|

Open enrollment means elevated employee communications regardingcoverage options and plan changes, but it also provides anopportunity to help clients educate their employees on topicsrelating to their existing benefits.

|

Enrolling in and using a voluntary or employer-paid visionbenefit can significantly reduce out-of-pocket costs for eye careand eyewear. What's more, it can also help diagnose ocular andsystemic conditions early on, which means improved health outcomes— plus heightened employee productivity and a reduction in overallhealth plan costs.

|

Here are some vision benefit tips you can share with clients tomake their members smarter about their eye care and eyewear choicesduring open enrollment:

|

Leverage the network. Using an in-network eyecare professional can save time and money. Some vision plansinclude limited coverage for out-of-network providers, but formembers to take full advantage of their benefit and save on out ofpocket costs, the optimal choice is visiting an in-networkprovider. Finding an in-network provider that matches their needsis easy; it simply takes visiting your vision carrier's website ormobile app. Members can search for an eye care professional basedon various filters including proximity, hours, languages spoken,services, and other helpful information.

|

If a member wants to learn more about an in-network doctor, theycan check out review websites such as Vitals.com, Healthgrades,Yelp, and Google Places. It is a good idea to not only look at thebest and worst reviews, but also look at the comments made in themid-tier ranges. This can provide valuable insight into the prosand cons of each provider's practice.

|

Related: Vision benefits: 3 reasons brokers should recommendthem

|

Understand coverage.  Before leavingfor the eye doctor or optical retailer, members should know whattheir vision benefit covers and how much they will be responsiblefor paying. Understanding common terms is the first step inunderstanding the benefit. Here are some common terms members willsee on vision carriers' websites, apps, and member brochures:

  • Frame allowance – A set dollar amount orpercentage covered by the vision plan towards the purchase offrames. The frame allowance may completely cover the frame ofchoice or reduce the employee's out-of-pocket cost.
  • Lens benefit - A set dollar amount orpercentage covered by the vision plan towards the purchase ofprescription lenses. The lens benefit may completely cover theeyeglass lenses or reduce the out-of-pocket expense.
  • Lens options pricing – A set dollar amount orpercentage covered by the vision plan toward the purchase of lensoptions. Examples of lens options include anti-reflective coatings,photochromic (light sensitive) lenses, UV coatings, and tints.
  • Contact lens allowance – A set dollar amountor percentage covered by the vision plan toward the purchase ofcontact lenses. The ever-changing costs associated with contactlenses and various types of contacts make it difficult to determinethe exact cost, so employees should discuss this option with theireye care professional.
  • Copay - A set dollar amount or percentage themember is responsible to pay at the time of service. This cost isdetermined by the plan selected.

Knowing this information saves money and makes for informedconsumers when it comes time to share expectations, wants, andspend limits with an eye care professional.

|

Apply flexible spending account (FSA) dollars to visioncare. More than 33 million U.S. consumers contribute to an FSAplan. If your clients offer a FSA benefit, their members can usethese dollars towards purchases of vision care services or productssuch as contact lenses, Lasik surgery and eyeglasses. This is avaluable supplement to their vision benefit.

|

Take advantage of additional discounts. Inaddition to eye exams and eyeglasses, many vision plans offerdiscounts on Lasik surgery, hearing exams, hearing aids, contactlenses, and other products and services. Detailing these value-addbenefits can go far toward increasing member satisfaction and theirperception of their employer, your client.

|

As open enrollment approaches, help your clients and theirmembers get the most value from their vision benefit. Sharing thisinformation can help members maximize benefits and reduceout-of-pocket expenditures. It can also boost employee satisfactionand productivity and keep members happier and healthier.

|

David S. Karlin is an insurance industry veteran with 30years of management experience in vision and prescription drug planadministration. He currently serves as president of National VisionAdministrators (NVA), Benecard Services, and Heartland FidelityInsurance Company.

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.