Health care tops the concerns of New Hampshire businesses and influences whether some businesses locate here, according a state business group.

More than three of five businesses surveyed last October cited health care as a top concern, the highest of any issue, according to David Juvet, senior vice president of the Business and Industry Association of New Hampshire.

Group President Jim Roche said health care costs are becoming an increasingly important factor in business relocation and expansion in New Hampshire.

From a competitive perspective, we have some of the highest health care costs in the country, he said.

New Hampshire in 2010 had the highest annual premium cost for family-size plan among the 50 states, at $15,204 $1,333 higher than the national average. Only the District of Columbia was higher, by $2, according to the Kaiser Family Foundation, a nonprofit foundation focusing on major health care issues.

Steven Sherkanowski, chief operating officer at Akumina, a Web development company, valued health care during recruitment.

To get folks interested in coming along on board, one of the things was making sure we had a competitive health care package, Sherkanowski said.

The Nashua business employs 12 people full time and expects to hire four more full-timers by years end.

As I bring younger people on board, it brings my premiums down, he said.

Officials at Anthem Blue Cross and Blue Shield in New Hampshire, where Akumina has its policy, said age is a factor, though, not the sole one, in determining premium costs.

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Health care a top issue for businesses in New Hampshire