January 21, 2026 Update:
Letter from Community Health System to Superintendent Misty Her:
January 21, 2026 Update:
Understanding your District Medicare Coverage
The Joint Health Management Board (JHMB) is providing this update to address confusion and misinformation currently circulating regarding Medicare enrollment and the District’s group Medicare plans.
This information is important for all Medicare retirees currently enrolled in Fresno Unified School District-sponsored coverage.
Key Clarification: Group Medicare vs. Individual Medicare
There is an important difference between individual Medicare coverage and the District’s employer-sponsored group Medicare plans offered through the District.
- Individual Medicare plans follow national enrollment periods set by the Centers for Medicare & Medicaid Services (CMS).
- District’s group Medicare plans operate under CMS-approved group rules and follow District enrollment timelines, not individual Medicare timelines.
Because of this difference, rules that apply to individual Medicare plans do not apply in the same way to the District’s group Medicare coverage.
Starting with the upcoming January 2027 renewal, the District will offer three group Medicare options: Aetna® MA-PPO, Kaiser Senior Advantage, and Medicare COB (similar to the District’s former July 2023 Medicare plan).
District Medicare Retirees will have the opportunity to review and choose among these options during the District’s group enrollment period.
The district administers enrollment changes through its group open enrollment periods, which run from October through November. Staying enrolled ensures uninterrupted coverage and keeps all District-sponsored Medicare options available to the member(s).
You Do NOT Need to Disenroll from Your District Medicare Plan
Some retirees have been told they must disenroll from their current Aetna® Medicare Advantage or Kaiser Senior Advantage plan by March 31, 2026, to later return to the Medicare COB plan. This is not correct for District group coverage. Opting out at this time would place a retiree in individual traditional Medicare rather than District-sponsored group coverage, and traditional Medicare alone does not include prescription drug or supplemental coverage unless purchased separately.
Please note:
- Disenrolling now is not required
- Disenrolling now may have unintended consequences
- Disenrolling now may cause unnecessary disruption to your coverage
Remaining enrolled in your current District-sponsored Medicare plan ensures:
- Continuous medical and prescription coverage
- Eligibility for all District-sponsored Medicare options
- CMS transition protections if plan changes occur
- Smoother enrollment timing with fewer administrative steps
Opting out early can create avoidable gaps, confusion, and additional administrative requirements that would otherwise be avoided.
If you have any questions, please contact the FUSD Benefits Office at (559) 457-3520
December 30, 2025 Update:
As of January 1, 2026, Community Medical Centers and Community Health Partners are no longer participating providers in the Aetna® Medicare Advantage network for JHMB members.
Contract negotiations between Aetna® and Community remain unresolved at this time. Because an agreement was not reached prior to the end of the contract negotiation deadline (December 31, 2025), Aetna® was required to terminate Community Medical Centers and Community Health Partners from the network.
What this means for members
While Community Medical Centers and Community Health Partners are no longer considered in-network, JHMB members:
- May be able to continue receiving care from out-of-network providers, as long as the services are covered by Medicare, the provider is willing to bill Aetna® as out-of-network, and the provider is willing to provide the member care.
- Depending on the plan and services received, members may experience higher out-of-network cost-sharing.
- In some cases, if a member pays for services up front, they may be eligible for reimbursement up to the Medicare-allowed amount, subject to plan rules and approval.
Because information shared by individual providers may vary, any statements regarding continued access or billing should be verified directly with Aetna®, as provider guidance may not reflect the current network status. If a member is unable to continue care with their current provider under their plan terms, they may need to seek care from another provider while negotiations remain unresolved.
What JHMB is doing
The JHMB, in collaboration with the District Benefits team and our consulting partners, is actively:
- Evaluating all available options in the market
- Reviewing data and materials requested from Aetna®
- Assessing potential paths forward to minimize disruption to members
At this time, no immediate alternative solution will be implemented, and no changes can occur quickly. Any future decisions will require careful analysis, Board review, and appropriate notice to members.
What you should do now
- Review any correspondence received from Aetna® regarding this change.
- Contact Aetna® Member Services using the phone number on your ID card for plan-specific questions, including how your plan’s ESA feature applies and whether transition-of-care options are available.
- If you experience access challenges or have questions related to benefits administration, you may contact the FUSD Benefits Office for support.
November 19, 2025:
If you are enrolled in Fresno Unified School District’s Aetna® Medicare Advantage PPO plan, you may have received a letter from Aetna®. Because the negotiation process is still underway, Aetna® has begun issuing letters to members today notifying them of potential changes in benefits if a new agreement is not reached.
What this means for you
- At this time, if an agreement is reached, your network access under your Aetna® plan will remain unchanged.
- If an agreement is not reached, there could be changes to network status for Community Medical Centers and Community Health Partners providers, which may affect out-of-network charges, benefit levels, or available providers.
- The letter you receive from Aetna® is required by regulatory process and is not a guarantee of changes—rather, it’s a notification of possibility.
The Joint Health Management Board (JHMB) is continuing to monitor the negotiations, and we are committed to ensuring that our members remain well-informed.
In the event an agreement is not reached by January 1, 2026, and you have a scheduled appointment, procedure, or are receiving ongoing treatment at a Community Medical Centers and Community Health Partners provider, we recommend calling the Member Services number on your Aetna® ID card to ask about your provider’s network status and to inquire about a Transition of Care option.
If you experience any issues with scheduling, service, or provider status due to this negotiation process, contact the FUSD Benefits Office at (559) 457-3520 so JHMB can assist where necessary.
January 2, 2025:
We’re pleased to announce that Aetna® and Saint Agnes/Fresno Surgical Center (Trinity Health) have reached an agreement on their contract renewal. If you are enrolled in one of Fresno Unified School District’s Aetna® PPO Plan A or B plans or Medicare Advantage PPO plans, your network status remains unchanged as part of this agreement.
If you have any additional questions or encounter any issues, please contact the FUSD Benefits Office at (559) 457-3520.
December 30, 2024:
The Joint Health Management Board (JHMB) is continuing to monitor the negotiations between Aetna® and Saint Agnes and Fresno Surgical Center (Trinity Health). Conversations are still fluid, and both parties are working diligently to reach a new agreement.
In the event an agreement is not reached by January 1, 2025, and you are receiving an active course of treatment that may go past that date, you should call the member service/customer service number on your ID card to get a Transition of Care request form for your doctor to fill out. Transition of Care (TOC) coverage can apply when your doctor or facility leaves the plan’s network or changes network status, or if certain laws or regulations require coverage. Approved TOC coverage allows a member who is receiving treatment to continue the treatment for a limited time at the highest plan benefits level.
Aetna® has posted answers to frequently asked questions pertaining to the Aetna® and Saint Agnes (Trinity Health) contract negotiations. It includes examples of active course(s) of treatment that may qualify for TOC (e.g., pregnancy, chemotherapy, surgery). Please click here to view their full Q&A along with their list of active course of treatment examples. For those in the middle of care, we encourage you to review the Q&A TOC responses and call the Member Services number on your ID card as mentioned above, where applicable. JHMB will continue updating the Health Connect website as negotiations continue, however, you can also find negotiation updates on the Aetna® website at Aetna – Trinity Health.
If you have any additional questions or encounter any issues, please contact the FUSD
Benefits Office at (559) 457-3520.
December 2, 2024:
If you are enrolled in Fresno Unified School District’s Aetna® Medicare Advantage PPO plan and have received services at Fresno Surgical Center within the last year, you may have received a letter from Aetna®. These letters are a requirement by CMS (Center for Medicare & Medicaid Services) during the process of negotiations between Aetna® and Trinity Health (Saint Agnes).
Conversations are fluid, and both parties continue to operate in good faith. The Joint Health Management Board (JHMB) is continuing to monitor the negotiations, and we are committed to ensuring that our members remain well-informed.
There should not be any interruptions or changes to your coverage at this time as a result of these negotiations. However, if you do experience problems, please contact the District Benefits Office, (559) 457-3520, so we can inform Aetna accordingly.
November 13, 2024:
If you are enrolled in Fresno Unified School District’s Aetna® Medicare Advantage PPO plan and have received care from a Saint Agnes Medical Center primary care physician within the last year, you may have received a letter from Aetna®. These letters are a requirement by CMS (Center for Medicare & Medicaid Services) during the process of negotiations between Aetna® and Trinity Health (Saint Agnes).
Conversations are fluid, and both parties continue to operate in good faith. The Joint Health Management Board (JHMB) is continuing to monitor the negotiations, and we are committed to ensuring that our members remain well-informed.
There should not be any interruptions or changes to your coverage at this time as a result of these negotiations. However, if you do experience problems, please contact the District Benefits Office, (559) 457-3520, so we can inform Aetna accordingly.
October 31, 2024:
If you are enrolled in one of Fresno Unified School District’s Aetna® plans, you may have received a letter from Saint Agnes Medical Center regarding the negotiations with Aetna®. There are no interruptions or changes to your coverage at this time as a result of these negotiations. The Joint Health Management Board (JHMB) is continuing to closely monitor the negotiations, and we will keep you informed on any changes in coverage.
September 30, 2024:
We’re pleased to announce that Aetna® and Community Medical Centers and Community Health Partners have reached an agreement on their contract renewal. If you are enrolled in one of Fresno Unified School District’s Aetna® PPO Plan A or B plans, or Medicare Advantage PPO plans, your in-network access will remain unchanged as part of this agreement.
September 24, 2024:
The official contract between Aetna® and Community Medical Centers has been extended to Friday, September 27, 2024. Conversations are fluid and both parties are still operating in good faith, but the Joint Health Management Board (JHMB) is continuing to monitor the negotiations, and we are committed to ensuring that our members are taken care of.
While conversations continue, you shouldn’t experience any changes to your currently scheduled appointments and procedures. In the event you encounter any issues with scheduling or medical services, please contact the FUSD Benefits Office at (559) 457-3520.
September 20, 2024:
The Joint Health Management Board (JHMB) is continuing to monitor the negotiations between Aetna® and Community Medical Centers. Conversations are still fluid but we wanted to notify our members about new details.
The official contract is set to expire on September 26, 2024, but both parties have continued to operate in good faith as conversations continue.
You may be receiving a letter from Aetna® regarding their negotiations with Community Medical Centers and Community Health Partners. Please note that these letters are not specific to Fresno Unified School District’s Aetna® plans. These negotiations impact all Aetna® members, not just our JHMB members.
The JHMB is committed to ensuring our members are taken care of.
While conversations continue, you shouldn’t experience any changes to your currently scheduled appointments and procedures. In the event you encounter any issues with scheduling or medical services, please contact the FUSD Benefits Office at (559) 457-3520.
August 30, 2024:
Aetna® continues to actively engage in contract negotiations with Community Medical Centers. As a result of these negotiations, there are no interruptions or changes to your coverage at this time. The Joint Health Management Board (JHMB) is continuing to monitor the negotiations closely, and we will keep you informed on any changes in coverage.
July 29, 2024:
If you are enrolled in one of Fresno Unified School District’s Aetna® plans, you may have received a letter from Aetna® regarding the negotiations with Community Medical Centers. There are no interruptions or changes to your coverage at this time as a result of these negotiations. The Joint Health Management Board (JHMB) is continuing to closely monitor the negotiations, and we will keep you informed on any changes in coverage.
The Joint Health Management Board (JHMB) is tasked with keeping you, as a Fresno Unified School District (FUSD) health plan member, informed of changes and updates that affect your benefits and coverage.
Aetna® is currently in contract negotiations with Community Medical Centers and Saint Agnes Medical Center—these types of negotiations are common in the healthcare industry.
JHMB and FUSD are not involved in the negotiations, but we are following them closely and are committed to keeping you updated on how any resulting changes may affect your coverage. We are hopeful that Aetna® reaches agreements with the two medical centers soon! Stay updated by keeping up with our posts on this site, or by signing up for our newsletters below.
FUSD Aetna Negotiations Communications
FUSD Health Care Plans: Staying Updated on Aetna’s Negotiations With CMC and Saint Agnes Medical Center
The Fresno Unified School District is closely following the contract negotiations between Aetna® and Community Medical Centers and Saint Agnes Medical Center. These negotiations, which are common in the healthcare industry, could lead to changes in the coverage for FUSD Aetna® health plan members.
Neither the District nor the Joint Health Management Board (JHMB) that manages our health plans is involved in the negotiations, but the District is closely following these discussions and is hopeful that renewed agreements will be finalized. Follow the JHMB website to stay updated on the latest developments regarding the negotiations, or contact the FUSD Benefits Department at
(559) 457-3520.
