Faced with rising health insurance costs and limited choices, the Texas cities of Bryan (66,000) and College Station (68,000) joined forces with Brazos County (152,000) to form a consolidated employee health care plan. Through an effort that included changes in plan administration and a requisite change in state law, these three localities conducted a joint RFP while retaining individual decision-making authority. More significantly, the communities reduced their health care premiums while providing a greater range of choices of hospitals and health care providers.