New York ? Health care costs continued to surge this year as family premiums in employer-sponsored plans jumped 11.2 percent, the fourth year of double-digit growth, according to a new study.

The cumulative effect of rising health care costs is taking a toll on workers: There are at least 5 million fewer jobs providing health insurance in 2004 than in 2001, according to the survey of 3,017 employers by the Kaiser Family Foundation and the Health Research and Educational Trust.

This year, 63 percent of employers offered health benefits to workers, down from 68 percent in 2001. The change is primarily driven by a decrease in the number of small employers, those with three to 199 workers, that offer coverage.

The average premium for a family of four grew to $9,950 annually. The family premium for a preferred provider organization, the most common type of insurance, hit $10,217 — the first time it broke $10,000. PPOs are plans that provide members with a network of discounted providers that charge a copayment but also allow for the use of other doctors and hospitals.

Employers with three to 24 workers reported the biggest increase in the average family premium, 13.6 percent.

“Health insurance is becoming unaffordable, especially for small employers. We should expect the ranks of uninsured to grow as small employers can’t afford health insurance,” said Drew Altman, president of the Kaiser Family Foundation.

Altman noted that the hike in health premiums outpaced both the 2.2 percent growth in wages and 2.3 percent growth in inflation by five times.

“There is a great sense that there is just no answer to this problem,” Altman added.

The average premium for single coverage rose 9.2 percent to $3,383 annually.

The percentage employees paid toward the premiums remained steady with singles picking up 16 percent of the tab, the same as in 2003. Employees paid 28 percent of the family premium, up from 27 percent last year.