It's that time of year again. The annual survey of just how much health insurance premiums rose this year, and and what it tells us about the future.

Premiums for employer-sponsored family health insurance in 2009 rose to $13,375 -- a five percent increase. That's a moderate rise, given recent trends, but it's still a lot given that general inflation actually fell 0.7 percent in the survey period, and wages went up 3.1 percent.

The annual report by the Kaiser Family Foundation and the Health Research & Educational Trust (HRET), found that since 1999, premiums have gone up a total of 131 percent -- while wages rose 38 percent and inflation increased 28. Back in 1999, a family policy cost $5,791.

Drew Altman, president and CEO of the Kaiser Family Foundation, said that the five percent increase is relatively modest, given recent historical trends. He didn't anticipate a return to "the kind of really astronomical trends" of double digit hikes seen in 2002-03, but it's likely that premiums would rise a more typical 8 or 9 percent in coming years (unless major national health reform legislation changed the scenario, and even then cost-saving measures might not be felt immediately.)

The survey analysis found that family premiums, if they rise at the average rate of the last five years, would surpass $24,000 in another 10 years. If they rise at the average of the last decade (8.7 percent), it would be a startling $30,800.

The price tag isn't the only component that's rising. In many cases, copays, deductibles and the share of the premium that the worker pays is also going up (see chart below). Some firms also reported reducing the scope of the benefits covered. Overall, though, few businesses reported that they plan to drop coverage -- only eight percent said it was "very likely or somewhat likely" the they will drop coverage completely in the next year. This applies to the 60 percent of firms that offer coverage. For small businesses with 3 to 9 workers, only 46 percent currently offer coverage.

A few other interesting bits from the survey and the accompanying Health Affairs web article:

• Large employers are more likely than small ones to offer high deductible plans with savings options (aka consumer directed health plans). But the takeup rate is higher in small firms than large ones.

• The number of large firms (200 or more workers) offering retiree health benefits dropped slightly, from 31 percent in 2008 to 29 percent in 2009. That has declined dramatically over the past two decades, from two out of three in 1988 and four out of 10 in 1999.

• Slightly more than half (58 percent) of employers that off health benefits also offer at least one wellness option, such as-weight loss programs, gym membership discounts, smokng cessation, personal health coaching or nutrition classes. These are more commonly found among large employers.

• One in five very large firms (1000 employees or more) now have a workplace clinic.

The half-full/half-empty glass conclusion of the report? Either employers have a strong commitment to continue to offer benefits -- or they made decisions about benefits and coverage before the full brunt of the recession hit. Stay tuned and find out more next year...