A survey by Hewitt Associates shows employers’ appetite for penalizing workers for unhealthy behaviors is on the rise.

Hewitt’s health care trends survey of nearly 600 large U.S. employers found 47% use or plan to use financial penalties over the next 3 to 5 years for employees who do not take part in certain health improvement programs.

Of those companies using or planning penalties, 81% say they would do so through higher benefit premiums, according to Hewitt, Lincolnshire, Ill., a human resources consulting firm. Other possible penalties: increasing deductibles or out-of-pocket expenses, both cited by 17%.

When asked what types of behaviors they would penalize, 64% of employers cited smoking, 50% indicated not participating in disease management or lifestyle behavior programs, and 45% specified not participating in biometric screenings.