San Diego employers will likely notice additional upticks in their health care costs for 2009, but forecasts show that the average rate of increase could slow to the lowest level since 2001.

On average, health care insurance will cost local businesses 7 percent more in 2009, down from increases of 8.9 percent in 2008 and 11.5 percent in 2007, according to estimates by Chicago-based human resources consultant Hewitt Associates. Hewitt polled 1,800 health plans nationwide, including 300 major employers and more than 13 million health plan participants.

“(Employers) are fighting back like you would not believe,” said Lee Reichenbach, a principal in Hewitt’s health management consulting practice. “They are doing everything they can to reduce their cost.”

The Hewitt data shows gradual year-over-year decreases in San Diego since 2003, when health care costs spiked 17.8 percent compared with 2002. Most of that increase was due to the fallout of the Sept. 11, 2001, terrorist attacks, when health agencies noticed a spike in doctor visits, according to Reichenbach.

Despite the slowing trend, San Diego remains at a higher year-over-year growth rate when compared with national figures. Health care insurance costs are expected to rise 6 percent nationally in 2009, compared with 7 percent locally.

But San Diego companies pay less, on average, for health insurance per employee. This year, local employers paid an average of $7,392 to cover employee health care costs. In 2009, they are expected to pay $7,919, compared with $8,863 nationally.

Out-of-pocket costs for San Diego employees also ranked below the national average, with expenses such as co-payments, co-insurance and deductibles reaching an average of $1,357 this year, compared with $1,707 nationally. Next year, employees are expected to pay $1,510 on average, compared with $1,880 on the national level.

Jerry Flanagan, a health care advocate with Santa Monica-based Consumer Watchdog, says employers are increasingly shifting the burden of health care costs to their employees.

“As we’re seeing now, folks are just going to forgo annual checkups or doctor visits to keep the money in their pockets,” he said.

He also noted that health insurance costs have outpaced the rate of inflation during the past several years, often by double or more.

“After years of double-digit increases, a slightly less increase is not something to celebrate,” he said.

Reichenbach says employers, who set their health insurance strategies at the beginning of the year, attempted to control cost burdens to their employees.

“Unfortunately, as the year went on and materialized, we were still going to see pretty significant cost increases in health care. Employers had to back off that strategy a little bit.”