In the past, retired employees of New York City were offered comprehensive health benefits that covered their Medicare costs. However, recently, the city and many unions have been pushing to shift retired employees to a privately operated Medicare Advantage program instead. This change has highlighted the nationwide shifts occurring between employers and retired workers with regards to health insurance benefits. The Advantage plans have a narrower network which reduces access to care and have been found to "upcode" by submitting inflated bills to Medicare. However, the Advantage plans are appealing to employers because they offer a way to significantly reduce costs.
See "In an effort to reduce costs, employers shifting to offer privately operated Medicare Advantage program for retired workers ", Mark Miller, New York Times, March 10, 2023