Hammered by a persistent recession and healthcare expenses that continue to climb, South Florida's employers are responding in dramatically different ways -- from offering greater benefits at no cost to asking workers to pay up to 35 percent more for insurance.

As many employees enter their open enrollment time to choose their health insurance options for next year, companies' plans for health insurance are ``all over the board,'' says Bruce Shanefield, a Miami-based benefits expert with Aon Consulting.

At one end is Baptist Health South Florida, the region's largest nongovernment employer, which is offering a new concierge service and essentially holding the line for its 13,000 employees. Employee pay for the premium will increase just slightly -- $3 per two weeks per individual, and $10 per family for the most popular plan, says Baptist benefits specialist Maggie Marshall.

For the AvMed health maintenance organization plan, for example, Baptist employees will pay $47.51 every two weeks for an individual plan, $144.52 for a family.

Contrast that with Broward teachers. Next year, as always, school employees will continue to be covered in an HMO at no cost to themselves, but if they choose to pay for family coverage they might see increases of 35 percent or more, says benefits director Dildra Martin-Ogburn.

The Broward teachers -- like their counterparts in Miami-Dade, as well as workers for the two county governments -- pay the total bill for dependents' coverage while paying nothing for their own HMO plan.

Last year, said Martin-Ogburn, dependent claims soared for a wide variety of people -- not just a few outliers. The school system is simply passing on those costs this year.

Teachers are astonished. ``This is absolutely unbelievable and wrong,'' says Susan Squire, a teacher at Sunset Lakes Elementary in Miramar. To cover her husband and two kids, she is already paying more than $500 every two weeks -- more than 20 percent of her after-tax pay.

For those fees to go up another 30 percent is ``absolutely ridiculous. . . . It's a terrible thing when you've worked there 29 years.''

For most South Florida employees, the increases will be smaller, but the national consulting firm of Hewitt Associates advises that workers spend extra attention this year in choosing what to do in 2010.

A Hewitt study found that employee healthcare costs, including out-of-pocket, rose 10 percent by 2009. ``With the average U.S. worker seeing just a 1.8 percent salary increase in 2009 -- the lowest in 33 years -- it's more important than ever for employees to make sure they use their benefits dollars wisely.''

SOARING COSTS

Locally and nationwide, the long-term trend is soaring costs. In the past 10 years, the annual studies of the Kaiser Family Foundation have found that family premiums in employer-based care have increased 131 percent nationally. A study by Families USA earlier this year found Florida employee healthcare costs climbed 3.7 times faster than wages.

A survey of major cities by the Milliman consulting firm found that for employer-based health coverage, Miami is the highest in the nation -- $20,282 for a family plan. That's total costs -- both the employer and employee portions. Couple that with Shanefield's observation that salaries tend to be lower in South Florida, and that helps explain why the region's percentage of uninsured is unusually high -- 28.1 percent in Miami-Dade, 21.8 in Broward, compared with 15 percent nationwide.

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