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VISION
 
State of Florida


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Open your eyes to better vision!

TAKE A CLOSE LOOK AT YOUR VISIONCARE BENEFIT

Open your eyes to quality vision care! VisionCare Plan offers a vision benefit plan designed especially for the employees of the State of Florida. An extensive network of optometrists and ophthalmologists provides you and your family with a benefit option that covers all routine eye care, including eye exams plus eyeglasses (lenses and frame) or contacts.

As one of the nation's largest and most experienced prepaid vision programs, VisionCare covers more than half a million employees and their families, providing eye care through a Florida and a national network of thousands of eye doctors.

VISIONCARE PLAN ELIMINATES EYEGLASS "STICKER SHOCK"

Shopping for a new pair of glasses is likely to leave you with a case of "sticker shock." But not with VisionCare Plan. That's because the plan helps control the high cost of eye care. Even if your VisionCare Plan requires you to pay a deductible (co-payment), our experience shows that your annual coverage cost will more than pay for itself even when just one family member uses the plan. And your savings increase as more family members use it.

YOU SAVE WITH VISIONCARE

You can save money two ways with VisionCare Plan. First, the cost of plan services and materials is discounted and prepaid. So except for any deductibles (co-payments), you have no out-of-pocket expenses for covered services and supplies. Second, you pay for coverage on a pre-tax basis.

Your coverage costs are deducted from your pay before any federal income or FICA taxes are taken out. This makes your taxable wage base lower, so you would pay less tax.

Here's an example of how the plan helps you save over the course of a year:

If You Get: You Pay:
  VisionCare Typical
  Doctor Retail
 
Eye exam 0.00    $55.00
Frame (designer style) 0.00    100.00
Lenses: bifocal* 0.00    75.00
Option (pink tint #1 or #2) 0.00    10.00
Copayment: $10 exam/$15 materials: 25.00    n/a
Premium ($6.96/month x 12) 83.52    n/a
 
  $108.52    $240.00
Pre-tax payment Tax savings:
(assuming 15% tax bracket & 7.65% FICA)
-18.92    0.00
 
  $89.60    $240.00


YOUR TOTAL SAVINGS THROUGH VISIONCARE: 63% OFF RETAIL

In this example, you would have saved $150.40 in vision care costs with VisionCare Plan. Keep in mind, however, that your actual savings will depend on your plan allowances, your actual premium, the doctors and materials you select, and your own tax situation.

*CONTACT LENS ALLOWANCE: If you prefer contact lenses, the plan provides an allowance of $105 in place of exam and glasses.

PLAN BENEFITS

VISION EXAM: The plan provides a complete analysis of the eyes and related structures to determine vision problems or other abnormalities.

FRAMES: The plan offers a complete selection of fashionable frames. Ask the doctor to show you the frames that the plan covers in full. (The doctor can also order a frame you find elsewhere.) If you choose a frame that costs more than the amount the plan allows, you'll simply pay the modest additional charges.

LENSES: Your VisionCare network doctor will order your lenses from an approved optical laboratory. The plan fully covers any lenses you need for your visual welfare, as determined by your network doctor. The doctor will also verify the accuracy of your finished lenses.

CONTACT LENSES: The plan covers contact lenses, but the extent of coverage depends on whether they are medically necessary in your case or if you choose them only because you prefer them. Here's how it works:
  • MEDICALLY NECESSARY LENSES: VisionCare Plan will furnish contact lenses for any of these conditions:
    • After certain types of cataract surgery
    • To correct extreme visual acuity problems that can't be corrected with eyeglasses to 20/70 in the better eye
    • Certain conditions of anisometropia and keratoconus
Your doctor may determine that you need contact lenses due to conditions other than those listed above. In that instance, the doctor can submit your case for review and ask VisionCare Plan for prior approval. If VisionCare approves the request, the plan will fully cover your lenses (after you pay the deductible) if you get them from a network doctor.

ELECTIVE LENSES: The plan also provides contact lenses that are not medically necessary. When you choose contacts instead of eyeglasses, the plan pays a flat allowance (see "You Save with VisionCare") toward the combined value of any or all of these services:
  • Eye exam

  • Extended exam to fit contact lenses

  • Contact lenses

  • Any follow-up visits
The contact lens allowance replaces all other benefits, and plan deductibles (co-payments) do not apply to contacts. You can select either the contact lens allowance or other covered services (exam, glasses), but not both.

EXTRAS: You also receive these value-added extras:
  • a 20% discount on a second pair of eyeglasses and/or

  • a 15% discount on professional service fees for elective contact lenses (exam, fittings). These extras are available for 12 months after your covered eye exam from the VisionCare Plan network doctor who performs the initial exam.
LASIK: If you are nearsighted or have astigmatism and wear glasses or contacts, you may be a candidate for LASIK.** You will pay no more than $1,800 in total fees for LASIK for one eye, or $3,600 for LASIK for both eyes, if you choose one of our RefractiveCare ophthalmologists.

** If qualified as a LASIK candidate by a network doctor.

FREQUENCY

Vision exam: Once every 12 months

Lenses: Once every 12 months

Frame: Once every 24 months

ELIGIBILITY

Employee: Your eligibility for the plan is determined by your employer. If you choose the vision care option under your Section 125 benefits program, your coverage stays in effect for one year. Family: If you enroll in the vision plan, you may also choose the vision care option for your family. Family coverage is also for one full year.

VISIONCARE NETWORK DOCTORS

Included in this brochure is a list of VisionCare network doctors. This list of names is designed to show you how convenient our services are. You'll receive a full list for your area, with addresses and phone numbers, when you request your benefit form.

Seeing a network eye doctor offers you the convenience of "one-stop shopping" because your doctor gives you everything you need -eye exam and materials-on a paid-in-full basis. VisionCare pays the doctor directly for the full cost of your covered services. You have no out-of-pocket expenses (except deductibles) unless you also choose cosmetic options.

RATES - BIWEEKLY

Employee only: $3.48/biweekly

Employee + family: $8.94/biweekly

RATES - MONTHLY

Employee only: $6.96/monthly

Employee + family: $17.88/monthly

USING VISIONCARE PLAN

AS EASY AS 1-2-3 ...
  1. Before you make an eye appointment you can request a Benefit Form in a number of ways: by calling our Customer Care Department at 1-800-939-5369; contacting us at our Web site, http://www.compbenefits.com/prod_serv/vision/overview.html; faxing us toll-free at 1-800-421-0100; or by completing a "Request" postcard (see your Benefits Administrator) and mailing it to VisionCare Plan.

  2. VisionCare Plan will send you a personalized benefit form that outlines your benefits, along with a list of network doctors for your area. Then, schedule your appointment with the doctor of your choice.

  3. Give the benefit form to the doctor during your first visit. You'll pay any deductibles at that time as well.
You have nothing more to do. The doctor provides you with all of the services listed on your benefit form and bills VisionCare Plan directly.

READY. . . SET. . . SIGN UP!
  • Read the information in this brochure.

  • Decide that good vision and good value are what you want.

  • Sign up for VisionCare Plan.
LIMITATIONS

PRIVATE PATIENT: If you do not obtain the VisionCare Plan benefit form and give it to your network doctor on your first visit, you will be treated as a private patient. This means that the doctor is not obligated to accept VisionCare fees as full payment for these services. The doctor can charge his or her usual fees, and you'll pay the difference.

EXTRA COSTS: The plan is designed to cover your visual needs rather than cosmetic choices. If you choose any of the following items and your network doctor doesn't have prior authorization from VisionCare Plan, there will be extra charges that you must pay. These items include:
  • Oversized, coated or faceted lenses

  • Blended or progressive lenses

  • Tinted or photochromic lenses (except pink #1 and #2)

  • A frame that costs more than the plan allowance

  • Other cosmetic items
NOT COVERED: The plan does not pay benefits for services or materials connected with:
  • Orthoptics or vision training, subnormal vision aids, aniseikonic lenses or plano (non-prescription) lenses

  • Replacement of lost or broken lenses and frames you receive from the plan, except at the scheduled intervals when plan services are otherwise available

  • Medical or surgical eye treatment

  • Services or materials provided as a result of any

  • Workers' Compensation law or similar legislation, or obtained through or required by any government agency or program, whether federal, state or municipal

  • Any eye exam required by an employer as a condition of employment

  • Service or material provided by any other vision care plan or group benefit plan that offers vision care benefits

  • All services not provided by a VisionCare network doctor

  • Two pairs of glasses instead of bifocals
EXTENSION OF BENEFITS

If you're an eligible plan member receiving services as of the date this coverage ends, service will continue to completion, but not beyond nine months after the date this contract ends.

FOR MORE INFORMATION

For more about this plan and how it works, check with your Benefits Department, or get in touch with VisionCare Plan by calling us toll-free number at 1-800-939-5369 or visit our Web site at http://www.compbenefits.com/prod_serv/vision/overview.html


Overview
Dental

Information about VisionCare Plan

Information about Primary Plus

Information about LASIK

Vision Health Topics

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MyCompBenefits for Eye Care Professionals

HIPAA FAQ for Providers


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