Retired Employees Health Insurance Information

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Retired Employees Health Insurance Information

The County of Fresno offers health insurance coverage options to eligible retired employees and their dependents. This page offers helpful resources regarding the current plans offered including rates, summaries of benefits, and more.

If you are a retiree currently on a County COBRA or Cal-COBRA plan and would like more information in regards to the COBRA or Cal-COBRA plans, please visit the COBRA Participants Health Insurance Information page.

Retired Employee Rate Sheet

Health and Dental Plans Information

Pre-65 Retiree Option

Anthem Blue Cross PPO 1500

With this PPO, or Preferred Provider Organization, plan, you will pay the full cost of non-preventative health care services until you meet the annual deductible. Once you meet the annual deductible you will be responsible for a 20% coinsurance. Once the out-of-pocket maximum is reached, the plan will pay the full cost of all qualified health care services for the remainder of the calendar year. This plan will allow you to use out-of-network providers, but at a higher rate. The deductible period for the Anthem Blue Cross PPO 1500 plan is based on the calendar year.

Click here to view this plan.

 

Medicare Supplemental Option

RetireeFirst (United American/UnitedHealthcare Rx)

  • Medicare supplemental plans work with Medicare, pickup up costs remaining after Medicare.
  • Enrollment into this plan requires enrollment into Medicare Parts A and B.
  • Medical and mental health coverage is provided by United American.
  • Prescription coverage is provided by UnitedHealthcare Rx.
  • Vision coverage is provided by Vision Service Plan (VSP).
Click here to view this plan.

 

Medicare Senior Advantage Options

Kaiser Permanente Senior Advantage - High Option

  • The High Option: This plan is called the "High Option," because it has higher monthly premiums, but lower copays for services.
  • Our Medicare Senior Advantage plans work much like an HMO plan, where members have set copays for services.
  • Enrollment into this plan requires enrollment into Medicare Parts A and B.

Kaiser Permanente Senior Advantage - Low Option

  • The Low Option: This plan is called the "Low Option," because it has lower monthly premiums, but higher copays for services.
  • Our Medicare Senior Advantage plans work much like an HMO plan, where members have set copays for services.
  • Enrollment into this plan requires active coverage in Medicare Parts A and B.
Click here to view these plans.

 

Dental Options

Delta Dental DPPO

PPOs, or Preferred Provider Organizations, allow you to use out-of-network providers, but at a higher rate. The deductible period for this PPO plan is based on the calendar year.

DeltaCare USA DHMO

HMOs, or Health Maintenance Organizations, are copay based and cover services performed solely by providers within their network (with the exception of emergency services).

Dental Plan Option Comparison Chart

Service Delta Dental DPPO DeltaCare USA DHMO
Annual Deductible $50 Per Individual
$150 Per Family
No Deductible
Maximum Benefits Allowed $2,500
Per Individual Per Year
No Annual Maximum
Preventative Services PPO Provider: 0%
Non-PPO Provider: 10%
$0 for Most Services
Basic Services PPO Provider: 10%
Non-PPO Provider: 10%
$0 for Most Services
A copay may be required for upgraded materials and services
Major Services
(Including Periodontics, Endodontics, and Oral Surgery)
50% $0 for Most Services
A copay may be required for upgraded materials and services.
Orthodontia (Adult) $1,880 Copay* $1,900 Copay
Orthodontia (Child) $1,660 Copay* $1,700 Copay
Additional Orthodontia Information *Once per lifetime With a maximum of 24 months of treatment. Pre and post-treatment services have additional copayments.

Visit deltadentalins.com to search for an in-network provider.

 

Qualifying Life Events

Health Plan Changes

Employees experiencing a qualifying life event outside of the Open Enrollment period have thirty (30) days from the event date to turn in the required forms and supplemental documentation to Employee Benefits.

Applicable changes may include enrollment into a Retiree health plan, enrolling an eligible dependent, and changing your plan options during those instances. Retirees who become Medicare eligible and wish to enroll into one of the County Medicare Supplemental or Senior Advantage options should contact Employee Benefits. As a reminder to retired participants, you may cancel your coverage or remove dependents throughout the year without a qualifying life event. For more information please contact Employee Benefits for clarification.

Please contact Employee Benefits obtain necessary forms for any applicable qualifying life event.

Please note, Employee Benefits is not responsible for lost/delayed forms sent through the mail and therefore not received by the deadline. To confirm receipt of forms and/or supporting documentation, please contact Employee Benefits.

Obtaining Medicare Eligibility

Retirees that become newly eligible for Medicare Parts A and B will have the option to enroll into the Medicare Supplemental plan or one of the Kaiser Permanente Senior Advantage (KPSA) plans. The County Medicare plans have prescription drug coverage (Part D) included. Therefore, if you enroll in one of the County Medicare plans do not sign up for another Part D program as this will cancel your coverage through the County of Fresno.

Retirees that wish to enroll into the County Medicare plan will have thirty (30) days from the Medicare effective date to turn in the Retiree Health Insurance Application, a copy of their Medicare card, and the applicable supplemental form (UnitedHealthcare Enrollment Request Form or Kaiser Permanente Senior Advantage (KPSA) Election Form).

Please note, Employee Benefits is not responsible for lost/delayed forms sent through the mail and therefore not received by the deadline. To confirm receipt of forms and/or supporting documentation, please contact Employee Benefits.

 

Retiree Discounts

The County is happy to announce that there are two (2) new discounts available to retired County employees; TruHearing and Dignity Memorial. Please contact Employee Benefits to obtain more information.

Contact Information

Human Resources - Employee Benefits
2220 Tulare St., 14th Floor
Fresno, CA 93721

Phone: (559) 600 - 1810
Fax: (559) 455 - 4787
Email: HRBenefits@fresnocountyca.gov

Office Hours Monday - Friday, 8am - 5pm

Provider Phone Numbers

  • Anthem Blue Cross: (800) 967-3015
  • Kaiser Permanente: (800) 464-4000
  • Retireefirst/United American: (833) 236-2092
  • Delta Dental: DHMO (800) 422-4234 DPPO (800) 765-6003
  • Vision Service Plan (VSP): (800) 877-7195
  • FCERA:(559) 457-0681
  • Medicare: (800) 633-4227

Important Notices