Welcome to Relocalizing Health. In this episode, we shine a light on Plainfield, Indiana, a town just west of Indianapolis, where public sector employees like police officers, firefighters, and public works staff were once priced out of their own healthcare. Nate Thorne, assistant town manager, joins us to share how Plainfield broke free from years of rising premiums and shrinking paychecks, fundamentally transforming its approach to employee health benefits.
Instead of accepting sky-high insurance costs as an inevitable “healthcare trend,” Plainfield’s leadership took courageous steps: moving to a self-insured health plan, forging a direct contract with their local hospital, and reimagining benefits so workers now pay zero deductibles and co-pays, with real dollars flowing back into their households. These savings built meaningful new programs like mental health support and childcare assistance, and Nate Thorne and his team are on a mission to show other cities and counties that there is a better way.
Whether you manage a city, run HR for a school district, or just want a behind-the-scenes look at how local governments can invest in their people and communities, this episode brings you the story, the lessons, and the playbook, direct from a Rosie Award finalist, on how to take back control of your health plan and rethink what’s possible for your workforce.
Timestamps:
00:00 Challenges of municipal worker benefits
04:21 Facing rising insurance costs
07:24 Challenge of risk in public policy
11:46 Implementing a Self-Insured Program
16:10 Managing healthcare spending changes
18:07 Cost-saving strategies for healthcare plans
22:02 Creative funding for employee benefits
26:18 Leadership and gradual progress advice
28:52 Challenges in the public sector
32:02 Managing retiree health benefits
35:13 Employee survey results on premiums
37:25 Annual employer gathering details
40:11 Plainfield's health plan changes
How Plainfield, Indiana Transformed Public Sector Health Benefits: Key Insights from the Relocalizing Health Podcast
Are you a city manager, HR professional, or someone interested in affordable and effective health benefits for public sector employees? You're in the right place. In this episode of the Relocalizing Health podcast, Nate Thorne, Assistant Town Manager of Plainfield, Indiana, and Dave Chase, delve into how one town overhauled its health plan and achieved remarkable gains for workers and their families without raising costs.
Let's break down the highlights and actionable takeaways for employers wanting to improve health care outcomes while managing budgets.
Plainfield's Wake-Up Call: Health Premiums Were Canceling Out Raises
Years ago, Nate Thorne noticed a troubling trend. As he described it, employees like police officers and firefighters were getting small annual raises, but those gains disappeared as insurance premiums rose even faster. If a 3 percent salary boost was wiped out by a 6 percent increase in insurance, workers effectively saw no pay increase. This was not sustainable for those responsible for the town’s safety and essential services.
Moving Away from the "Healthcare Happens to Us" Mindset
Most municipal leaders accept rising insurance premiums as an unfortunate norm, explained Dave Chase. Plainfield’s leadership, however, refused to accept this fate. They realized the importance of actively engaging in health care management, not just being passive participants. This mindset shift set the stage for transformative change.
The Shift to a Self-Insured Model with Direct Hospital Partnerships
One of Plainfield’s biggest wins has been its direct contract with the county’s local hospital, Hendricks Regional Health. According to Nate Thorne, this narrow network approach not only improved care quality, but it also reduced costs. The partnership led to the creation of a wellness center where employees receive advanced primary care, preventive screenings, and other services at no cost.
More than 70 percent of Plainfield employees and their families now participate in the wellness program. This proactive approach keeps workers healthier and helps prevent catastrophic medical events that strain health plans.
Zero Deductibles and Copays: Building a Robust and Sustainable Plan
Many might assume that offering no deductibles or copays comes with unsustainable costs. The opposite is true for Plainfield. The direct contract model and active plan management have allowed the town to avoid millions in additional expenses over the past decade. Nate Thorne shared that savings are reinvested into new benefits, such as mental health services and support for child care through creative use of HSA and FSA funds.
Even when facing high-cost years, the town’s reserves have enabled it to cover claims without shifting more costs to employees, which keeps morale and well-being high.
Lessons for Other Municipalities: Courage, Education, and Collaboration
What holds other towns back? Frequently, it is fear of risk, resistance to leaving fully insured models, or lack of education on self-insured options. Nate Thorne emphasized the importance of having passionate leadership, a knowledgeable broker, and a willingness to learn from others. Start with small steps, build relationships with local providers, and share experiences with neighboring employers.
Importantly, Plainfield doesn’t keep its playbook a secret. The team publicly shares their approach, believing that broader adoption of these proven strategies can benefit communities everywhere.
Looking Ahead: Continuous Adaptation and Employee Engagement
Plainfield continues to innovate. Initiatives on the horizon include developing affordable options for retirees and addressing the costs of new therapies, such as GLP-1 drugs for chronic disease management. Employee input plays a significant role: regular surveys and benefits committee meetings ensure that the plan evolves to meet real needs, as described by Nate Thorne.
Key Takeaways for Forward-Thinking Employers
Plainfield’s story is a testament to the power of local solutions, direct provider relationships, and active health plan management. When municipalities reframe health care as an investment rather than just an expense, everyone benefits: employees, taxpayers, and the community at large.
If you're ready to explore similar innovations in your town, start by shifting your mindset, leveraging local partnerships, and learning from peers like Plainfield. As Dave Chase closed out, the tools and solutions are here. All it takes is the courage to make it happen.
Ready to help your employees thrive and save taxpayer dollars? Follow the lessons from this episode to begin relocalizing health in your own community.
Learn More:
RosettaFest 2025 - https://rosettafest.org/
Health Rosetta - http://healthrosetta.org/
Nautilus - https://www.nautilushealth.org/
Kynexions - https://kynexions.com/
Dave Chase - https://www.linkedin.com/in/chasedave/
Podcast Website - https://relocalizinghealth.com/
Nate Thorne - https://www.townofplainfield.com/directory.aspx?EID=7