What's at stake?
Some retirees will be able to choose from the district’s current Medicare Advantage Plan and from a new plan that is similar to one offered by FUSD prior to 2023
After a week of mounting demand resulting in an extension of healthcare access from Community Health System, Fresno Unified leaders on Thursday announced an additional option plan for retirees.
The move comes a day after a sudden announcement from FUSD Superintendent Misty Her during Wednesday’s board meeting, where Her said Community agreed to an extension for retirees to access care through Feb. 20.
Now, after a close-door meeting with the district’s Joint Health Management Board (JHMB), retirees will be able to choose from the district’s current Medicare Advantage Plan and from a new plan that is similar to one offered by FUSD prior to 2023.
“Some Medicare retirees have asked for that choice, and we are responding, however, due to regulatory requirements, implementing this option could take several months,” said Fresno Teachers Association (FTA) President Manuel Bonilla during the news conference.
Bonilla also stressed that offering this plan will not prevent future network disruptions, reiterating that the current dispute is between FUSD’s insurance carrier, Aetna, and Community Health Systems.
Additionally, Bonilla said that the demands of district leaders have not been fully met yet.
According to Bonilla, when district leadership met with Community’s leadership on Wednesday morning, district leaders asked for a 30-day contract extension allowing Medicare-aged retirees to have full access to Community providers in the midst of negotiations.
Community leaders instead offered limited access to physician visits and prescription refills effective through Feb. 20. Moreover, Bonilla says that it is still unclear if the limited access will cover lab and imaging work and referrals for follow-up care.
Community leaders have not explained why it is only offering a limited extension or why it did not offer an extension of access to care between Jan. 1 and Wednesday.
What’s the new option for Medicare-age retirees?
The “new” option would let retirees enroll in a plan similar to one the district offered prior to 2023, a supplemental insurance that covered remaining costs for retirees enrolled in Medicare Parts A and B.
The district’s financial officer, Patrick Jensen, said during the news conference that retirees will be able to choose the new plan when the enrollment period begins in October of this year. The alternative plan would take effect Jan. 1, 2027.
Jensen also explained that any retiree who wants to exit the district’s coverage altogether and become a sole Medicare client can do so during Medicare’s enrollment in the spring.
In all, retirees will have the option between the new supplemental plan, the current Aetna Medicare Advantage Plan, as well as the district’s Kaiser plan when enrollment opens.
However, the district said that the actions taken by the JHMB on Thursday are not a complete resolution to the current disruption.
“Thursday’s JHMB meeting will not resolve this immediate issue as that will give retirees another option on what health plan they want to cover them,” the district said in an email to Fresnoland on Thursday. “We need Aetna and Community to come to an immediate agreement. They can also extend the timeline for negotiations to allow members to continue receiving services.”
