Enrollment & Eligibility

Understand your options.

Eligibility

Whether you are a full-time employee, part-time employee, or retiree of Fresno Unified School District, you have options when it comes to your healthcare coverage—and your dependents have options, too. Learn more about who can enroll and how to get started here.

Who Can Enroll?

Permanent employees working a minimum of 4 hours a day or 20 hours a week are eligible and are required to participate in the benefits program. Eligible employees may also choose to enroll family members, including a legal spouse/state registered domestic partner and/or children.

Children are considered eligible if they are your or your spouse’s/state registered domestic partner’s:

Biological child, stepchild or adopted child up to the age of 26
Child up to the age of 26 subject to a Qualified Medical Child Support Order (QMCSO)
Child under permanent legal guardianship up until it ceases due to child’s legal age attainment, death, marriage, military enlistment, adoption or any other reason declared by a court
Child of any age if they are incapable of self-support due to a physical or mental disability that existed prior to such child reaching the age of 26

When Does Coverage Begin?

Benefits for eligible new hires commence on the first day of the month following your date of hire. Eligible employees must complete their benefit enrollment forms and submit to the Benefits Department within 31 days of benefit eligibility.

New full-time employees who do not actively make benefit elections during their initial eligibility period will be automatically enrolled with “Employee Only” coverage in Medical Plan A, Delta Dental PPO™, VSP Vision, and Standard Basic Life Insurance plans. Employees must complete enrollment forms to add coverage for dependents or select alternate plans.

New part-time employees who work less than 20 hours a week may enroll in the UnitedHealthcare Dental HMO and/or VSP Vision plan at their own expense.

Your enrollment choices remain in effect through the end of the benefits plan year.

Please note, if you miss the enrollment deadline, and are automatically enrolled in benefits as described above, you will not be able to change your benefits coverage until the next Open Enrollment period unless you experience a special enrollment event during the plan year. Please review the HIPAA Special Enrollment Rights Notice on page 36 for more information.

No Opting Out

All eligible active District employees shall be required to participate in the Health Care Plan and pay the monthly contributions and assessments, at least at the Employee Only level, for the Plan(s) or coverage. You will automatically be enrolled in Medical Plan Option A, Delta Dental®, VSP Vision, and Basic Life Insurance if you don’t make an election within 31 days of benefit eligibility. Coverage for your dependent(s) and/or choosing an alternate plan is available at your expense. It is important to note that if coverage is waived for your dependents, the next opportunity to enroll in our group benefit plans would be the next open enrollment or when a special enrollment event occurs.

Enrollment

Changes to your health and welfare benefits can only be made during one of the instances below:

Within 31 Days of Your Eligibility Date

This eligibility window is for newly hired employees or for employee’s returning from an unpaid leave. The district offers an online system that walks you through the process of enrolling into your health and welfare benefits. An email will be sent to your FUSD account with the link to your New Hire enrollment portal.

Within 31 Days of a Special Enrollment Event

You qualify for a Special Enrollment Event if you have recently experienced certain life events, including getting married, entering into a domestic partnership, having a baby, adopting a child, or obtaining permanent legal guardianship over a child. You have 31 days from the day of the event to fill out a “Special Enrollment Form” and submit it to the Benefits Department.

During Open Enrollment

Every year, from October 1 through November 30, the district hosts its yearly Open Enrollment period. This is your opportunity to make changes to your benefits (such as adding or removing dependents, switch to a different plan, etc.). Changes will take effect January 1 of the following year.

Online Enrollment for New Employees

By your start date, you should receive an email at your District email address from the Benefits Department. After reviewing your options, complete your enrollment online. The District’s online enrollment system will walk you through each of your enrollment decisions. You can start and finish when it’s convenient for you using the unique hyperlink sent to your District email address. If you do not receive an email or have questions when completing your online enrollment, contact the District’s Benefits Department.

Special Enrollment for Dependents

If you are declining enrollment for your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll your dependents through special enrollment if they lose eligibility for that other coverage (because of separation/divorce, termination of employment or reduction in hours, death, or cessation of employer contribution), or if your dependents were receiving COBRA coverage and their eligibility for COBRA has expired. However, you must request enrollment within 31 days after your dependents’ other coverage ends.

In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may enroll your new dependents. The District also allows you to enroll a child placed in your permanent legal guardianship outside of open enrollment, subject to the Special Enrollment requirements. If you are enrolling a new dependent as a result of birth, adoption, placement for adoption, or permanent legal guardianship, you can also enroll your spouse or state-registered domestic partner if he or she was not previously enrolled in the Plan, but only if he or she is otherwise eligible to participate in the Plan.

Part-time employees are only eligible to enroll in dental and/or vision insurance if they experience a special enrollment event.

Special enrollment rights may also exist in the following circumstances:

If your dependents experience a loss of eligibility of Medicaid or a State Children’s Health Insurance Program (“SCHIP”) coverage and you request enrollment within 60 days after that coverage ends.
If your dependents become eligible for a state premium assistance subsidy through Medicaid or a SCHIP with respect to coverage under their plan and you request enrollment within 60 days after the determination of eligibility for such assistance.

To request Special Enrollment or to obtain more information, contact the District’s Benefits Department.

Frequently Asked Questions

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