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

According to a new employer survey conducted by FidelityInvestments and the National Business Group on Health outWednesday, employers plan to spend an average of $521 this year peremployee on wellness-based incentives within corporate health careprograms, double the per employee average of $260 reported in2009.

That's also a 13% jump from the average of $460 reported for2011.

Growth is particularly evident in the mid-sized market, as 77%of employers plan to offer wellness-based incentives in 2013, morethan double the 38% of mid-market employers that offeredwellness-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'scosts is to incent their workforce to lead a healthier lifestyle,”Adam Stavisky, said senior vice president of Fidelity's benefitsconsulting business.

“Employers of all sizes have embraced wellness-based incentivesto help control costs, and companies are now looking at ways todesign and optimize their programs to maximize their positiveimpact on health for both the organization and employees,” Staviskysaid.

The survey also found that the overall use of wellness-basedincentives among corporate employers continues to increase. Nearlynine out of 10 employers surveyed indicated that they currentlyoffer wellness-based incentives (86%), an increase from 73% from2011 and 57% from 2009.

The most popular wellness-based incentives continue to be adecrease in premiums (61%), cash or gift cards (55%) or anemployer-sponsored contribution to a health savings account orsimilar heath care-based savings vehicle (27%).

This year a majority of employers (54%) will expand theirwellness-based incentives to include dependents, up from 45% in2011. And roughly half will now include spouses/dependents incommunications about wellness programs.

But employers want employees to do some of the work, too: 15% ofemployers surveyed are requiring employees to complete some sort ofhealth activity—such as an employer-sponsored biometric screeningor health risk assessment—in order to determine their eligibilityfor one or all of the company's health plans in 2013.

The survey results also show that 10% of employers will berequiring employees to complete an HRA or risk being defaulted intoa less attractive subset of the company's health plan, while 7% ofemployers indicated failure to complete a biometric screening wouldresult in being defaulted into a less attractive subset of theircompany's health plan.

In addition, 3% of employers indicated that failure to completean HRA or biometric screening would result in loss of benefits for2013.

This article was originally posted at BenefitsPro.com, a sistersite of Credit Union Times.