Employers have doubled their spending on wellness incentives in the last four years, new research finds.

According to a new employer survey conducted by Fidelity Investments and the National Business Group on Health out Wednesday, employers plan to spend an average of $521 this year per employee on wellness-based incentives within corporate health care programs, double the per employee average of $260 reported in 2009. That's also a 13 percent jump from the average of $460 reported for 2011.

Growth is particularly evident in the mid-sized market, as 77 percent of employers plan to offer wellness-based incentives in 2013, more than double the 38 percent of mid-market employers that offered wellness-based incentives in 2010.

“As the cost of providing health care continues to increase, employers recognize one of the key ways to manage their company's costs is to incent their workforce to lead a healthier lifestyle,” Adam Stavisky, senior vice president of Fidelity's benefits consulting business, said. “Employers of all sizes have embraced wellness-based incentives to help control costs, and companies are now looking at ways to design and optimize their programs to maximize their positive impact on health for both the organization and employees.”

The survey also found the overall use of wellness-based incentives among corporate employers continues to increase. Nearly nine out of 10 employers surveyed indicated they offer wellness-based incentives (86 percent), an increase from 73 percent from 2011 and 57 percent from 2009.

The most popular wellness-based incentives continue to be a decrease in premiums (61 percent), cash or gift cards (55 percent) or an employer-sponsored contribution to a health savings account or similar heath care-based savings vehicle (27 percent).

This year a majority of employers (54 percent) will expand their wellness-based incentives to include dependents, up from 45 percent in 2011. And roughly half will now include spouses/dependents in communications about wellness programs.

But employers want employees to do some of the work, too: 15 percent of employers surveyed require employees to complete some sort of health activity—such as an employer-sponsored biometric screening or health risk assessment—in order to determine their eligibility for one or all of the company's health plans in 2013.

The survey results also show that 10 percent of employers will require employees to complete an HRA or risk being defaulted into a less attractive subset of the company's health plan, while 7 percent of employers indicated failure to complete a biometric screening would result in being defaulted. In addition, 3 percent of employers indicated that failure to complete an HRA or biometric screening would result in loss of benefits for 2013.

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