MONTGOMERY — Alabama’s largest insurance provider said it expects premium rate increases in the “low single digits” for 2013.

For many Alabamians on employee-sponsored Blue Cross and Blue Shield of Alabama insurance, that will translate into a bigger paycheck deduction.

That will likely be the case for the about 30 full-time employees at 3-GIS in Decatur. Company President Tom Counts said their insurance rates have gone up every year since they opened in 2006. While the company pays the lion’s share of the health insurance costs, each year it passes the premium increases on to the employees.

“It puts a bigger burden on our employees, and I wish we could say we’ll cover it, but we just can’t,” Counts said.

“It’s just not practical.”

Counts said he wrote his monthly check to Blue Cross and Blue Shield on Friday morning to cover his obligation. It’s a painful check to write, he said, but offering good insurance and other benefits is something Counts has to do to stay competitive. He said he’s fighting to hire and keep skilled employees that other high-tech companies in north Alabama want.

Koko Mackin, vice president of corporate communications for Blue Cross and Blue Shield of Alabama, said premium increases for the company’s products have been in the high single digits the past five years.

Mackin said in an email that premiums are determined by the number of doctor and hospital visits members make, the cost of those visits and the costs of medications and medical procedures.

“We work hard to keep our operating costs down, so that overall, more than 90 cents of every premium dollar is spent on our members’ medical treatments,” she wrote. “In addition to operating at one of the lowest administrative expense ratios in the health insurance industry, Blue Cross is focused on keeping medical treatment costs as low as possible for our customers.”

In September, the Kaiser Family Foundation reported annual premiums for employer-sponsored family health insurance reached $15,745 in 2012, a 4 percent increase from 2011.

On average, workers paid $4,316 for their coverage.

According to Keiser, premiums have increased 97 percent since 2002. That’s three times as fast as wages or inflation.

A recent study by the American Medical Association said Alabama had the least competitive health insurance market in the nation. Blue Cross and Blue Shield accounts for 88 percent of the market, the study states.

Calls to another Alabama insurer, United Health Care, were not returned Friday.

Business owners such as Counts say more choices would be better for customers.

“I wish there were other options out there,” he said. “I would really like to see some competition.”

Affordable Care Act changes

Proponents of the Affordable Care Act say small businesses will have more choices in 2014.

That’s when the federal law’s exchange mandate takes effect and each state must have in place a virtual marketplace where small businesses and uninsured individuals can compare providers’ rates and select the one best for them.

Gov. Robert Bentley recently said Alabama will not set up its own exchange, but will instead rely on a federal version.

Part of the Affordable Care Act requires large companies to provide insurance to full-time workers starting in 2014, but they will not participate in the exchanges.

Still, proponents and the federal government say employees at larger companies should see decreases in cost because of increased competition among providers that will potentially have millions of new customers.