Jim Brown started doing aerobics, running and lifting weights two years ago to slim down. Now his employer is giving him another reason to stay in shape and eat right: money.

Worthington Industries Inc. (search) — one of the rare businesses that has been paying the full cost of employee health insurance — put limits on its generous policy last year. The company said its workers had to take responsibility for their health if they wanted to continue getting free health insurance.

"I had a choice to be lazy or lean," said Brown, 44, an information technology employee who lost 90 pounds and has reached his goal of 210 pounds. Despite being overweight, Brown didn't have any health problems, but he noted: "If I hadn't changed, things probably would catch up with me."

Worthington, a steel processing company that employs 8,000, is among a growing number of businesses turning to worker incentives, both big and small, to help slow health insurance costs.

In Minneapolis, Fairview Health Services (search) gives gift certificates of up to $100 at the company store for workers who take part in health programs. UnitedHealthcare (search), headquartered in the Minneapolis area, will knock about $100 a year off health insurance premiums for filling out a 10-minute assessment that asks employees about their diet and blood pressure and then suggests ways they can improve their health.

The nation's largest hospital operator, HCA Inc. of Nashville, Tenn., said that in 2002 it saved $2.76 for every $1 it invested. The employer gave a $116 cash incentive to each participant who completed a weight-management program.

Other companies or insurance plans have offered workers financial rewards for exercising, dieting or other healthy behaviors. Some have started onsite fitness programs and are paying for gym memberships.

Health insurance costs have been rising at double-digit percentage levels for several years. The increase slowed from 12 percent in 2004 to 10 percent this year, according to a study by consulting firm Watson Wyatt of 555 employers with at least 1,000 employees.

Bruce Kelley, a senior consultant with Watson Wyatt, said in an e-mail that many companies realize that without incentives health programs tend to draw few workers or those at low risk of problems.

"That's a smart strategy," Kelley said of Worthington's Healthy Choices plan.

Worthington pays insurance premiums as long as employees work toward their goals, which could be as simple as trying to climb a few flights of stairs.

Employees who don't participate must pay $25 a month for single coverage and $50 a month for family coverage, still far below what other corporate health plans require. Typically, U.S. workers pay an average of $64 per month for themselves and $200 for a family plan, according to a Watson Wyatt survey of employers.

At Fairview Health Services,the rise in the cost of health insurance premiums has slowed to 9 percent a year over the past three years, said Barb Eischen, director of health and benefits services at the company, which operates hospitals and other medical services.

Premiums at Worthington were up 15 percent or more in each of the three years before the program started its "Healthy Choices" program. Chief executive officer John P. McConnell figures it will take five years to determine if it's cutting costs.

Health care consultant Allan Baumgarten said relying on inducements to help save money sounds like a new spin on programs in which companies offered counseling, for example, to help people quit smoking or lose weight.

"There is always something new you can try," he said. "Whether or not you get any results that you can take to the bank is a little harder to see."