To stave off double-digit increases in the cost of employee health plans, small and midsize companies cut benefits in 2003, according to a survey and analysis by Mercer Human Resource Consulting and Marsh Inc. ( www.marsh.com ). This held costs to an average of $6,130 per worker, up 9.8% since 2002. Companies with fewer than 50 employees limited their per capita costs to $5,795 by instituting provisions discouraging dependent coverage and imposing high deductibles. But businesses with 1,000 to 1,999 employees spent considerably more—$6,472—per worker, reflecting the challenge of competing for labor with larger employers that have greater purchasing power. The findings are based on responses from 1,904 employers.