What does fall mean, besides zillionaires in uniforms playing with bats and balls for hours into the night? It means open enrollment, as surely (and as dimly to most people) as April means opening day.

Studies show that employees often spend less time choosing their benefits than they might on selecting a new television. “Poor or shortsighted choices can have catastrophic financial consequences,” says Barry Lundquist, interim president of the Council for Disability Awareness in Portland, Maine.

So this year, you can start reviewing your choices carefully. It won’t be as fun as the old ballgame.

With cost increases for group medical coverage running up to 11 percent for 2010, guess who’s going to foot much of that tab? Employees. Expect a bigger bite from your paycheck and/or heftier co-payments, deductibles or co-insurance, according to Tom Lerche, senior vice president and health care leader for Aon Consulting.

And those extra costs will also buy you some likely hassle: Aon forecasts that more employers will conduct dependent eligibility verification audits, which typically identify four to eight percent of dependents as ineligible. There will also be fewer vision and dental plans.

Going out of network is going to be harder, explains Andrew Rubin, vice president for clinical relations at NYU’s hospital.  “We are now seeing plans where the insurer pays only 20-30 percent of the physician fee,” he adds.

You can fight back. If your premium is increasing, revisit this plan. You may do fine with a cheaper one,  says Sande Drew, senior media consultant with eHealthInsurance.

Check your spouse’s plan to see if it makes  more financial sense to let your better half cover you or your kids.

Mix and match. Depending on health conditions, sometimes it is less expensive for certain family members to be on a separate plan than the employer-sponsored plan. Do the math on separate policies if there are special needs.

Or spend your own money- which you’ll do more wisely. On the bright side, more employers are offering consumer directed plans such as health savings accounts, savings accounts that employees can fund tax free for health care costs. Unlike Flexible Spending Accounts, leftover money in an HSA can accumulate indefinitely and be invested- even for retirement, a use that would require a tax payment. An HSA can only work in sync with an insurance plan that charges a high deductible, according to Wells Fargo, so open-enrollment periods make prime time for testing the HSA math.

With more medical plan options having employee cost sharing, Flexible Spending Accounts (FSAs) provide a tax advantaged way to fund out of pocket costs for medical, dental, and vision costs.

And you can save money on cupcakes, invest it in running shoes, and find medical savings. Preventive benefits are being expanded and more employers are offering them with reduced or no employee cost sharing.

Forty one percent of employers surveyed by Aon Consulting offer a gift card or merchandise as an incentive to get healthy, and some of those offer more rewards to those who join a wellness program. Furthermore, to encourage wellness, some companies are offering discounts on gym memberships, smoking cessation classes and even massage therapy and acupuncture.

More employers are also offering additional  elective benefits that you’d pay for, including coverage for critical illness, additional life insurance, group auto, and homeowners insurance. “Voluntary plans are being added to replace coverage that the employer once provided,” says Chris Clevidence, president of Ashbrook-Clevidence Insurance Co. That may leave a bitter taste, but you’d still rather have the coverage than miss it. Right?

Employers are setting up “Benefit Banks” to allow employees to pick and choose which insurance is most important to them, says Travis Middleton, secretary of the Texas Association of Health Underwriters. Since these are typically individual products, they are transportable, easily taken to another job —  no small matter in this economy.