Group Vision Insurance & Employer Sponsored Eye Care

Group vision insurance is fairly straightforward, but we’ll give a brief overview of how it works from the perspective of employer-sponsored plans. The premiums for group eye care insurance are low and cover basic services like annual eye exams, eyeglass frames and lenses, and contact lenses. Under a group plan that includes vision coverage or eye health benefits package, it is most common for the insurance premium to be deducted directly from the employee’s paycheck.

Like with other types of group health insurance, vision plans often use a network of service providers that have an agreement with the insurance provider. If the employee goes to a certified eye care professional within the network, they receive the maximum benefit that the plan will pay out.

Some plans, such a group vision PPO, allow the employee to go to any provider regardless of whether they are in the network, though the portion paid by the company offering group vision insurance is typically less when going out of network.

If you require glasses either for the first time or to replace the old ones, vision insurance will help you pay for those expensive items. The degree to which you pay and the provider pays depend on the group health insurance policy.

Use this helpful online tool from the California Optometric Association to find an optometrist in your area. You can search by name, city, zip code, language and health insurance provider.

Some health benefit plans don’t offer much beyond a discount, while others provide more comprehensive network administration services, like coverage for eye surgery and LASIK. Naturally, the plans that provide more healthy vision services cost more and the key to finding the right group vision insurance for your business is very important.

Get a FREE, no obligation cost estimate for a quality group vision plan by contacting us today! Call us at the number at the top of the page to learn more or get started with a FREE estimate right away by using the form to the right!

Group Vision Insurance

Should Your Company Offer Group Vision Insurance?

Unlike other types of healthcare services, a group eye care plan does not have to be all-inclusive in order to satisfy the requirements of the essential health benefits under the Affordable Care Act. In fact, the only requirement is that the group health plan include a provision for pediatric vision services.

Another consideration is that many group vision plans will have a monetary cap on more expensive services. Standard services like coverage for routine eye exams, prescription glasses and contact lenses are likely to be included in most group vision plans; on the other hand, eye surgery and advanced procedures for serious health conditions are probably not covered. In these cases, the insurance provider will usually pay up to a certain insured benefit amount, with the employees pay the remainder.

Surveys regularly show that a quality group health benefit is the most important factor in job satisfaction, even ranking above important factors like salary and vacation time. Approximately 75% of working age adults need corrective lenses, so offering a good vision care plan is a great way to set yourself apart from other employers in your industry.

For many years, group plans benefits have been one of the top priorities for employers. This is because the law mandates that employers with over 5- full-time employees provide health insurance benefits or pay a penalty fine. But the law doesn’t extend to vision insurance. So, it is up to the company to provide such medical plans. But there are several advantages of offering vision healthy benefits to your employees. Let’s take a quick look at the complete details.

Enhances Reputation

Group vision insurance plans will cover routine eye examinations and offers discount program on eyewear purchases. There are a few policies contributing toward laser corrective surgery or some other procedures at the in network providers.

High-cost routine eye care health plan funded by the employer is one less headache for the employees. Do offer these plan benefits, particularly when they are at the risk of digital eye strain through long hours in front of the computer system.

It shows that you care for your employees. Providing these additional perks will differentiate your company from the rest of the participating providers.

Enhances Productivity

If employees know that you care for them, it will support employee productivity. But providing eye care benefits isn’t enough. You should also educate your employees about the benefits of the vision service plan and the services provided for eye exam.

Explain to your employees what is vision care insurance and what it covers. This will ensure they use the plan better and save money. Talk about the common eye problems your employees might experience, such as dry eye, eye strain, common eye diseases, and damage from the ultraviolet sun rays.

Keeps Your Employees Healthy

Group vision insurance covers regular eye exams at no extra cost where doctors can examine the patients to detect their vision. At times, the doctors might see some changes in the eye that can be a sign of an onset of medical conditions, like diabetes.

Vision exams might also help you to detect high blood pressure, high cholesterol, heart problems, or eye disease. If these problems are detected early, patients can avoid costly treatments and easy access to vision insurance.

All these, in turn, will help in keeping your employees fit and healthy.

Increases Employee Retention

A majority of the people who work for an organization tend to feel valued if they are able to finish work within a deadline or knock a project out of the park. Employee benefits will help in showing this and can attract more candidates. Believe it or not, group health insurance is one of the top things that job-seekers look for.

But many organizations do not offer vision health insurance as a part of their company health policy.

So, by providing the benefit you can stand out from others and provide a seamless experience to your employees. It will help in retaining talented employees and hiring new ones.

How does Group Vision Plans Work?

Your eyes are worth protecting. Diseases, such as glaucoma or cataracts are more common as you grow older. Employees who are sitting in front of the computer for long hours are more prone to develop various eye problems.

It can be offered alongside group health insurance, but most of the small business owners neglect providing this coverage.

If someone has vision insurance, they send the vision insurer to check the premium for individual plans or simply have the premium deducted from the paycheck for the plans sponsored by the employer.

In return, you receive benefits, such as prescription glasses, vision exams, and contacts from the insurance company. A few vision care small business plans will need you to see a provider in the policy’s network. In other plans, you are required to be treated by an ophthalmologist or optometrist.

So, you have to visit a vision care professional with a license and certificate to treat patients. You can then purchase prescription glasses or contacts from pearle vision, target optical, or any other independent providers as per your employee health plan.

Buying a Vision Health Insurance

In case you already go to an eye doctor and you want to keep seeing him/her, you need to make sure that the plan that you are getting is going to be covered by the insurance company.

You can get your own insurance or get it from an employer. A basic vision plan will range from $5-$35 a month as premiums for one person. If you want to extend the plan to a domestic partner or spouse, you might have to pay a little more for the vision care plan.

Your employer can provide vision insurance and it might only have one opportunity every year to sign up during the yearly open enrolment period. Remember, an individual coverage plan might charge a one-time enrolment fee along with a monthly premium.

No matter whether you get your coverage through insurance company or individually, make sure that you compare the total annual cost of the policy to the anticipated vision care expenses. Don’t pay out more than you are expecting to receive.

What are the Limitations of a Vision Service Plan?

A vision insurance plan can come with some limitations. Let’s check them out-

The health plan from the insurance company might cover the lenses for your glasses but you might be able to get only the basic lenses. In case you get anti-glare or lightweight lenses, you will have to pay additional money.

You might be able to get frames from your vision insurance providers but only to a certain amount. Thus, if you want a pair of frames that cost $250, just a part of the cost might be covered by the business network plan. Or the vision care plan might cover the retail markup of the glass frames and you will have to pay the wholesale cost.

In certain cases, the network plans might have a waiting period of 30-36 months. But during this waiting periods, you might receive little or no health benefits. The main aim of these waiting period is to keep people waiting until they have a costly problem signing up for the policy. The way insurance organizations pay benefits when people require them is by distributing risk among the group of people. While some members of the insurance policy are healthy, others aren’t. But most people are going to experience some problems at varying times. Insurance organizations use the premiums from healthy people for paying the expenses of unhealthy people.

Since the vision insurance benefits are not limited only to the products and services of vision correction or eye exams, unlike group health insurance, having a pre-existing problem is not going to increase your monthly premium.

Types of Vision Insurance Plans

Vision insurance plans are usually available in different forms.

Vision Benefits Package

A vision benefits package offers a free eye care service and also eyewear within a pre-determined amount in exchange for an annual membership fee or premium and a small co-pay for every time you receive the service.

Discount Vision Plan

A discount vision plan offers eyewear and eye care at a discounted price after paying the annual membership fee or the premium.

In certain cases, both plans might also include a deductible fixed amount that you have to pay the eye care provider out of your own pocket prior to the insurance benefits becoming effective.

Both types of vision insurance can be customized to cater to the savings requirements of an extensive range of customers, including unions, school districts, and companies.

Usually, vision plans provide coverage for the following products or services-

  • Eyeglass frames
  • Annual eye examinations
  • Discounted rates for PRK and LASIK
  • Contacts
  • Eyeglass lensesSome reputable vision insurance providers need to have member satisfaction and quality assurance service for answering your questions. They resolve your issues or disputes with an eyecare practitioner in the network of the policy.

Final Thoughts

Deciding if you want to get vision insurance might be a little tricky. It isn’t a unilaterally bad or good deal. If it makes sense for you to buy a policy is based on various factors, such as the options you have, the kinds of vision care services and products you require, and how frequently you are using them.

To know that you are signing up for the right product, which will be valuable to you, research before signing up.

Curious about how affordable it can be to offer a comprehensive group vision plan? Call us today at the number at the top of the page to learn more or get an instant quote by using our online proposal request form!

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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