After pay, health care insurance is the most important inducement small businesses use to recruit and keep workers, according to a new survey.

Yet due to rising costs, almost 10% said they could dump their health coverage next year or are unsure about it, reports the National Association of Professional Employer Organizations, Alexandria, Va., which conducted the survey. More than half the 365 small businesses in the survey said their premiums rose as much as 10% this year.

NAPEO’s survey shows 71% will continue to insure their workers in the coming year, but another 5% remain unsure about continuing.

NAPEO surveyed members’ clients in November and found that health care costs were their second-biggest worry after attracting workers.

Around 20% of small business surveyed said they would raise copayments for employees’ office visits or deductibles, while about 25% said they’d raise premiums.