Fresno Unified retirees filed a formal letter of demand Thursday against the district and School Board, alleging elder abuse and opposing the imposition of the Aetna Medicare Advantage Plan.

“The main concern is that without their consent, the retirees and their beneficiaries had their medical coverage switched to an Aetna Advantage plan that doesn’t constitute the lifetime medical coverage that retirees and their beneficiaries have been entitled to,” attorney Kevin Little said.

In 2023, the Joint Health Management Board — comprised of union representatives and district staff — placed retirees on Aetna’s Medicare Advantage plan. The for-profit provider caused retirees to “(Experience) systematic harm documented through testimony, patient interviews, and provider communications,” the document states.

Prior to the advantage plan, retirees had Medicare as their primary insurance and a district provided secondary plan. And on Jan. 16 of this year, JHMB voted to allow that option to return.

The problem: The plan doesn’t go into effect until Jan. 1, 2027.

“(People need) this issue to be rectified immediately, not a year from now,” Little said.

A group of retirees has been advocating for this plan since the district removed it as an option. And concerns amplified 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.

“We recently received the complaint, so we are still in the initial review process. However, it’s our policy not to discuss items involving potential litigation,” a Fresno Unified spokesperson said in a statement to GV Wire.

The group submitted an additional claim “letting (the district) know that if this issue is not resolved to our satisfaction that we fully intend on filing suit,” Little said.

Related Story: Fresno Unified Retirees Healthcare Demands Are Met — for Now

Demand Letter Alleges ‘Elder Abuse’

The letter, filed on behalf of approximately 6,200 retirees and beneficiaries, details “elder abuse and civil rights violations.”

“The district’s conduct — knowing or reasonably should have known that network disruptions, prior authorization denials, and plan opacity would disproportionately harm the oldest, most vulnerable retirees—constitutes systematic elder abuse,” the letter states.

Aetna Advantage Plan caused retirees “systemic harm” through its cancelation of medical appointments for cancer care, lung transplant, and specialty care patients, documents say.

And now, there is uncertainty surrounding retirees’ access to care offered through Community and its medical partners. A significant portion of retirees rely on Community specialists and cannot switch providers mid-treatment, retirees say.

And those who suffer from cognitive decline or do not have family advocates cannot navigate the appeals process Aetna requires.

Additionally, the temporary agreement between the district and Community, allowing care through Feb. 20 is “creating ongoing uncertainty for retirees and providers alike.”

Fresno Unified Trustee Susan Wittrup’s first priority is getting this care back.

“That’s a pathetic response from Community. It’s not system wide,” she said. “It’s the tiniest concession that they could give. And I’m very disappointed in Community for taking access away from our retirees who need it so desperately.”

Calls to all other trustees were not returned.

However, the letter points to “network instability” and “restricted provider networks” as the origin of these issues.

Retirees have incurred massive injury due to the coverage, according to Emily Brandt, a retired English teacher. And she feels some district leaders have been “insensitive to issues” and have a gap in understanding regarding what life is like for older retirees.

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

Retirees Cite Previous Lawsuit in Demands

The demand letter cites a 2010 court decision, which found that Fresno Unified violated the promise of lifetime benefits offered to employees and demanded the district “restore the benefit and make retirees whole for their losses.”

Fresno Unified paid $3.2 million to the affected retirees and approximately $2.5 million in legal fees according to public records acquired by GV Wire.

The district has violated this ruling and once again stripped retirees of lifetime benefits, according to the letter.

“The promised lifetime health benefits constitute vested deferred compensation that cannot be impaired without legal justification or additional consideration. The Medicare Advantage Plan substitution provides neither,” documents state.

Fresno Unified committed to paying for retiree health care beginning in a 1977 bargaining agreement, according to the original lawsuit. In return, employees forwent salary increases.

The district altered that benefit in 2005 after negotiating with employee unions — reducing health-care liability.

After, the district began requiring retirees to pay for benefits to help close a health-care funding gap. But retirees, who were guaranteed free health care, accused the district of breaking its promise.

The ruling required the district to reinstate the free benefits policy and repay — with interest — contributions made by retirees since 2005. The district agreed to extend the date of the judgment to include all those who retired before Sept. 1, 2006.

“It’s our contention that there’s no lawful reason to treat post-2006 retirees differently,” Little said. “Pretty much everyone who is being impacted by this was associated or employed by the district in 2006… We believe there’s no lawful justification to interrupt the vested rights of these beneficiaries.”

Related Story: Fresno Unified, Teachers Union Say Community Using Retirees as ...

Aetna Doesn’t Meet Lifetime Benefits, Letter Claims

The letter asserts that the health care coverage offered to retirees does not qualify as “lifetime benefits,” which the district promised retirees.

Currently, Aetna’s Medicare Advantage PPO and Kaiser Senior Advantage HMO are the only options of retirees ages 65+. The School Board approved the continuation of a contract between the district and Aetna in December.

Fresno Unified will pay about $530 per member, increasing expenses by 85%, according to School Board documents. Expenses will increase by 11.7% in 2027.

“The district’s continued characterization of Aetna Medicare Advantage and Kaiser Senior Advantage as “lifetime benefits” is legally and factually false,” documents state. “Only original Medicare, as a federal program existing permanently through statute, qualifies as a true lifetime benefit within the meaning of the 2010 court ruling and the district’s historic promises. For-profit managed care products can be modified, terminated, or narrowed by contract at any time.”

Additionally, JHMB imposed Aetna Medicare Advantage on retirees without consent, consultation, or legal justification, the document alleges.

However, JHMB asserts it did communicate with retirees. The board met with FURA three times prior to the 2023 decision, Fresno Unified CFO Patrick Jenson previously told GV Wire.

In 2024, the retirees group sent their own letter of demand to the district— threatening litigation if retirees could not access the previous Medicare plan.

The district requested specific examples of individuals that were experiencing coverage issues during an in-person meeting, but FURA never responded, according to Jensen.

“A structure intended to ‘embody core union values: transparency, democratic representation, informed consent, and accountability to the members whose lives are affected’ instead evolved into a decision-making apparatus that made changes of extraordinary permanence with minimal engagement of members or retirees,” the letter states.