The survey found that 80 percent of small accounts, with 50 or less employees, saw premium increases between 10-to-30 percent over the past six months since May of 2003. Of medium-size clients, with between 51 and 500 employees, 78 percent experienced increases in the 10-to-30 percent range. In large accounts of 501 or more employees, 45 percent saw increases in the 10-to-30 percent range.

On the group life side, close to half of small and medium-size accounts saw no increase and 30 percent of large accounts experienced no change. Increases were primarily in the 1-to-10 percent range, with 27 percent of small accounts and 29 percent of medium-size accounts. Only 14 percent of large accounts saw increases between 1 and 10 percent.

Regionally, the Northeast and the Midwest appeared to report the sharpest increases, but other sections of the country were no less affected. Brokers in the Midwest said 100 percent of small accounts saw premium rates increase between 10 and 30 percent; 91 percent of medium accounts saw the same percentage of increase; while 63 percent of large accounts experienced such increases.

In the Northeast, 83 percent of small accounts and 87 percent of midsize accounts saw increases of 10-to-30 percent, while 67 percent of large accounts realized these increases.

CIAB said that brokers reported clients were having a hard time keeping coverage. While not eliminating coverage, clients were passing on the cost in higher deductibles or elimination of some benefit in order to hold down costs. Employers also asked for higher contributions from employees. They also increased drug co-pay amounts.

John Tracey, a senior vice president for Parker, Smith and Feek, an insurance brokerage firm, and Assurex Global Partner, based in Seattle, Wash., said his clients saw general increases of between 10 and 20 percent--some as high as 38 percent.

A bad economy has forced businesses to "cut back significantly" on the amount they pay out to support employee benefits, he said. One employer had to slash its support of medical benefits to each employee by about half because the business could not afford it, explained Mr. Tracey. They did this by increasing deductibles and cutting benefits, some of which became employee purchase benefits.

He felt that by next year there would be some moderation of increases, maybe within the 10-to-12 percent range. He said states are beginning to take action on tort reform to help control physician and hospital cost in the area of mal-practice. He also felt drug companies are starting to show some restraints as protests rise over escalating costs and some states begin to take action to control costs.

Ultimately, he said, the only way costs can be controlled would be with a federal stop loss program that covers over $50,000 in medical expenses. Individuals under the plan would be responsible for the first $50,000 that would be covered by private health insurance. Additionally, he said, changes needed to be made to the Medicare ? Medicaid program.

Other brokers spoken to made similar observations about increases, noting that increases generally were 10 percent or more, and some higher.