Healthcare costs are expected to reach a five year high in 2011 as employers spend more on their workers healthcare costs and employees face more out of pocket costs according to a study released Monday.

The consulting group, Hewitt Associates, found that healthcare costs are expected to have an overall rise of nearly 9 percent because of higher medical claim costs, an aging population, and changes under the new healthcare reform law.

The average total healthcare premium per employee working at a large firm will be $9,821 in 2011 rising from $9,028 in 2010.

"Everyone has a strong focus on costs and the need to find solutions," said Jim Winkler, a managing principal in Hewitt's healthcare business line. "It's a very serious concern."

The study determined that Los Angeles, Sacramento, San Francisco and San Diego were among the metropolitan areas nationwide where employers have experienced the largest cost increases this year.

Insurance information for 350 companies in Hewitt's database was used in the study. The company employee numbers varied from 1,500 employees to above 200,000.

Hewitt analysts blame the recession as companies choose to hold on to veteran workers and delay new appointments. Older employees usually incur higher health costs. The spike in insurance rates can also be attributed to the recently adopted healthcare reform package.