Vision
Benefits Enrollment & Changes
You may enroll in benefits during your first 31 days of full-time employment. However, once elections have been submitted, you are unable to make changes even if you are still within your 31-day enrollment window. You may also make changes to current coverage within 31 days of the date you experience a qualified change in status or change coverage during the annual open enrollment period. Open Enrollment is typically held November 1 – 15 each year, and elections made during this period become effective January 1 of the next calendar year.
Vision / EyeMed
No changes for 2024
To see if your vision care provider is in the EyeMed network, go to https://eyemed.com/en-us, and search for providers in the Insight network. Look for providers with the PLUS designation to receive the enhanced exam and frame benefit.
Although an ID card is not required, EyeMed will mail ID cards to each employee who enrolls. You may also print ID cards from the website.
Vision Plan Rates
|
Coverage Tier |
2023 & 2024 Semi-Monthly Premium |
|
Employee Only |
$3.56 |
|
Employee + Spouse |
$7.56 |
|
Employee + Child |
$6.98 |
|
Employee + Family |
$12.07 |
Vision Summary
In-Network Benefits
|
Description of Service |
Amount You Owe |
|
Vision Exam |
|
|
At PLUS providers At all other Insight network providers |
$0 Copay $20 Copay |
|
Contact Lenses Exam (fitting and evaluation) |
$40 Copay for Standard Fitting/10% off Premium Fitting |
|
Frames At PLUS providers
At all other Insight network providers |
$225 allowance for selected frames; 20% off amount over your allowance
$175 allowance for selected frames; 20% off amount over your allowance |
|
Standard Plastic Lenses |
|
|
Single Vision |
$25 Copay |
|
Bifocal |
$25 Copay |
|
Trifocal |
$25 Copay |
|
Lenticular |
$25 Copay |
|
Progressive- Standard |
$80 Copay |
|
Progressive- Premium Tier 1 |
$100 Copay |
|
Progressive- Premium Tier 2 |
$110 Copay |
|
Progressive- Premium Tier 3 |
$125 Copay |
|
Progressive- Premium Tier 4 |
$80 – 20% off retail price less $120 allowance |
|
Contact Lenses (in lieu of eyeglasses) Conventional
Disposable
Medically Necessary |
$0 Copay, 15% off balance over $175 allowance
$0 Copay, patient pays 100% of balance over $175 allowance
$0 Copay, plan pays in full |
|
Diabetic Care Services (Covered every 6 months) |
$0 Copay for medical follow-up exam (Following the initial comprehensive eye exam) |
|
Laser Vision Correction |
Lasik or PRK from US Laser Network 15% off retail price or 5% off promotional price |
Frequency
|
Description of Services |
Frequency |
|
Lenses (in lieu of contact lenses) |
Once every calendar year |
|
Contact Lenses (in lieu of glasses) |
Once every calendar year |
|
Frames |
Once every calendar year |
Out-of-Network Benefits
If you use out-of-network providers, you will need to pay in full at time of service and then submit a claim to EyeMed for the out-of-network reimbursement amount in the chart below.
|
Description of Service |
Amount the Plan Pays |
|
Vision Exam |
Up to $45 |
|
Frames |
Up to $88 |
|
Standard Plastic Lenses Single Vision Bifocal Trifocal Lenticular Progressive Lenses Contact Lenses (in lieu of eyeglasses) |
Up to $30 Up to $50 Up to $65 Up to $100 Up to $50 Up to $140 (Up to $210 if medically necessary) |