All three cities use a range of strategies including:
- Wellness programs
- Chronic disease management
- Employee clinics
- Cost shifting to employees
- Plan design changes
- Trust fund
Although all three cities offer retiree health care benefits and require retirees who are eligible for Medicare to enroll, only one city has begun to prefund retiree health obligations. The other two cities pay for retiree health on a pay-as-you-go basis, typical of American local governments.
With an aging workforce and a growing ratio of retirees to active workers, governments recognize they cannot be complacent about a benefit as important – and costly – as health insurance. This brief sheds light on some of the strategies that show promise.