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A survey of 120 larger employers finds they expect to pay an average of $521 per employee on wellness-based incentives during 2013. That’s an increase of 13 percent from a similar survey in 2011 and double the rate in 2009.

Fidelity Investments and the National Business Group on Health conduct the surveys, with the latest being done online last October and November. Surveyed companies range from less than 2,000 employees to more than 50,000. Eighty-six percent of surveyed employers offer wellness-based incentives, up from 73 percent two years ago and 57 percent in 2009. Mid-market employers have doubled use of incentives in the past two years, with almost half in 2013 planning to offer more than $500 per employee. Other survey results include:

* Fifteen percent of surveyed employers require employees to complete some type of health activity, such as a biometric screening or health risk assessment, and some are moving non-compliant employees into less attractive health plans or the loss of health plan coverage.

* The most popular wellness incentives are decreased premiums, cash or gift cards, or employer contribution to a health savings account or similar account.

* Fifty-four percent of surveyed employers have expanded wellness incentives to dependents, compared with 45 percent two years ago.

* Forty-one percent include or plan to include outcomes-based metrics in their wellness programs, such as reducing cholesterol, blood pressure or waist measurements.