TO: All Participants Enrolled in Plan Option C or Kaiser Senior Advantage under the Fresno Unified School District’s Health Care Plan
DATE: September 8, 2017
Over the last several months, the Joint Health Management Board (JHMB) has been considering whether to renew the agreement for Kaiser Plan Option C and Kaiser Senior Advantage for the 2018 calendar year. At this time, the Board is deadlocked in their decision to renew or terminate Kaiser for the upcoming year.
We sincerely recognize the issues that this creates for our members currently participating in Kaiser and those who may be considering it for this year’s open enrollment. Both the JHMB bylaws and each union agreement outline the arbitration process that the JHMB has now initiated to resolve this deadlock in the timeliest manner.
We will provide you with updates on this process as quickly as possible in the upcoming weeks. However, it is possible that a decision may not be confirmed until this year’s open enrollment period has already begun. That said, here are some things we feel you should consider as we work towards a final decision.
Things You Should Consider for Open Enrollment
This year’s open enrollment period will occur from October 2 – December 1, 2017. As stated, it is possible that a final decision regarding Kaiser will not occur until during the open enrollment period. While we cannot be sure as to when a decision will be made, we recommend that you consider the following options during this year’s open enrollment to ensure you have the right coverage for you and your family.
If You Wish to Remain in Plan Option C or Kaiser Senior Advantage
If you wish to remain in Plan Option C or Kaiser Senior Advantage, you do not need to take any action. Should the JHMB agree to maintain Kaiser, your coverage will continue on January 1, 2018. However, should the JHMB decide to terminate Kaiser, you will be notified and your coverage will be defaulted to PPO Plan Option A with Anthem Blue Cross. Currently, the co-payments and out-of-pocket costs between Plan Options A and C are the same.
In addition, if your coverage is defaulted to Plan Option A, the JHMB will make every attempt to provide for smooth transitions of care between the two plans. We will also, at that time, provide pertinent details regarding any transition of care issues.
If You Wish to Change Coverage
Should you wish to change coverage from Plan Option C to Plan Options A or B, simply review the material provided in the open enrollment packet sent to your home in the coming weeks and make the best decision for you and your family. The materials will provide detailed instructions about how to change coverage and enroll dependents.
More Information Coming Soon
For the first time in our 12-year history, the JHMB has reached a deadlock that has led to arbitration. We recognize the challenges that this creates for you and your family as you consider your healthcare options for the upcoming year. We will do our best to provide an update as quickly as possible once a decision is made.
Until then, please be sure to review the open enrollment materials mailed to your home in the coming weeks. If you have any additional questions, please download and review the FAQ provided below.
Download FAQ
SPECIAL NOTE: Kaiser Permanente® will not be able to address questions regarding the JHMB’s current deadlock. It is the JHMB’s decision to maintain or terminate the Kaiser plan option and therefore Kaiser’s customer service representatives will not be able to provide any updates or direction regarding the outcome of the JHMB’s arbitration.
