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SECTION 9.0 - VISION PROGRAM (Administered by National Vision Administrators – NVA)

Your Vision Benefits are being provided to you by National Vision Administrators (NVA). NVA maintains an extensive network of participating doctors of Optometry and Ophthalmology nationwide to provide professional vision care for persons covered under the Plan. If you have any questions regarding your benefit, you can call NVA at 1-800-672-7723.


Benefits


A participant (and/or dependent) is entitled to one vision examination and one pair of glasses (lenses and frames) or cosmetic contact lenses once every two calendar years. Each eligible (both member and dependent) is covered up to a total reimbursement of $150.00. Children under the age of 19 or dependent students under the age of 25 are entitled to the vision benefit once every calendar year.


A member (or dependent) has the option to go to either a NVA network provider or a doctor of their own choosing. However, if consulting a doctor outside the NVA network, the member will not be able to enjoy the discounts in place with NVA.


Vision Examination: A complete analysis of the eyes and related structures to determine the presence of a vision problem. In- network doctors can charge up to $38.00 for the vision examination.


Lenses: The NVA network Doctor will order the proper lenses if needed. The program provides the finest quality lenses fabricated to exacting standards. The doctor also verifies the accuracy of the finished lenses. The costs of the lenses vary according to the type of lens. Network doctors will charge the wholesale cost of the lenses plus 25%. Please consult your provider for price.


Frames: A participant may select any frame. All frames provided by network providers will cost the wholesale price plus 20%. Please consult with your provider about the cost of the frame prior to purchase.


Contact Lense: When contact lenses are selected in lieu of glasses, the network provider will charge the wholesale cost plus 25%.


Overages: Any charges exceeding the $150.00 maximum reimbursement will be the responsibility of the patient based on the plan allowance and wholesale pricing plus the appropriate percentages.


Filing Claims: In network claims will be handled by the participating provider. You only have to present your NVA card. For out-of-network services, you will have to pay the claim and submit a claim form to NVA for reimbursement. Claim forms can be obtained by calling NVA at 1-800-672-7723.