Employers can achieve an estimated return on investment (ROI) of seven dollars for every one dollar they invest in vision benefits. Yet, many vision plans have not changed in years as busy HR teams and benefits advisors focus on time-consuming medical plan decisions.
By default, vision plan selection is often based on the lowest premium, which can overlook significant opportunities to enhance the benefit's value to employees and optimize the return for employers.
"Spreadsheets don't tell the whole story," says Barry Shinske, Regional Vice President of Sales at EyeMed. "Ultimately, employees aren't going to remember whether they paid $6 a month, for example, for their vision coverage. They're going to remember how much they paid out of pocket for their eye exams, eyeglasses or contacts. And that’s what determines the value of vision benefits."
Shifting the decision-making focus starts with uncovering what the spreadsheet-only approach misses, understanding true ROI drivers, and asking the right questions.
Avoiding the premium-only evaluation gap
With vision benefit premiums largely paid by employees, member experience is a significant factor that premium-only comparisons often overlook.
“Employees experience their vision benefits at the point of service, not in their monthly payroll deduction,” says Natasha D’Sa, Vice President of Sales at EyeMed. “Standard plan designs from the 1980s and 1990s haven’t kept up with the standard of care and often cover less than 50% of the actual eye care experience. That creates sticker shock for employees at the point of service.”
To compare vision plans beyond the spreadsheet, advisors should focus on evaluating the member experience, considering value drivers like access to care, enhanced benefits, special offers and digital tools.
Delivering ROI for employers and employees
Vision benefit ROI isn't necessarily tied to lower premiums.
Employers achieve returns when employees use their benefits to access preventive vision care. Comprehensive eye exams can detect more than 270 different health conditions, enabling early intervention that helps reduce medical costs and improve outcomes.
Employee utilization depends on perceived value. Sometimes, a slightly higher premium can deliver significantly lower out-of-pocket costs, driving utilization and satisfaction.
"For example, EyeMed’s Eye360 plan encourages preventive care by eliminating copays for vision care exams and providing an additional $50 allowances for frames and contacts,” Shinske explains. “So, if you have an annual after-tax premium cost of $60, members can immediately realize a return on their premium investment through the $10 copay elimination plus the reduced out-of-pocket costs. In addition, Eye360 provides a $100 allowance for a second pair of glasses. And that’s on top of our 40% discount on a second pair. You can see how the savings from enhanced benefits and special offers start to stack-up.”
Optimizing vision plan value
Benefits advisors must look closer at vision plan options and evaluate the extras that don't make the spreadsheet to achieve meaningful ROI.
"We want advisors to ask us questions," Shinske says. "Let us tell you about how the plan meets today's standards of care. Let us give you the details and break down the member out-of-pocket costs."
Questions should focus on member experience and plan performance, such as:
· What percentage of members utilize in-network benefits? (Higher in-network usage typically correlates with member satisfaction.)
· How accessible is the provider network geographically – and by appointment availability?
· What digital tools and member communication resources are available?
· What are customer service hours and response capabilities?
"To get the best vision benefits solution, you have to focus on the member," D'Sa explains. D’Sa goes on to encourage Benefits Advisors to ask for help to "design a plan that's right for your client's specific workforce population with a price tag that's affordable. And without limiting the members’ choice of providers or materials selection—frames, lenses and lens coatings. Ideally, with employees largely paying for vision care premiums, there should be no barriers to access care or Rx solutions.”
By looking beyond price, understanding ROI drivers and asking member-experience-focused questions, advisors can better identify vision plans that reduce member out-of-pocket costs, boost satisfaction and increase utilization.
Discover how EyeMed helps you and your clients see what’s possible: eyemed.com/experience
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