COLUMBIA, S.C. - State workers and retirees face higher insurance rates and benefits changes under a proposal the state Budget and Control Board will consider Tuesday.

The state health plan will cost $132.7 million more to operate in January than it did this year, according to a report on the employee insurance program. The state is putting $40.9 million more into the plan and benefits changes and higher premiums make up the balance.

The proposal calls for saving $36 million by changing benefits. The plan targets $13.7 million in savings by raising an annual deductible by $100 to $450. And $12.2 million would be saved with participants paying $2 more for each prescription. The plan would drop coverage for gastric bypass surgery, a drastic weight reduction operation.

On the premium side, workers covering only themselves would expect insurance to rise 24 percent to $85.86 monthly. A worker insuring his family would pay 17 percent more with $275.58 in monthly premiums. The higher premiums cover $55.8 million of the higher costs.

With rising medical costs, the only choices are reducing benefits, raising rates or a combination of the two, House Ways and Means Committee Chairman Bobby Harrell, R-Charleston, said. Harrell is one of the budget board's five members who will decide specifically what happens to rates and benefits at Tuesday's meeting.

"Health care costs are skyrocketing," Harrell said. "Until health care costs come under control, this kind of thing, unfortunately, is likely to continue in the public and the private sector."

The board also will decide how the state implements new, federal health savings accounts. The board's proposal calls for creating a new, high-deductible health insurance plan.

Harrell said that can be a way of saving money for people in good health who don't regularly visit doctors.

That plan would have an deductible of $3,000 for individuals and $6,000 for a family and cover 80 percent of the cost for care by in-network doctors and hospitals.

Workers would be able to save up $2,600 for an individual and up to $5,150 for families through the health savings account. The coverage costs $9.28 monthly for single workers and $108.56 for families. The plan covers an annual physical exam and flu shot with no deductible.

Gov. Mark Sanford had been hoping the state would develop those kind of choices in health insurance plans for employees, said Sanford spokesman Will Folks.

Folks said other proposals would be hashed out on Tuesday.