The Joint Health Management Board strives to ensure its members are informed and responsible health care consumers, in the most cost-effective and efficient manner. To that end, we have streamlined the benefits information we provide to both active employees and new hires to the District. The information is this section reflects the plan information as of the date it was published. To review the latest plan amendments, click on the “Full Plan Booklet and Plan Amendments” tab below.
The Benefits Information Guide is your initial resource to understanding and selecting the best benefit options for you and your family. We encourage you to review this booklet in its entirety to learn more about:
- Who is eligible to participate
- How to enroll and how to make changes during the year, if applicable
- Each benefit available to you and a summary of what is covered under the plan
- The carriers who administer our benefits and how to contact them if you need assistance
We appreciate the hard work and dedication you bring to the Fresno Unified School District. If you have any questions about the employee benefits and wellness programs described in this booklet or would like more information, please refer to your plan documents and insurance booklets (available under the “Full Plan Booklet” tab above) or contact the Benefit Department at (559) 457-3520.
In support of your health,
Joint Health Management Board
REMINDER: The information is this booklet reflects the plan information as of the date it was published. To review the latest plan amendments, click on the “Full Plan Booklet” tab above.
The Joint Health Management Board (JHMB) is pleased to provide you with the Fresno Unified School District Employee Health Care Plan Booklet. This Plan Booklet includes the most current benefit and vendor information under the three Medical Plan Options that became effective April 1, 2012 including Plan clarifications up to August 1, 2012, and the most recent Plan Amendments.
The Plan Booklet primarily describes the benefits applicable to individuals enrolled in Medical Plan Options A and B offered by Anthem Blue Cross; however, it also describes important information for all participants, such as Contact Information, Employee Assistance Program, Chiropractic Care, Dental Benefits, Life Insurance, and General Plan Provisions relating to contributions and eligibility including termination of benefit provisions. You may download the entire Plan Booklet or download the section of the Plan Booklet for each specific health care benefit.
Participants in Plan Option C, Kaiser Permanente option, should review a separate Evidence of Coverage brochure describing benefits offered through Kaiser Permanente and applicable sections of this Plan Booklet to familiarize yourself with all provisions of the plan of benefits offered through the District.
Official Health Care Plan Booklet (PDF)
Inserts
- INSERT I – Medical Plan Comparison (Options A, B and C)
- INSERT II – Self-Pay Rates Applicable to Plan Benefit
- INSERT III – Preventive Services (Options A and B)
Plan Amendments
2021
- Covered Medical Benefits and Covered Prescription Benefits for Plan Options ‘A’ and ‘B’ – COVID-19 Vaccine and Preventative Services (Effective January 1, 2021)
2020
- Covered Medical Benefits for Plan Options A and B – Non-Emergency Ambulance Services (Effective October 15, 2020)
- Dependent Eligibility – Mentally or Physically Disabled Child Clarification & Voluntary Termination of Covered Dependents Outside of Open Enrollment (Effective September 17, 2020)
- Behavioral Health Benefits for Plan Options A and B (Effective September 17, 2020)
- COVID-19 Testing and Related Items/Services and Telehealth Visits (Effective March 18, 2020)
- Dependent Eligibility – Disabled Child Clarification (Effective January 28, 2020)
- Dependent Eligibility – Domestic Partner Clarification (Effective January 1, 2020)
2019
- Dependent Eligibility – Domestic Partner Clarification (Effective October 17, 2019)
- Non-Assignment – General Plan Provision (Effective June 1, 2019)
- Dependent Eligibility – Permanent Guardian Clarification (Effective 5/24/2019)
2018
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- Coinsurance and Out-of-Pocket Expenses for Plan Option ‘A’ (Effective 6/1/2018)
- Chiropractic Care Plan Schedule of Benefits for Plan Options ‘A’, ‘B’, and ‘C’ (Effective 1/1/2018)
- Medical Plan Schedule of Benefits for Plan Options ‘A’ and ‘B’ – Planned Surgery Benefit Program through BridgeHealth (Effective 1/1/2018)
- Prescription Drug Plan of Schedule Benefits for Plan Options ‘A’ and ‘B’ – Select Formulary (Effective 1/1/2018)
- Covered Medical Benefits for Plan Options ‘A’ and ‘B’ Medical Expenses – Transplant Travel and Lodging (Effective 1/1/2018)
- Behavioral Health Benefits for Plan Options ‘A’ and ‘B’ (Effective 1/1/2018)
2017
- Market Reform Regulations Issued Under the Patient Protection and Affordability Act of 2010 (Effective 7/1/2017)
- Changes to Medical & Prescription Drug Benefits for Plan Options A and Plan B (Effective 7/1/2017)
- Prescription Drug Tiers and Available Day Supplies for Plan Options A and Plan B (Effective 1/1/2017)
2016
- Internal and External Claims Review Procedures (Effective 7/15/16)
- Prescription Drug Formulary for Plan Options A and Plan B (Effective 1/1/2016)
2015
- MESVision – Changes to Maximum Out-of-Pocket Copays for Spectacle Lens Options – Out of State (Effective 9/1/2015)
- Network Provider Out-of-Pocket Annual Maximum for Plan Options A and Plan B (Effective 7/1/2015)
- Prescription Drug Plan Schedule of Benefits for Plan Options A and Plan B (Effective 1/1/2015)
- MESVision – Changes to Maximum Out-of-Pocket Copays for Spectacle Lens Options (Effective 1/1/2015)
- Employer Sponsored Health Plans Are No Longer Required to Provide Certificates of Creditable Coverage (Effective 1/1/2015)
2014
- Health Care Coverage Reinstatement for Reservists (Effective 8/1/2014)
- Dependent Eligibility Definition (Effective 7/1/2014)
- Plans A & B Requirements Under the Patient Protection and Affordability Care Act related to Participation in Clinical Trials and Limitation on Member Cost-Share (Effective 7/1/2014)
- Acupuncture Care Benefit (Effective 5/1/2014)
- Third Party Liability and Subrogation (Effective 1/1/2014)
- Non-Network Outpatient Surgery Coverage (Effective 1/1/2014)
2013
- Dependent and Disabled Child Definitions (Effective 12/1/2013)
- Retiree Voluntary Continuation of Coverage (Effective 9/1/2013)
- Birth Control Administration (Effective 7/1/2013)
- Vision Coverage – MES Vision (Effective 1/1/2013)
2012
- Prescription Drug Coverage – Step Therapy Regimen (Effective 10/1/2012)