Health Insurance for Active and Retired City Employees: Asheville, Denver, and Oklahoma City


Public and private employers face the same challenge: how to control the continuing growth in health care costs? This brief examines how three city governments — Asheville, Denver, and Oklahoma City – have responded to rising health care costs.

Center for State and Local Government Excellence
Publication date:
September 2011
Filed under:
Research Studies
Download publication:
NC State brief_Health Insurance_Cities_12-068

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.