Requiring local government employees and retirees in New York to pay a share of health insurance premiums could save more than $1 billion annually, according to a think tank report released Monday.

Most municipalities and many school districts pay most or all of the medical insurance costs incurred by current employees, the Nelson A. Rockefeller Institute of Government report said. In contrast, state employees and retirees who retired after 1982 shoulder 10% of individual premiums and 25% of family coverage. The institute is an independent policy think tank affiliated with the State University of New York.

“A significant — and growing — portion of New York State’s financial assistance for local governments and school districts pays for local employee and retiree health insurance premiums,” the report said. “The state must, and can, control the growth of employee and retiree health benefit expenses without compromising the quality of the services.”

The report recommended requiring all public employees to make minimum premium payments as state employees do or join the state’s insurance plan.

The abundance of collective bargaining agreements with public employees complicates attempts to change, according to Mark LaVigne, the deputy director of the New York State Association of Counties.

“These employee contributions for the most part are subject to labor-management agreements,” LaVigne said. “Each county would not just have one labor management agreement in terms of health care insurance premiums, but may have several.”

It was typical for school district employees to pay nothing for health insurance premiums 20 years ago, according to Carl Korn, spokesman for the New York State United Teachers union. That is no longer true, he said

“The vast majority of school employees already pay toward their health insurance costs,” Korn said. “In fact, there is a trend toward employees paying even larger shares of their health insurance costs.”

New York City Mayor Michael Bloomberg proposed mandatory premium contributions last year but did not get those concessions from the unions during collective bargaining.

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