulting arm of Aon Corp., Chicago.

The researchers included those results in a summary of results from a recent benefits and talent survey that drew on responses from 2,172 employers. About 57% of the participating employers have 501 or more employees.

Only 6.3% of the participating employers said their health costs are increasing 20% or more this year, before plan changes, researchers write.

Participating employers are considering many different health management and wellness options, such as encouraging employees to exercise more, to cut costs, but many are hostile toward the idea of cutting costs by shifting to account-based health plan designs or reducing the scope of family coverage options.

About 25% said they are not planning to restrict coverage for spouses, 32% said they are not planning to offer consumer-driven health plans on a full-replacement basis, and 24% said they are not planning to offer consumer-driven health plans even as an option.

Some other ideas rejected by 25% or more of the participants include setting up an on-site fitness center or medical clinic, buying coverage through a coalition, self-insuring, linking health coverage contributions to salary, and offering wellness program participation incentives of $300 or more per employee.

Aon researchers also found that the idea that a shift to account-based health plans might create opportunities for independent newcomers was mistaken.

Blue Cross and Blue Shield plans and the 3 largest insurers outside of the Blue Cross/Blue Shield universe administer about 77% of the Aon survey participants’ consumer-driven health plans.

The claims administration market concentration is even higher for CDH plans than it is for the market as a whole, the Aon researchers report.

The Blues and the 3 largest non-Blue plans handle administration for 72% of all participating plans, the researchers report.

In the voluntary benefits sector, 29% of the participating employers offer voluntary long term care insurance, but only 4.3% help pay the voluntary LTC premiums.

About 6.1% of the participants offer voluntary pet insurance, but only 0.3% help pay for coverage for employees’ companion animal dependents.