The recession is forcing employers to increase cost-sharing approaches as plan participants increase their use of the benefits out of fear they might lose them, a new survey finds.

While less than 4% of plan sponsors have cut or are considering cutting health care benefits altogether, many are ramping up their cost-sharing approaches, according to the study by the International Foundation of Employee Benefit Plans, Brookfield, Wisc.

IFEBP found 35% of plan sponsors are increasing employee deductibles, coinsurance or copays due to the financial crisis, while nearly the same proportion are also increasing employee premiums. Other cost-sharing actions that plan sponsors have taken include adding consumer-driven health plans as an option (13%), replacing a current plan with a consumer-driven plan (10%) and instituting spousal charges (11%).

Perhaps fearing an impending layoff, plan participants are increasing use of their benefits, the survey found. About one-third of plan sponsors reported seeing an increase in the number of participants filling prescriptions and engaging in costly medical procedures. In addition, 24% observed growth in the number of participants adding dependents to their plans. At the same time, 18% have introduced or are considering dependent eligibility audits.

About 20% of respondents reported plan participants are delaying medical care and skimping on prescription drugs because of financial problems.

The study also found 18% of the respondents have introduced or are considering introducing wellness initiatives due to the economy.

In addition, 85% believed that the financial crisis has made major federal health care reform more likely.

“The financial crisis has led some to conclude that health care and the economy are inextricably linked. You can’t separate one from the other,” said Sally Natchek, senior director of research for the foundation. “Given the burden of growing health care costs, it’s likely that health care reform will continue to be at center stage.”

The survey was conducted March 30 to April 6. Respondents included corporate plan sponsors, public and governmental plans, multiemployer benefit funds and others with benefit plans.