The Archive — Fresno County Health Cost Watch

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.

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In Their Words

The numbers have names. Fresno County employees, in their own words, on what the preliminary 2027 rates mean at their kitchen tables. Shared with permission. The County originally offered biweekly contributions of $473 for Employee Only, $803 for Employee + Spouse, $843 for Employee + Child(ren), and $1,198 for Family coverage. Its updated proposal, presented October 26, 2026, is $460, $1,007, $871, and $1,415. These accounts were shared under the preliminary rates, before either offer; the update under each account states what the County’s original offer and its updated proposal mean for the same coverage. The October 26 figures are a proposal — pending approval, not final.

$50.70 → $77.51 biweekly, employee + children — under the updated October 26 proposal

My name is Monica, and I am currently at the top of the pay scale for an Office Assistant II position. I currently pay $50.70 biweekly for health insurance coverage for myself and my three children, with $15 copays. Under the new rates, my biweekly premium would increase to $170.51, with $25 copays. This is a significant increase in both premiums and out-of-pocket costs. I work two jobs to meet my family’s financial obligations, including rent, utilities, car payments, car insurance, groceries, gas, and phone expenses. I also help support my daughter, who is away at college. With these responsibilities, the increased health insurance premium would place a substantial financial burden on my household.

The new premium would cost approximately $341.02 per month, compared to my current cost of approximately $101.40 per month. This increase is simply not affordable within my current budget. Additionally, I do not qualify for medical assistance because my gross income exceeds the eligibility limit, even though my take-home pay does not accurately reflect my financial obligations and available income.

I value my job, take pride in my work, and am committed to continuing to serve in my role. However, I am concerned that the substantial increase in health insurance costs will make it increasingly difficult for employees like me to afford adequate coverage for our families.

I respectfully ask that you reconsider these health insurance rate increases and explore more affordable plan options for employees and their dependents. Employees should not have to choose between maintaining essential health coverage and meeting their family’s basic living expenses. Thank you for your time and consideration. I sincerely hope you will take these concerns into account and work toward providing more affordable health care options for employees and their families.

October 26 update — the same coverage (Cypress, Employee + Child(ren), with DeltaCare DHMO): the preliminary figure in her account above is $170.51 per check. Under the County’s original offer it would be $105.51 per check; under the updated October 26 proposal it is $77.51 per check — $155.02 a month, and $28.00 per check less than the original offer. Costs still rise from her current $50.70. Proposal pending approval — not final.

— Monica, Office Assistant II, covering herself and three children

$99.64 biweekly — $199.28 a month on the Cypress plan under the updated October 26 proposal

My name is Lakeisha I am a current employee for the County of Fresno. I am an Office Assistant II. I am a single parent of four children. I am a one household income and currently have Anthem BC along with the dental, and vision plan for me and my four children. I have attached a snip of what I have to pay for health coverage for me and four children which will end on 12/20/2026.

Now looking at the new rates for me and my four children I would have to get the Anthem EPO Cypress plan which will cost me $192.64 biweekly, I cannot afford to pay $385.28 a month for health coverage for me and my children. I am barely surviving now. I must pay rent, PG&E, water, garbage, car note, car insurance, health insurance, food, gas, and necessities for us.

With the rates going up I am forced to choose which bills I must pay. I have no help from family; I don’t get child support for my children. I take care of them alone along with all the bills that I must pay every month. With rates climbing the charts this is going to be a very big struggle for me I don’t know how me and my children are going to live, let alone eat.

October 26 update — the same coverage (Cypress, Employee + Child(ren), with Delta Dental DPPO): the preliminary figure in her account above is $192.64 per check. Under the County’s original offer it would be $127.64 per check; under the updated October 26 proposal it is $99.64 per check — $199.28 a month, and $28.00 per check less than the original offer. Proposal pending approval — not final.

— Lakeisha, Office Assistant II, single parent of four

“I would just be working to pay my insurance.”

To whom it may concern, my name is Elisa and I am an office assistant for Fresno County. I want to let you know that these price increases are not humane. How am I going to survive with this type of increase? I have so many medical appointments — I would just be working to pay my insurance. How would I pay for groceries and my monthly rent payment? We’re not getting any pay increase to help pay these high insurance premiums.

October 26 update: the County originally offered biweekly contributions of $473 (Employee Only), $803 (Employee + Spouse), $843 (Employee + Child(ren)), and $1,198 (Family). Its updated October 26 proposal is $460, $1,007, $871, and $1,415. Her account does not name a plan or coverage tier, so no personal figure is updated here. Proposal pending approval — not final.

— Elisa, Office Assistant

The Paper Trail

The 2027 renewal didn’t come down because the County paid more. It came down because coverage was cut. Here is the public record, document by document — every entry links to its source.

May 30, 2025

SJVIA’s board orders a competitive search for its benefits consultant. Keenan & Associates had held the job since 2017, at $24,000 a month. Source: SJVIA staff report, May 1, 2026 (PDF)
March 17, 2026

The County Board suspends competitive solicitation of the 2027 health plan proposals themselves. This is an annual step — the same action was taken for Plan Year 2026. Source: Board of Supervisors agenda, Item 26 (PDF)
May 1, 2026

USI wins the SJVIA consulting contract through the RFP — four proposals received; Keenan, USI, and Milliman interviewed as finalists. The award: $2,300,000, June 1, 2026 through December 31, 2031, by unanimous vote. Source: SJVIA staff report (PDF) Executed agreement (PDF)
July 17, 2026

The preliminary 2027 renewal lands: +29.2% overall. In the meeting record, SEIU Local 521’s representative calls “an approximate 29% increase in health care costs” unsustainable. Source: SJVIA staff report, Item 13 (PDF)
August 21, 2026

The final Anthem renewal is approved at +16.55% — and the packet shows how the number came down: “Removal of Anti-Obesity Medication (AOM/GLP-1) coverage from Anthem medical plans. Elimination of the Yosemite EPO $0 plan. Modification of the Sierra and Pismo plans, including the addition of deductibles, adjustment of copays, and increased specialty pharmacy cost sharing.” Kaiser’s plans kept GLP-1 coverage. Source: SJVIA board packet, August 21, 2026 (PDF)

The County’s 2027 enrollment materials present the restructured Sierra and Pismo designs as the Cypress and Maple plans priced in What Care Costs above.
September 8, 2026

Kaiser’s renewal is approved (+4.92% across SJVIA), completing the 2027 medical renewal. Source: SJVIA special meeting packet (PDF)
October 6, 2026

The County Board approves the 2027 premiums. What the County itself will contribute — the number that decides your paycheck deduction — is not set in public. It is negotiated with the unions in closed session. Source: Board of Supervisors agenda, Items 9 and 19 (PDF)
October 26, 2026

The County presents a revised proposed contribution at the bargaining table. The proposal — an MOU addendum for SEIU Local 521 Units 3, 4, 12, 22 & 36 and a session rate sheet (“Rates approved by BOS on October 6, 2026 — County contribution pending approval”) — sets the biweekly contribution at $460 (Employee Only), $1,007 (Employee + Spouse), $871 (Employee + Child(ren)), and $1,415 (Family), effective the pay period beginning December 21, 2026. It is a proposal pending approval, not a final agreement, and the deduction tables on this page now reflect it. Source: documents presented at the October 26, 2026 bargaining session
Now

The County is re-bidding its own benefits consultant (RFP 26-074). Its stated reason: USI now advises SJVIA, and the County wants an independent consulting partner to give it objective guidance in the County’s own interests. Source: Fresno County RFP 26-074
October 26, 2026

Tentative agreement reached on the County’s revised proposal (Family contribution $1,415 biweekly), pending member ratification.

What you won’t find: minutes of the bargaining sessions themselves. California’s Meyers-Milias-Brown Act keeps meet-and-confer negotiations behind closed doors — the public sees the outcomes, not the talks. Every document above is a public record, and you can request more: Fresno County public records requests; SJVIA records requests go to the SJVIA Manager through the County.

The records are public. The responsibility is orphaned.

For Hospitals, Clinics & Care Teams

Fresno County is one of the region’s largest employers, and county employees and their families are your patients. The 2027 numbers on this page land in your facilities long before they land anywhere else — as the follow-up that gets postponed, the prescription that gets split, and the family member who quietly drops off a plan during open enrollment.

What the data means for patient access

Under the County’s October 26, 2026 proposal, the two high-deductible family plans carry a $0 premium — their cost is a $3,500 / $6,000 deductible — while the most expensive family plan (Kaiser HMO) costs an employee $411.50 every two weeks — $10,699 a year — before a single claim is filed. At midpoint pay, 125 of the County’s 132 job classifications pay more than the IRS affordability threshold (10.22% of pay) for that plan; on the median-priced family plan (Anthem EPO Maple, $163.21 per pay period), 3 of 132 do.
When coverage costs cross what a paycheck can carry, open enrollment — which closes November 20, 2026 — is when families make the trade: a cheaper plan with a higher deductible, or no family coverage at all. Either way, the care doesn’t disappear. It arrives later, sicker, and harder to pay for.
These are the County’s own figures: the County’s October 26, 2026 proposed contribution, the deduction tables presented at that session, and the San Joaquin Valley Insurance Authority (SJVIA) 2027 renewals, including the Anthem plan’s +21.24% renewal. Figures are a proposal, pending approval, until the County publishes final tables; this page will be updated when it does.

How care teams can use this page

Financial counselors and patient-access staff: the calculator above prices every plan and tier for each of the County’s 132 job classifications at entry, midpoint, and top pay steps. It takes about a minute and flags when a cost crosses the federal affordability threshold — a useful starting point for coverage conversations during open enrollment.
Medical social workers and care coordinators: if a patient’s treatment plan depends on a spouse’s or parent’s county coverage, this page shows what that coverage will actually cost the household in 2027, so discharge and follow-up plans can be built on real numbers.
Community benefit and community health teams: Fresno’s own community health needs assessments rank access to care among the county’s top priorities. Sharing these numbers with the county employees in your waiting rooms is a low-cost way to act on that priority before the November 20 deadline.

Downloads

Waiting-room flyer (PDF, one page)

Prints cleanly in black and white; suitable for waiting rooms, financial-counseling offices, and staff break rooms. A provider outreach letter is available on request.

Every figure on this page comes from a public document — Fresno County Employee Benefits open-enrollment materials and SJVIA renewal documents — and each table carries its source line. This site is an independent information project: it is not a Fresno County website, it is not affiliated with the County or SJVIA, and it collects no data. All calculations happen in the visitor’s own browser.