Nineteen percent of small employers in the Mercer survey said they would lower their 2009 costs by adding a high-deductible plan that's coupled with an employee-controlled spending account. These accounts are known as health savings accounts, or HSAs. An HSA works like a savings account but in this case, the funds you deposit are pre-tax and can only be used for medical expenses.

Watson Wyatt Worldwide, a leading global consulting firm, found a few trends in its open enrollment survey this year:

-- Some employers are requiring that employees complete health risk assessments. In exchange for their participation, they receive an incentive award.

-- More employers are also replacing co-payments for prescription drugs with co-insurance arrangements in an effort to control costs. With a co-payment you pay a specified amount depending on the type of medication you take or whether there is a generic form available. Co-insurance is when you share a percentage of the cost with the insurance company. A typical split is 80/20. So, for example, your insurance picks up 80 percent of the cost of your medication and you pick up 20 percent.

-- Nearly 30 percent of employers surveyed by Watson Wyatt and the National Business Group on Health plan to operate on-site clinics next year.

-- More employers are covering preventive medical care and even preventive drugs at 100 percent with no deductible.

To help you make better choices during open enrollment, Aetna and the Financial Planning Association have created "Plan for Your Health," a public education campaign for workers. I suggest you go to the Web site www.planforyourhealth.com, where you will find some very helpful tools and information. On the right-hand side of the home page you will see a link for open enrollment information.

In years past, you may have quickly looked over your benefits opting for what you've always had. Or maybe you forgot to do anything and your employer defaulted you into the previous year's selections. But this year with the economy in such distress you need to focus on which options are best because you'll need any savings you can get.