Fresno Unified’s Joint Health Management Board approved an additional health care plan Thursday, expanding options for retirees.

Soon, Medicare eligible retirees will have the option to enroll in traditional Medicare with the district providing a secondary plan.

“We are very excited, grateful and relieved for the offer to return to traditional Medicare and our employer supplemental healthcare plan. This was the ask and we are delighted,” said Elizabeth Robeldo, a current Fresno Unified teacher who works with retirees.

An outspoken group of retirees has been advocating for this plan since 2023, when the district removed it as an option.

They say their insurance plan, under Aetna, pushes prior authorization for procedures, referral rules, denials, and insurer-run appeal

Currently, retirees’ only options are Aetna’s Medicare Advantage PPO and Kaiser Senior Advantage HMO.

“This morning, the Joint Health Management Board took action to approve additional options for our retirees,” said Manuel Bonilla, Fresno Teacher Association president. “Some Medicare retirees have asked for that choice, and we are responding.”

Recently, retiree concerns came to a head when contract disputes between Atena and Community Medical Centers caused thousands to be cut off from care offered through the region’s largest medical provider.

Community announced Wednesday it will extend access to clinic visits and prescription refills through Feb. 20 while negotiations continue. This includes emergency services and ongoing treatments, including cancer care.

Related Story: Fresno Unified Retirees Will Have to Wait Until 2027 for New Medicare Option

Fresno Unified Retirees Can Enroll in Fall

Medicare eligible retirees will be able to select this option during the district’s standard open enrollment period lasting from Oct. 1 through Nov. 30.

The new coverage will take effect on Jan. 1, 2027 — almost one year from now.

Federal regulatory requirements and the district’s creation of a comprehensive communication plan are the reasons behind the long wait, Fresno Unified’s CFO Patrick Jensen told GV Wire.

Fresno Unified will present insurance contracts to the School Board and provide detailed information to retirees in August and September, Jensen said.

District communications, including educational resources and enrollment support, will help retirees properly compare options and make an informed decision.

However, Bonilla and JHMB member Jon Bath believe that most retirees will stay on the Aetna Medicare Advantage plan. The plan provides lower costs for folks who are on fixed incomes, according to Bath.

Related Story: Thousands of Fresno Unified Retirees Cut Off From Health Care

Retiree Request Representation

Now, retirees are advocating for an independent retiree representative to be placed on JHMB.

“The concern is that retirees over the age of 65 are still effectively left out of the agreement and our ask is to appoint an independent senior advocate to be appointed during these negotiations to speak directly to the needs of our most vulnerable retirees,” Robeldo said.

Currently, JHMB has representatives from all local union groups and district management. The union and administration each get one vote.

JHMB met with the Fresno Unified Retiree Association leadership three times prior to the 2023 decision to add Aetna, according to Jensen.

But the retirees group sent a letter of demand to the district in 2024 — threatening litigation if retirees could not access the previous Medicare plan.

“Retirees have also experienced a lack of medical services coverage through the new Aetna Plan, imposed upon them by the District with no other comparable alternative to the Plan that was in place prior to July 2023,” the letter of demand states.

The district requested specific examples of individuals that were having denial or lack of coverage issues, according to Jensen, but FURA never responded.

Retirees are hoping that a representative can ensure they are advocated for.

“I personally have been asking for a senior health care advocate who is independent. To have legal authority over these meetings to make sure that things are done in a proper way,” Emily Brandt told GV Wire.