Where is your health insurance premium heading?

For Linda Pierce, it’s an additional $10-a-week expense she can’t live with. For Tom Allen, the result is an extra $3.50 a week he’ll be glad to pocket.

This is the season when employees learn how much their health care costs will change next year. Hewitt Associates LLC, a human-resources research firm outside Chicago, estimated in a recent survey that workers would see an average 10 percent increase.

Locally, the numbers, percentages and repercussions vary markedly, depending on the extent of the coverage, the employer’s willingness to share the cost and the employee’s circumstances. 

Pierce, 60, a cashier at a local retail store, last month found out the price of her Anthem Blue Cross and Blue Shield  coverage would jump 54  percent next year, from $37 to $57 every two-week pay period.

That’s about an extra $520  a year – a cost Pierce said she can’t afford.

“I sat down with my calculator and said: Can I give something up?” she said . “But I have to pay for every one of my expenses. I have nobody to help me.”

So Pierce will forgo health insurance next year. She’ll continue her twice-a-year doctor’s visits, paying full price, and hope for the best. She has high blood pressure, but even under her health plan her pills weren’t covered. Luckily for her, they cost $4 a month.

“I am worried, of course,” said Pierce, who lives in Norfolk. “Knock on wood, I haven’t had problems since I had the blood pressure. But you never know.”

Allen, 62, a truck driver for Wal -Mart Stores, got good news.

The rate for him and his wife will drop nearly 4 percent , from $184 to $177 every two weeks. The Optima coverage will shrink in other ways – doctor’s visits will cost $20, up from $15 – but he’s not complaining.

“It was great, because I originally thought it was going up,” said Allen, who lives in Virginia Beach. “I’ve got no complaints. I’ve been pretty happy with the level of service and the way things have been going.”

For similar coverage, subscriber rates next year will go up 8  to 12 percent at Anthem and about 12 percent at Optima, executives at the insurance companies said.

However, both said employers are increasingly opting for “benefit buy-downs,” such as higher deductibles and decreased emergency-room coverage, that lower cost increases for employees. For example, Optima’s increase might be 9 percent rather 12 percent.

Representatives of both insurers, as well as the Hewitt firm, said the increases were in line with those of recent years.

“It’s kind of ho-hum because of the big reform thing,” said Cathy Tripp, a Hewitt official. “Everyone’s not trying to rock the boat until they see what’s going on with that.”

It’s not ho-hum for Richard Hill, 54, a mechanical engineering technician at Norfolk Naval Shipyard in Portsmouth.

His Blue Cross/Blue Shield rates will go up nearly 16 percent , from $70 to $81 every two weeks. At the same time, his coverage will narrow. Emergency care has been fully covered. Starting next year, Hill will have to supply a $25 co-payment and then pay 15 percent of the total bill.

“My pay has been increasing at the same rate as inflation,” said Hill, who is divorced and lives in Portsmouth. “But with health care costs increasing much more, I’m falling behind. And I suppose that many others are in the same boat.”

The premium outlook swings a wide pendulum in Hampton Roads.

At Norfolk Southern Corp., for instance, insurance premiums will rise 18 percent for union members and 12 percent for non-union employees, spokesman Robin Chapman said. For city workers in Virginia Beach, premiums won’t change a penny.

That’s because the city is self-insured, said Susie Walston, a deputy city manager, and it saved enough through low use of medical services this year to cover cost increases in 2010.

Doña  Storey, president and CEO of Quality Technical Services Inc. in Virginia Beach, a manager of facility projects, said her insurer wanted to increase her overall bill 36 percent. She went with an alternative plan, shaving the cost increase  to 14 percent .

However, “we had to give up some benefits for our employees,” said Storey, who has 18 full-time workers. “That’s what we always try to avoid.”

Last year, the barrage of premium increases forced her to switch from paying all of her workers’ premiums to 60 percent. She’s staying at 60 percent next year, b ut it will cut into profits.

“Because my health care goes up, that doesn’t mean I get to raise the rates” for clients, Storey said. “We are on fixed-rate government contracts.”

Kevin Kordek, president of A-Active Termite & Pest Control Co. in Virginia Beach, pays for 50 percent of premiums for employees  but requires them to pay the premium for any dependents.

Last month , he faced an overall 19 percent cost increase when he renewed his Optima insurance program for 27 employees. Kordek, too, said he can’t pass on the costs to clients. Nor will he drop coverage for his staff.

“I don’t really see health insurance as being a negotiable benefit,” he said. “As a small-business owner, I have to think through my employees’ minds.”

Officials from Anthem and Optima attributed cost increases to factors such as higher charges for medical services and increased incidence of disease.

“A lot of it is around utilization and technology and an aging population,” said John DeGruttola, Optima’s senior vice president for sales and marketing. “Everybody’s getting a year older. As you get older, you require more services, unfortunately.”

In Hampton Roads, he said, the incidence of diabetes and related diseases has grown to 10 percent from 3 percent in 2000.

Half  the cost of medical care “is related to lifestyle conditions,” such as obesity and smoking, said Jeff Ricketts, Anthem’s regional vice president for sales. “If we choose to lead unhealthy lifestyles, it’s going to cost us a lot more money to do that.”

For Pierce, the cashier, the health care calculations involved a different set of variables. Could she squeeze an extra $40 or so out of her monthly budget to pay for the increase when she was already barely making it after taking out $500 for rent, $160 for heating oil, $70 for electricity, and so on?

The answer, she decided, was no.

“Health care providers need to realize that not everybody is a millionaire,” Pierce said.

Philip Walzer, (757) 222-3864, phil.walzer@pilotonline.com