Health plan premiums have increased 7.4 percent this year for large employers–far less than the expected 13 percent increase–according to a study that cites employer cost containment efforts and increased employee management of their health benefits for the surprising finding.

A report released March 17 by Boston-based Fidelity Investments, Changing Benefits, Critical Decisions: The Health Benefits and Behavior Study, said increased plan changes and educational efforts by employers and a more consumer-oriented approach by workers joined to blunt the impact of rapidly rising health care costs. Key employer cost containment strategies included shifting more of the expense of health care to workers and reducing coverage to avoid huge premium increases.

“Plan adjustments made by employers and changes in employee behavior positively contributed to an overall mitigation of health plan cost increases in 2004,” stated Brad Kimler, senior vice president of Fidelity Health and Welfare Consulting.

He noted that employees generally stayed with their health plans when their contributions were scheduled to increase less than 10 percent compared with last year. However, among employees facing increases of more than that, a significantly higher percentage changed health plans.

In addition, according to the study, more employees are using flexible spending accounts (FSAs) this year than last, and they are diverting more of their money into them. And employees are becoming increasingly savvy about using web-based tools for health care purposes.

“It’s becoming more apparent that employees are increasingly engaging and taking more responsibility when it comes to their health care benefits,” said Kimler.

Highlights of the Fidelity report include:

* The total premium cost to employers and employees combined this year is averaging $7,281 per employee, an increase of 7.4 percent from the $6,779 average in 2003.

* Employees are paying a greater share of the total cost of their employer-sponsored health care, covering 28.8 percent of the cost in 2004 compared with 26.5 percent last year.

* While most employees made no changes to their coverage for this year, about 11 percent chose new health plans.