What’s at stake?:
In response to a letter of complaint on behalf of 6,200 retirees, Fresno Unified School District denied the letter’s allegations.
In response to a letter on behalf of 6,200 retirees impacted by a recent health coverage disruption, Fresno Unified has said its claims are baseless, emphasizing that no retirees have lost health insurance coverage.
On Jan. 22, a letter of complaint drafted by local attorney Kevin Little on behalf of the affected retirees was filed to the Fresno Unified School District and its board. The letter demands that the district return to its pre-2023 self-funded healthcare plan and reimbursements for expenses accumulated from network restrictions and coverage denials.
The letter also pushed back against district statements that only 25% of retirees use Community Medical Centers, saying the district does not include patients also receiving specialist care and other services at Community facilities. Additionally, the letter alleges that Fresno Unified’s conduct is tantamount to elder abuse.
“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.
On Monday, FUSD released a statement describing the letter’s claims as untrue.
“These allegations are baseless, misleading, and have unnecessarily alarmed retirees who understandably care deeply about their health coverage,” the district said in a news release.
The district said that retirees still are and will continue to receive health insurance coverage, stating again that the current issue arises from unresolved negotiations between Community and Aetna, one of the district’s insurance providers.
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The district responded to one of the letter’s claims that the transition in coverage by the district’s Joint Health Management Board (JHMB) in 2023 was done without consent, consultation or legal justification to retirees.
The letter also claims that the district engaged in secret negotiations with the JHMB for two years before the change. District officials say the transition process was transparent and included representatives from the Fresno Unified Retiree Association (FURA), the district and the JHMB.
Specifically, the district said, the FURA sought the help of an independent healthcare consultant over an 18-month period between 2021 and 2022. According to the district, consultant Joanna Smith, CEO of Health Liaison, Inc., met with JHMB staff to ask questions, raise concerns, and advised FURA during this period.
The retiree letter notes that the district has until Feb. 28 to confirm acceptance of the demands and a timeline for restoration of coverage for retirees. The district’s statement did not comment on the letter’s timeline.
In a brief phone call, Little told Fresnoland that he would take legal action if the district did not respond.
“I’m hopeful that we don’t have to take that step and that we can take a cooperative approach to this,” Little said.
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