The online survey of 156 executives, by the Financial Executive Research Foundation and Corporate Synergies Group, finds that while 54% of respondents want to keep worker costs for medical benefits at a minimum, their companies continue to be forced to act against that desire. The online survey was augmented by 11 in-depth interviews, according to FERF, the affiliate of Financial Executives International, and Corporate Synergies, a privately held employee benefits broker and consulting firm.

The report, titled "Trends and Tradeoffs in Employee Medical Benefits," finds that 21% of companies represented by the executives actually have reduced or eliminated salary increases or bonuses for employees as a response to rising medical costs --- although the great majority (88%) said their approach has been to increase employee cost-sharing, or to adjust co-pays or deductibles. Reducing medical benefits themselves has been the course chosen by 38%, the survey says.

"Employee benefits represent a major portion of total compensation costs --- 47% of companies said that providing employee medical benefits for the most recent fiscal year cost more than 10% of their total compensation costs," noted Tom Thompson, co-author of the report and a FERF research associate. "Yet, with less than half of financial executives saying that they are very informed about various benefits options and therefore comfortable making the decisions, it's clear that the complexity of these decisions is weighing on the minds of senior financial executives."

John Turner, president and CEO of Corporate Synergies, said finance executives "are clearly faced with tough financial tradeoffs as they remain committed to offering medical coverage to their employees. Yet in aggregate, these decisions -- increased employee cost-sharing, higher deductible plans, reduced employee raises and bonuses -- can mean significantly less disposable income for employees." While short-term actions taken often involve "slightly tweaking plans year over year," he said, "it's important that financial executives look at the big picture and realistically consider, and communicate, the long-term implications to their employees."

The survey suggests that certain benefits still not "on the table," for the most part, include reducing non-medical benefits, or eliminating dependent coverage. Only 9% of companies have taken the first step, and 2% the second.