If you’re a typical American worker, or if you manage one or more of them, you’ve spent the better part of 2009 dodging layoffs, buyouts, furloughs, salary cuts and other reductions. No big surprise there.

Given all of that, you also shouldn’t be surprised at this: Your employer-sponsored benefit packages next year are going to hit you with more out-of-pocket expenses, a bigger push for wellness, fewer choices and options, and tighter cost controls.

This is what benefits experts at Watson Wyatt Worldwide, a leading global consulting firm, have identified as trends that employees can expect to see in their 2010 benefit packages during their open enrollment period this fall. According to Watson Wyatt, these include:

• Higher out-of-pocket costs. More than four in 10 employers in a recent Watson Wyatt survey said they will raise deductibles, co-payments and out-of-pocket maximums due to the economic crisis. Some employers might raise doctor visit co-payments by $5. Others might no longer provide 100 percent coverage for in-network services, opting instead to introduce some level of co-insurance to encourage workers to be more aware of the cost of services. Deductibles for individual and family coverage are expected to increase by $50 to $100 or more among some employers.

• Greater use of incentives to stay healthy. Employers are continuing their push to improve the health of employees and their families. In addition to continuing the focus on wellness communication, employers are offering workers (and, in some cases, spouses) more incentives such as gift cards, cash and discounted premiums for undergoing a health risk assessment or participating in smoking cessation, weight management or fitness programs. They are also giving workers access to on-site health coaching as well as using health service providers to deliver Web-based and telephonic coaching.

• Consumer-directed health plans. More employers will offer CDHPs next year as they are increasingly viewed as an effective way to control rising costs. Those employers adopting new plans are generally adding a high-deductible plan, often with a health savings account. Most employers adding these plans will offer them as an option to workers rather than replacing their traditional health plans.

• Consolidation of health plan offerings. Some employers plan to reduce the number of health plan options they offer to workers. As more employers consolidate and change their health plans and networks for 2010, some employees might have to change physicians or pay higher out-of-network costs.

• Prescription drug benefits. Some workers will see changes to their prescription drug benefits in 2010. As part of an overall movement to CDHPs, a number of employers are introducing a CDHP prescription drug benefit option that typically offers workers 100 percent coverage on a list of preventive medications. Other companies are introducing value-based designs that include zero co-pays on certain prescription drug therapies that are known to help lower health costs and reduce hospitalizations.

• A closer eye on spousal and dependent coverage. Employers are increasingly revisiting spousal and dependent coverage in their efforts to control rising costs. Some employers are requiring spouses to complete health-risk assessments, while others are charging higher premiums for working spouses who have access to other health care coverage. More employers are also expected to audit their workers to eliminate dependents who are not eligible for coverage.

With health care costs expected to rise 10.5 percent in 2010, slightly more than the 10.6 percent forecast increase in 2009, it’s not surprising that employers continue to tighten up on the cost and management of benefit programs. That’s because double-digit increases in health care and other benefit costs are just not sustainable for anyone. Even the most generous organization is going to need to find some way to spread these increases among everyone getting the benefits.

Watson Wyatt senior consultant Tom Billet says these benefit plan changes for 2010 are due to the “uncertain economy and rising health care costs that show few signs of slowing.” Of course, that’s at the core of the national debate on health care reform too.

If anything is clear in all of this, it’s that the unrelenting double-digit increase in the cost of health care will continue to affect everyone—both employers and employees—no matter how you feel about the reform efforts coming out of Washington. And, it’s why the debate on the subject isn’t likely to be solved anytime soon.

Get my latest blog updates on human resources and workforce management news by following me on Twitter.