This year's annual Open Enrollment for 2024 benefits occurs from October 1 to November 30, 2023. If you are now a retiree who still needs to enroll in Medicare, you are required to enroll or re-enroll in Medicare and also fill out the District’s Retiree Election Form and Enrollment Form, returning them to the District Benefits Office by no later than Thursday, November 20, 2023. All changes will be effective January 1, 2024. Please review the following brief highlights to understand the options you have for 2024.
As a Medicare-eligible retiree, you have different options regarding your medical and prescription coverage. As a reminder, if you wish to make changes to your coverage, or add/remove eligible dependents, you must complete the Benefits Open Enrollment form.
If you are already enrolled in Medicare and are a retiree, visit this Open Enrollment guide.
Aetna Medicare Advantage Plan Option
Effective July 1, 2023, the PPO option for Medicare-eligible retirees transitioned to the Aetna Medicare Advantage Plan. The new plan offers additional benefits for Medicare-eligible members and Medicare-eligible dependents, including no deductibles, no out-of-pocket charges, and no co-pays in many cases. The Aetna Open Choice PPO plan, for non-Medicare-eligible dependents, resembles PPO Plan A. These plans provide you and your dependents with medical and prescription drug coverage featuring a provider network available in Fresno County and throughout most of the United States.
If you were previously enrolled in the PPO Plan A or B, you likely have been enrolled in the new Aetna Medicare Advantage plan (unless you chose Kaiser Senior Advantage or opted out). During this open enrollment period, you are able to review your options and make desired changes on the enclosed Open Enrollment form.
If you are requesting to enroll/re-enroll into the Aetna Medicare Advantage plan, you must do so by November 20, 2023. Any other changes you wish to make to your existing Aetna Medicare Advantage plan coverage can be made during the annual Open Enrollment period from October 1, 2023, to November 30, 2023.
For information about the Aetna Medicare Advantage (PPO) Plan, contact Aetna Customer Service 1-888-267-2637 or visit aetnaretireeplans.com.
Kaiser Permanente® Senior Advantage Plan Option
From October 1, 2023 to November 20, 2023, Fresno Unified School District is offering an enrollment opportunity for the Kaiser Permanente® Senior Advantage plan. This employer-sponsored group coverage is available to Medicare-eligible retirees and spouses. There are no changes in benefits for this plan for 2024.
If you wish to change to Kaiser Permanente Senior Advantage (KPSA) plan effective January 1, 2024, you will have to make this change during this enrollment period and return your election forms to the District’s Benefit Department by November 20, 2023.
To learn more about the Kaiser Permanente Senior Advantage plan, please contact Kaiser Permanente at the information provided below. Enrollment forms are available for pick up at the District Benefits Office.
For information about the Kaiser Senior Advantage (HMO) Plan, contact Kaiser Permanente, (855) 843-8390 (TTY 711 for the deaf, hard of hearing, or speech impaired). The phone lines are open seven days a week, 8 a.m. to 8 p.m.
As a reminder, if you wish to change to Kaiser Senior Advantage effective January 1, 2024, you will have to make this change by November 20, 2023. Any other changes you wish to make to your current health plan offerings can be made during the annual Open Enrollment period from October 1, 2023, to November 30, 2023.
If you do not want to participate in either the Aetna Medicare Advantage or Kaiser Senior Advantage plans, you have the opportunity to opt out. If you choose to opt out, you will not have medical or prescription coverage through Fresno Unified School District and will not be able to re-enroll until either the next Open Enrollment opportunity, or if a special enrollment event occurs.
Medicare Enrollment Reminder
The Joint Health Management Board wants to remind you of the importance of continued enrollment in Medicare once you are eligible. The District’s Health Care Plan indicates that you must enroll in Medicare Parts A & B as soon as you and/or your spouse become eligible for Medicare as a retiree.
In order to keep enrollment in either the Aetna Medicare Advantage or Kaiser Senior Advantage plans, you need to have current Medicare enrollment. Furthermore, if you enroll into a Medicare Advantage or Medicare Prescription Drug plan elsewhere, you may be disenrolled from the plan you are enrolled with through the Fresno Unified School District. If you are currently enrolled in another Medicare Advantage or Medicare Prescription Drug plan elsewhere, your new enrollment in the Aetna Medicare Advantage may disenroll you from the other plan.
Vision Plan Changes
Vision coverage is now provided by VSP Vision as a PPO plan. The switch to a new provider also comes with additional in-network benefits, including an increased in-network frame allowance to $175 (up from $130), added calendar year allowance for glasses and contact lenses, and added full coverage for progressive and transition lenses.
To locate an in-network VSP Vision provider, go to www.vsp.com, click on “Find a Doctor.” You can search by location, office or doctor. Any questions pertaining to your vision coverage can be directed to VSP Vision by calling (800) 877-7195, or by visiting the website at www.vsp.com.
Dental Plan Changes
Delta Dental Premier® Incentive Plan
If selecting the Delta Dental Premier Incentive Plan, you will receive additional benefits including up to 100% coverage for many dental services through in-network and out-of-network providers. The plan is on a new tiered structure designed to increase your benefits as you continue receiving dental care every year. This plan is an enhancement of the existing Delta Dental Dental PPO™ plan.
The new incentive-tiered structure applies to preventive services, restorative services, periodontics, endodontics, oral surgery, and crowns & inlays. There is 100% benefits coverage for participants covered by the plan as of December 31, 2023. Otherwise:
- 70% coverage when receiving dental care for the first year enrolled
- 80% coverage when receiving dental care for the second straight year while enrolled
- 90% coverage when receiving dental care for the third straight year while enrolled
- 100% coverage when receiving dental care for the fourth straight year (or longer) while enrolled
Note: Benefits will decrease by 10% if you do not receive dental care each year.
For further assistance or to find an in-network dentist, contact Delta Dental® at (866) 499-3001 or visit www.deltadentalins.com.
UnitedHealthcare Dental HMO Updates
Benefits have been increased for the existing UnitedHealthcare Dental HMO plan:
- Composite fillings and root canals are now no charge.
- All oral surgery, crowns & inlays, and prosthetics & bridges are now no charge.
- The maximum out-of-pocket expense for 24-month orthodontia services have been reduced to $1,250.
You can contact UnitedHealthcare at (800) 999-3367 or find an in-network dentist at www.myuhc.com.
2024 COBRA/ED CODE 7000 Dental and Vision Rate Change
Effective January 1, 2024, for retirees on automatic premium deduction for Dental and/or Vision through CalPERS/CalSTRS, premiums will update automatically. No action is needed. You will receive a notice regarding the rate change.
Retirees who are on a monthly bill pay through the bank/bank transfer/writing checks to FUSD, premium payments must be adjusted accordingly.
Retiree Workshop Dates
Have questions about your benefits as a District retiree? We are holding two workshop days to assist you in what you need to do to maximize your plan.
We will hold two sessions per day on Tuesday, October 17, 2023, and Wednesday, October 18, 2023, at DoubleTree by Hilton, Fresno Convention Center, located at 2233 Ventura St. in Fresno. The first session each day will start at 9 a.m. and end at 11 a.m., and the second session will be held from 1 to 3 p.m.
New, Employee-Centered Website
JHMBHealthConnect.com is your go-to resource on your benefits. As a retiree, the new Joint Health Management Board website is designed to help you understand and use those benefits. Whether you have questions about your Aetna Medicare Advantage or Kaiser Senior Advantage plan, your specific benefits, or your healthcare, HealthConnect will point you in the right direction, supporting you on you journey to better health and wellness.
Stay Connected – Sign Up for Monthly Updates & Benefit Alerts
Every month, the JHMB provides our plan participants with healthful information to help them along their path to better health. This includes benefits alerts and key reminders, upcoming events, healthful news and local activities, wellness offerings, healthy recipes, and even a Healthy Aging Corner for our age 55+ plan participants. If you are not currently receiving these healthful email updates,
Dependents Eligibility Reminder
Notify the District when your ex-spouses and dependents are no longer eligible for benefits.
As a reminder, you are required to notify the District within 60 days following the date on which any dependent no longer meets the eligibility criteria for dependent coverage (including divorce or legal separation; and the termination, dissolution or nullification of Domestic Partnership).
Failure to notify the District within the required time period may cause you to be responsible for the reimbursement of any claims paid for ineligible dependents.
WellPATH Program Update
WellPATH, the Employee Wellness Program for Fresno Unified School District, is pleased to offer a variety of wellness services throughout the year. Below are some highlights of the WellPATH program.
Participate in Wellness Challenges – Improve Your Health and Win Prizes
Throughout the year, the WellPATH Program serves up wellness challenges to jumpstart and/or cultivate healthy habits among its members. These challenges typically run six to eight weeks and offer individual and work site incentives based on healthy eating, exercising, and educational activities.
Become a WellPATH Champion!
WellPATH Champions are on-site ambassadors for the WellPATH program who are committed to creating a workplace culture of health and wellness. They share wellness-related information with coworkers and help them connect with wellness programs and activities. WellPATH Champions receive program benefits and incentives. Contact WellPATH if you would like to receive information about becoming a WellPATH Champion.
Participate in a WellPATH Wellness Screening – ”Know Your Numbers” and receive a $50 Gift Card!
There are important numbers that we all need to know in order to safeguard our health. Cholesterol, blood pressure, waist size, body mass index, and blood sugar are key indicators of our risk for major illness. By knowing these numbers, we can take action to reduce our chances of developing heart disease, diabetes, and other major illnesses. It is very important to get these numbers checked on a regular basis and you can learn this information by attending a WellPATH Know Your Numbers wellness screening. These are offered at various District locations throughout the year. Visit our Wellness Screenings page for the current schedule.
Additional Services Offered by WellPATH
WellPATH offers many additional services, including:
- Annual preventative wellness screenings ($50 gift card for participating)
- Wellness challenges (Gift Card Prizes for qualifying participants)
- Free onsite group fitness classes
- Annual flu shot clinics (NEW – $25 gift card for receiving your flu shot at a WellPATH event)
- Monthly health education
- Wellness coaching
- Personal training (member must qualify)
- Behavior modification (member must qualify)
Take a Healthy Minute and Schedule a Preventative Cancer Screening
Under the District’s health plan, all participants are eligible for FREE preventive cancer screenings. Take a Healthy Minute and schedule an appointment with your physician today to get up-to-date with your routine cancer screenings.
Employee Assistance Program (EAP) – Available to Retirees Too!
The Employee Assistance Program, offered through Claremont EAP, helps you resolve personal issues before they become more serious and difficult to manage. Claremont will support you quickly and confidentially in dealing with the stresses and challenges of everyday life. You and your family members can receive the following professional, confidential counseling services:
- 5 Free Counseling Visits per Incident
- Financial Services
- School/College Assistance
- Pet Care Referrals
- Wellness Referrals
- Legal Consultations
- Child/Elder Care Referrals
- Adoption Assistance
- Daily Living/Convenience Referrals
The EAP also provides access to resources that can help you address virtually any personal concern or question. Visit www.ClaremontEAP.com for more information or call Claremont EAP at (800) 834-3773 to discuss your question or issue with an experienced counselor who will refer you to the resources most appropriate for your needs.