What's at stake?
Fresno Unified could drop the lapsed insurance contract, but officials say the process would take months.
Roughly 1,500 retirees on Medicare who receive medical coverage from Fresno Unified have lost access to Community Medical Centers following unresolved negotiations.
In the last board meeting of 2025, the Fresno Unified Board of Education approved a contract with insurance company Aetna to maintain healthcare coverage for around 6,200 retirees and dependents.
However, at the time of the board meeting, contract negotiations between Aetna and Community were still ongoing despite a deadline of Dec. 31. Around 1,500 retirees and dependents see a primary care doctor at Community.
But with that deadline now passed Community facilities are no longer considered “in-network”, leaving many retirees with only emergency services available to them.
“I want to assure our retired employees that the JHMB (Joint Health Management Board), in coordination with the district’s benefits team and external consultants, have been and are actively evaluating all options, reviewing data requested from Aetna, and assessing potential paths forward,” said Superintendent Misty Her in a statement on Monday.
Previously, district Chief Financial Officer Patrick Jensen told the board that the district’s contract with Aetna could be cancelled if Aetna isn’t able to maintain coverage with a major local hospital.
Originally, the board had approved the contract with Aetna to prevent any gaps in coverage for the rest of the retirees who would not be impacted by the negotiations.
While cancelling the contract with Aetna could allow the district to switch all retirees to a different provider, Jensen warned that such a process could take six months to complete.
According to an update posted on their website on Dec. 30, the JHMB noted that enrolled retirees may continue to receive care from out-of-network providers, but only if:
- Services provided are covered by Medicaid
- The provider is willing to bill Aetna as out-of-network
- The provider is willing to provide care
Aldo De La Torre, division president of Community’s insurance services & managed care, also shared with Fresnoland that those who were receiving care at Community may be able to request for a continued care provision.
“If a patient in this group is in active treatment with a Community Health Partners physician, they can request authorization from Aetna for a ‘continuity of care’ provision,” De La Torre said in an email to Fresnoland.
“This would allow Community providers to continue to provide services for up to one year upon Aetna’s approval to allow ample time for the patient to transition to another provider while still receiving the care they require.”
It wasn’t immediately clear when the Fresno Unified school board planned to revisit the issue.
Correction: An earlier version of this story misidentified the insurance program affected retirees’ reliance on. Those affected rely on Medicare.
