What Fresno County health coverage costs in 2027 — in the County’s and SJVIA’s own numbers.

The Raw Numbers

Everything below comes from published County and SJVIA materials and the documents presented at the October 26, 2026 bargaining session. Where a figure carries a status, it is stamped — the October 26, 2026 figures below are the tentative agreement reached that day, ratified by the members on November 10, 2026; the County’s final signed deduction tables have not been published yet.

What the County contributes toward your premium (biweekly, full-time)

TENTATIVE AGREEMENT — OCTOBER 26, 2026 — RATIFIED BY THE MEMBERS — NOVEMBER 10, 2026

Sources: Fresno County employee health plan reference (2026 rate sheets); County of Fresno 2027 offer as reported in County open-enrollment materials (prior offer); and the County’s revised proposed contribution presented October 26, 2026 — MOU addendum (SEIU Local 521 Units 3, 4, 12, 22 & 36) and session rate sheet (“Rates approved by BOS on October 6, 2026 — County contribution pending approval”), effective pay period beginning December 21, 2026. The October 26 figures are the agreed rate, ratified by the members on November 10, 2026.

What comes out of your paycheck in 2027 (biweekly employee deduction)

TENTATIVE AGREEMENT — OCTOBER 26, 2026 — RATIFIED BY THE MEMBERS — NOVEMBER 10, 2026

Sources: Rate sheet presented at the October 26, 2026 bargaining session (“Rates approved by BOS on October 6, 2026 — County contribution pending approval”), effective pay period beginning December 21, 2026. Ratified November 10, 2026. Final printed deduction tables are still to come from the County; the figures shown are the ratified agreement’s.

Why costs are going up: the SJVIA renewal

Source: SJVIA Plan Year 2027 final renewal.

What else changes in 2027

• Three plans are eliminated. The Anthem EPO Yosemite, Sierra, and Pismo plans end after 2026. They are replaced by two new EPOs: Cypress and Maple.
• High deductibles go up. The 2027 high-deductible plans (Anthem HDPPO and Kaiser HDHP) carry a $3,500 individual / $6,000 family deductible. The 2026 Anthem HDPPO deductible was $3,300 individual.
• The employee-only contribution is cut. Under the County’s October 26 proposal, the Employee Only contribution drops from $473 to $460 — the only tier cut — while the dependent tiers rise above the County’s earlier offer (Family to $1,415).
• Both high-deductible plans are $0 premium. Under the October 26 proposal, the Anthem HDPPO and Kaiser HDHP show a $0.00 employee deduction at every coverage tier. The cost on those plans sits in the deductible — $3,500 individual / $6,000 family — not in the premium.

Sources: SJVIA Plan Year 2027 final renewal; County of Fresno open-enrollment materials; Fresno County employee health plan reference (2026).

Family coverage vs. a county paycheck

Under the ACA, family coverage is considered unaffordable when the employee’s share of the lowest-cost family plan exceeds 10.22% of household income (the IRS percentage for plan year 2027). Measured against county pay ranges — using salary as the household-income measure for a single-earner family — the October 26, 2026 proposal numbers show:

• On the cheapest family plans (Anthem HDPPO and Kaiser HDHP, $0.00 per pay period under the October 26 proposal), the premium alone exceeds the 10.22% threshold for no classification — on those plans the cost is the $3,500 / $6,000 deductible, not the premium.
• On the median-cost family plan (Anthem EPO Maple, $163.21 per pay period = $4,243 a year), 3 of 132 SEIU-represented classifications exceed the 10.22% threshold at the midpoint of their pay range.
• On the most expensive family plan (Kaiser HMO, $411.50 per pay period = $10,699 a year), 125 of 132 classifications exceed the threshold at midpoint pay.
• The median-cost family plan stays under 10.22% only at a salary of $41,522 or more. At the entry step of the lowest-paid classifications, it takes 11.8% of gross pay.

Sources: Fresno County Salary Resolution, Section 100 (updated August 3, 2026); family-tier deductions under the ratified October 26, 2026 agreement (session rate sheet); IRS Rev. Proc. 2026-26 (2027 affordability percentage: 10.22%). Analysis covers the 132 classifications in Units 3, 4, 12, 22, and 36.

Employee Cost Briefs — the Tentative Agreement

TENTATIVE AGREEMENT — OCTOBER 26, 2026 — RATIFIED BY THE MEMBERS — NOVEMBER 10, 2026

The October 26 proposal does not make 2027 coverage inexpensive — costs still go up in 2027. But because the County increased its contribution, the proposal makes coverage for dependents substantially less expensive than it would have been under the County’s original offer. On the Anthem EPO and Kaiser HMO plans, the employee deduction falls by $204.00 per check for Employee + Spouse, $28.00 per check for Employee + Child(ren), and $217.00 per check for Family coverage compared with the original offer, and both high-deductible plans go to a $0 premium. Employee Only is the exception: the proposed County contribution for that tier falls from $473 to $460, so its deduction rises $13.00 per check on the non-high-deductible plans. Bottom line: Costs still rise in 2027, but the County's increased contribution makes the October 26 proposal hundreds to thousands of dollars a year better than the original offer for employees covering dependents.

All amounts in the briefs below are biweekly employee deductions and include Delta Dental DPPO. The contribution comparison behind them — 2026 actual, the County’s original offer, and the October 26 proposal, by tier — is in The Raw Numbers above.

Download The Deductible Page (PDF, 2 pages)

The Deductible Page is now the printable handout for these numbers — the five plans side by side, what a lower deductible costs, and the worst-case year. The detailed six-brief set is preserved in the campaign record.

FSA & HSA — the tax-advantaged accounts

The County offers Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA), both administered by Navia Benefit Solutions. Both let you pay copays, deductibles, prescriptions, dental, and vision costs with pre-tax dollars.

• Which account goes with which plan: Anthem EPO Cypress, Anthem EPO Maple, and Kaiser HMO pair with a Health Care FSA. The high-deductible plans — Anthem HDPPO 3500 and Kaiser HDHP — are HSA-eligible: enroll in one and you may open an HSA through Navia.
• HSA limits (IRS, 2027): $4,500 self-only / $9,000 family, plus a $1,000 catch-up contribution at age 55+. The limit is the combined employer + employee total. Contributions can be started, stopped, or changed monthly, and HSA money rolls over year to year and stays yours.
• County HSA seed: $0. The County’s proposal includes no employer HSA contribution. SEIU’s counter-proposal asks for $75 per check ($1,950 a year) — it would count toward the IRS limit, and it is not in the County’s proposal.
• You cannot hold both: a general-purpose Health FSA cannot be held at the same time as HSA contributions. A Limited-Purpose FSA (dental and vision only) can pair with an HSA.
• FSA elections happen at Open Enrollment — which closes November 20, 2026, at 5:00 PM PT — and are generally fixed for the plan year. The 2027 Health FSA limit is $3,400, and there is no carryover — unused funds are not returned or rolled over, though expenses may be incurred through March 15, 2028, with claims filed by May 15, 2028. Unused FSA money is subject to use-it-or-lose-it, so elect only what you expect to spend.

Anthem EPO Cypress

• What it costs under the proposal: Family coverage is $291.66 per check, Employee + Spouse is $177.75, Employee + Child(ren) is $99.64, and Employee Only is $60.34.
• Who gains most: Employees covering a spouse or a family gain the most compared with the original offer — $5,304 and $5,642 less per year, respectively. The gain for Employee + Child(ren) is $728 per year.
• Employee Only exception and deductible: Employee Only costs $13.00 more per check than under the original offer. Cypress also has a $500 deductible, so the paycheck deduction is only part of the cost of care.
• FSA: This plan pairs with a Health Care FSA through Navia — set aside pre-tax dollars at Open Enrollment to pay this plan’s copays and its $500 deductible. Elect only what you expect to spend: unused FSA money is subject to use-it-or-lose-it.

Tentative agreement — ratified by the members November 10, 2026.

Anthem EPO Maple

• What it costs under the proposal: Maple has the lowest deductions among the non-high-deductible plans: $21.42 for Employee Only, $88.23 for Employee + Spouse, $27.63 for Employee + Child(ren), and $163.21 for Family.
• Who gains most: Employees covering a spouse or a family gain the most compared with the original offer — $5,304 and $5,642 less per year, respectively. The gain for Employee + Child(ren) is $728 per year.
• Employee Only exception and deductible: Employee Only costs $13.00 more per check than under the original offer. Maple also has a $1,000 deductible, so the paycheck deduction is only part of the cost of care.
• FSA: This plan pairs with a Health Care FSA through Navia — set aside pre-tax dollars at Open Enrollment to pay this plan’s copays and its $1,000 deductible. Elect only what you expect to spend: unused FSA money is subject to use-it-or-lose-it.

Tentative agreement — ratified by the members November 10, 2026.

Anthem HDPPO 3500

• What it costs under the proposal: The employee premium deduction is $0 at every coverage tier.
• Who gains most: Employees covering a spouse or a family gain the most compared with the original offer — $4,632.94 and $5,631.08 less per year, respectively. Employee Only and Employee + Child(ren) were already $0 under the original offer.
• Deductible warning: A $0 premium is not $0 for care. This plan carries a $3,500 individual / $6,000 family deductible; that deductible is the plan’s major employee cost.
• HSA: This is an HSA-eligible plan. Pre-funding the full $3,500 individual deductible from your own pre-tax pay takes $134.62 per check; pre-funding the full $6,000 family deductible takes $230.77 per check — your own money, spread across the year instead of a lump sum when care happens.

Tentative agreement — ratified by the members November 10, 2026.

Kaiser HMO

• What it costs under the proposal: Kaiser HMO remains the highest-deduction plan at every tier: $100.77 for Employee Only, $263.42 for Employee + Spouse, $168.76 for Employee + Child(ren), and $411.50 for Family.
• Who gains most: Employees covering a spouse or a family gain the most compared with the original offer — $5,304 and $5,642 less per year, respectively. The gain for Employee + Child(ren) is $728 per year.
• Employee Only exception: Employee Only costs $13.00 more per check — $338 more per year — than under the original offer.
• FSA: This plan pairs with a Health Care FSA through Navia — set aside pre-tax dollars at Open Enrollment to pay this plan’s copays and its deductible ($500 individual / $1,000 family). Elect only what you expect to spend: unused FSA money is subject to use-it-or-lose-it.

Tentative agreement — ratified by the members November 10, 2026.

Kaiser HDHP

• What it costs under the proposal: The employee premium deduction is $0 at every coverage tier.
• Who gains most: Employees covering a spouse or a family gain the most compared with the original offer — $3,721.38 and $4,243.46 less per year, respectively. Employee Only and Employee + Child(ren) were already $0 under the original offer.
• Deductible warning: A $0 premium is not $0 for care. This plan carries a $3,500 individual / $6,000 family deductible; that deductible is the plan’s major employee cost.
• HSA: This is an HSA-eligible plan. Pre-funding the full $3,500 individual deductible from your own pre-tax pay takes $134.62 per check; pre-funding the full $6,000 family deductible takes $230.77 per check — your own money, spread across the year instead of a lump sum when care happens.

Tentative agreement — ratified by the members November 10, 2026.

What Care Costs

Premiums decide what comes out of your paycheck; the benefit design decides what care costs when you actually use it. Below is the cost-of-service detail for all five Plan Year 2027 plans — deductibles, copays and coinsurance, therapy and chiropractic limits, and prescription tiers — transcribed from the County’s published 2027 plan documents. Pick your plan and scan down.

Read this section carefully: the benefit designs shown are from the County’s published Plan Year 2027 plan documents. A tentative agreement on the County’s 2027 contribution toward premiums was reached on October 26, 2026, and SEIU Local 521 members ratified it on November 10, 2026; the premium and deduction figures shown on this page are the ratified agreement’s figures, pending the County’s final signed tables. Each plan summary is a brief outline of coverage — if a summary and the Evidence of Coverage differ, the Evidence of Coverage prevails. The Kaiser documents are Kaiser’s “Disclosure Form Part One” principal-benefit summaries.

Download The Deductible Page (PDF, 2 pages) The simple version: what a lower deductible costs, what each plan covers from day one, and the worst-case year — made to print and share.

Notes on this section

• † Kaiser does not split facility and physician charges. Emergency care, outpatient surgery, and inpatient hospital care each carry a single member charge in the Kaiser summaries (the inpatient charge expressly includes room and board, surgery, anesthesia, X-rays, laboratory tests, and drugs). Kaiser also notes that a member admitted directly from the emergency department pays the inpatient cost share instead of the emergency department cost share.
• Mail-order supply lengths differ by carrier. Kaiser mail-order refills are priced for up to a 100-day supply; Anthem home delivery is a 90-day supply. Anthem retail pharmacies fill a 30-day supply (90 days at designated “Retail 90” pharmacies, at the multiples shown in the mail-order row).
• Anti-obesity / GLP-1 drugs: “Anti-obesity/GLP-1 coverage was removed from the Anthem plans for 2027 per SJVIA's August 21, 2026 board action; the plan summaries themselves do not list these drugs (formulary governs).”

Email the Board

The Board of Supervisors sets the County’s contribution. This tool drafts a short, factual email using your own numbers. Nothing is sent by this site. The draft is built in your browser; the button below hands it to your own email app, addressed to the recipient you choose — your own district supervisor, all five supervisors, or the Clerk of the Board — and you review and send it yourself. You can also copy the text and send it any other way you like.

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Send it to Clerk of the Board My supervisor — District 1 (Pacheco) My supervisor — District 2 (Bredefeld) My supervisor — District 3 (Chavez) My supervisor — District 4 (Mendes) My supervisor — District 5 (Magsig) All five supervisors

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Plan

Coverage tier Employee Only Employee + Spouse / DP Employee + Child(ren) Family

Biweekly deduction ($)

One line in your own words (editable)

Use my calculator numbers

You choose the recipient above. The Fresno County Board of Supervisors: District 1 — Brian Pacheco, [email protected]; District 2 — Garry Bredefeld (Chairman), [email protected]; District 3 — Luis Chavez (Vice Chairman), [email protected]; District 4 — Ernest “Buddy” Mendes, [email protected]; District 5 — Nathan Magsig, [email protected]. Or send it to the Clerk of the Board of Supervisors, [email protected] — the email address the County publishes for Board correspondence (County of Fresno, Board of Supervisors proclamation request form, fresnocountyca.gov). Supervisor names and emails verified Oct 21, 2026 from fresnocountyca.gov. The draft is generated fresh on this page each time; this site keeps no copy.

The Archive — The Campaign Record

This is the record of the fight, preserved as published: the employees who spoke in their own words, the public documents that carried the argument, and the guidance written for the care teams who see what these numbers do to patients. Entries are preserved as they ran — status lines inside them reflect the date each was written, not today’s.