EyeMed Network. HumanaVision

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Archibald Terry
6 years ago
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1 EyeMed Network HumanaVision

Feel good about choosing a HumanaVision plan We re happy you are considering a HumanaVision plan. It s important your employees keep their eyes healthy and get routine care.

3 Feel good about choosing a HumanaVision plan We re happy you are considering a HumanaVision plan. It s important your employees keep their eyes healthy and get routine care. A comprehensive eye health exam can help prevent vision loss, but also detect more serious diseases in the body such as diabetes, hypertension, multiple sclerosis, and brain tumors. A vision plan is one of the top five most desired benefits, after medical insurance, by employees.1 You can feel good knowing HumanaVision plans encourage prevention, early diagnosis, and treatment, helping employees stay healthy and preventing permanent vision loss. Feel even better knowing: More than 35,000 national providers at 20,000 retail locations. Nine out of 10 members are satisfied with the availability of doctors in their area. 2 Members can visit some of the nation s top optical providers at LensCrafters, Pearle Vision, Sears Optical, Target Optical, and JCPenney Optical. Many offer convenient after-work and weekend appointments. Members receive up to 40 percent savings on their choice of fashionable eyewear frames, plus substantial savings on replacement contact lens purchases online and Lasik and PRK procedures. LIMRA International HumanaVision member satisfaction survey, Humana member satisfaction survey, You and your employees can expect friendly, personal service. In fact, 9 out of 10 calls are resolved to the customer s satisfaction on the first call. 3 You won t break your budget offer a voluntary HumanaVision plan without increasing your benefits budget.

4 Optimum Focus See a participating provider See a nonparticipating provider See a participating provider See a nonparticipating provider Exam with dilation as necessary $10 copay $30 allowance $10 copay $30 allowance Contact lens exam options 1 Standard contact lens fit and follow-up Premium contact lens fit and follow-up Frames 2 Discounts available on all frames except when prohibited by the manufacturer. Standard plastic lenses Single vision Bifocal Trifocal Lens options 2 UV coating Tint (solid and gradient) Standard scratch-resistance Standard polycarbonate Standard anti-reflective coating Standard progressive (add-on to bifocal) Other add-ons and services Up to $40 10% off retail $130 allowance, 20% off balance over $130 $0 copay $0 copay $0 copay $40 copay Up to $40 10% off retail $65 allowance $100 allowance, 20% off balance over $100 $25 allowance $40 allowance $55 allowance $25 copay $25 copay $25 copay $40 copay For the Optimum and Focus plans, standard polycarbonate available at no charge for dependents up age 19. All other members pay a fixed charge of $40. $45 copay $65 copay 20% off retail price $45 copay $65 copay 20% off retail price $50 allowance $25 copay $40 copay $55 copay Contact lenses (applies to materials only) Conventional $130 allowance, 15% off balance over $130 $104 allowance $115 allowance, 15% off balance over $115 $92 allowance, Disposable $130 allowance $104 allowance $115 allowance $92 allowance Medically necessary $0 copay, paid in full $200 allowance $0 copay, paid in full $200 allowance After initial purchase, replacement contact lenses may be obtained via the Internet at competitive prices and mailed directly to the member. Frequency 3 Examination Lenses or contact lenses Frame Once every 24 months Once every 24 months Once every 24 months Once every 24 months Additional plan benefits Lasik or PRK Other discounts Receive a 15% off retail price or 5% off promotional price for Lasik or PRK from the US Laser Network, owned and operated by LCA Vision. Since Lasik or PRK vision correction is an elective procedure, performed by specialty trained providers, this discount may not always be available from a provider in your immediate location. For a location near you and the discount authorization, call LASER6. Receive a 20% discount on items not covered by the plan at network providers, which may not be combined with any other discounts or promotional offers, and the discount does not apply to EyeMed providers professional services or contact lenses. Retail prices may vary by location Standard contact lens fitting: spherical clear contact lenses in conventional wear and planned replacement (examples include but not limited to disposable, frequent replacement, etc.) Premium contact lens fitting: all lens designs, materials and specialty fittings other than standard contact lenses (examples include toric, multifocal, etc.) For the Advantage Plan, frame, lenses, and lens option discounts apply only when purchasing a complete pair of eyeglasses. If purchased separately, member receives 20% off the retail price. Frequencies are based on date of service.

Advantage See a participating provider See a nonparticipating provider $10 copay $30 allowance 40% off retail price $50 copay $70 copay $105 copay $40 copay $45 copay $65 copay 20% off retail price

5 Advantage See a participating provider See a nonparticipating provider $10 copay $30 allowance 40% off retail price $50 copay $70 copay $105 copay $40 copay $45 copay $65 copay 20% off retail price $15% off retail price Unlimited Unlimited Unlimited Unlimited Vision health impacts overall health Eye health exams are an important part of routine preventative healthcare. Because many eye and vision conditions have no obvious symptoms, your employees may be unaware of problems. Early diagnosis and treatment are important for maintaining good vision and preventing permanent vision loss. * Access to leading optical retailers to fit busy lifestyles With HumanaVision EyeMed Select network, your employees will have access to more than 35,000 national providers at 20,000 retail locations and independent practice optometrists, ophthalmologists, and opticians. Providers are at some of the most recognizable names in eye care: LensCrafters, Pearle Vision, Sears Optical, Target Optical, and JCPenney Optical. Many offer after-work and weekend appointments, so your employees can schedule an appointment around their busy lifestyles. In some locations, one-hour service is available. Plus, to ensure a consistent and quality experience for members, all providers credentials are verified audited and monitored through a third-party Quality Assurance Program using national industry standards. According to the Vision Council of America, vision problems affect 120 million Americans and cost businesses an estimated $8 billion annual because of reduced productivity. Personalize your HumanaVision plan You ll work with your broker and our own vision expert to design a plan that best fits you and your employees needs. You can: Choose voluntary or employer-sponsored plans Offer employees a choice of three vision plan options (available for groups with two or more enrolled when sold with a Humana medical or dental plan) Talk directly with a Customer Care specialist at and/or manage your plan online at HumanaVisionCare.com Use the enrollment option that works best for you Web, list enrollment, or paper * American Optometric Association

6 Using HumanaVisionCare.com, you can: find a network provider view benefits check eligibility order replacement contact lenses with valid prescriptions Plus, members can quickly find network providers and check the status of claims. HumanaVision plan guidelines Eligibility Employer contribution Participation Employer-sponsored at least 75% 10 or more enrolled* Voluntary less than 75% 10 or more enrolled* * 2 9 considered if sold with Humana medical or dental insurance plans with a minimum of 25% participation and no fewer than 2 enrolled. All case sizes not available in all markets. Limitations and exclusions 1. Lost or broken materials are not covered. 2. Discounts do not apply for benefits provided by other group benefit plans. Allowances are one-time use benefits; no remaining balance. 3. Orthoptic or vision training, subnormal vision aids, and any associated supplemental testing. 4. Medical and/or surgical treatment of the eye, eyes, or supporting structures. 5. Services provided as a result of any Worker s Compensation law. 6. Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under plan. 7. Plano non-prescription lenses and non-prescription sunglasses (except for 20% discount). 8. Services or materials provided by any other group benefit providing for vision care. 9. Two pair of glasses in lieu of bifocals. 10. Aniseikonic lenses.

8 Dental Vision Life Disability Voluntary benefits GN HV 7/09 Vision products insured by Humana Insurance Company or Humana Insurance Company of Kentucky or Humana Health Benefit Plan of Louisiana, Inc. Policy number: GN , CA , MO , NV , OH , OK , VA , or WI

EYEMED VOLUNTARY VISION PLAN SUMMARY PLAN DESCRIPTION

Your Group Plan EYEMED VOLUNTARY VISION PLAN SUMMARY PLAN DESCRIPTION TLC COMPANIES VOLUNTARY VISION EyeMed Vision Care will be your provider for quality eye care services. EyeMed Vision Care s