Vision Insurance
Vision is the least expensive line on most benefit statements and one of the first things employees check. It is worth getting the network right.
Who it is for
Employers rounding out a benefits package, and anyone who buys glasses or contacts every year and pays for them out of pocket.
Vision is usually the cheapest line on a benefits statement – an easy addition for small groups and an obvious voluntary offering where budget is tight. For employees at a screen all day, it is a benefit they use and remember.
- Groups adding vision alongside medical and dental
- Employers offering voluntary, employee-paid vision at group rates
- Families with children who need a new prescription every year
- Individuals whose medical plan covers eye disease but not eyewear
What is covered
Routine eye exam
- One comprehensive exam per plan year
- Modest copay
- Includes the refraction medical plans typically decline
Frames and lenses
- Frame allowance on a set frequency
- Single-vision, bifocal or trifocal lenses
- Discounted upgrades – progressives, anti-reflective, photochromic
Contact lenses
- Allowance toward contacts and the fitting
- Usually instead of frames for that period, not both
Where you can use it
- Retail chains and independent optometrists both participate
- Employee preference should drive the network choice
Vision insurance is not medical eye care
A vision plan pays for routine exams and eyewear.
- Glaucoma, cataracts, retinal conditions, injuries – medical plan
- We explain the difference in enrollment meetings
- Right card presented at the right office
How AIS helps
- Network before price. We check that the retailers and independent optometrists your employees already use are in network.
- Allowance, not just copay. Two plans at the same rate can differ substantially in the frame and contact allowance and in the lens-upgrade discounts. That comparison is the work.
- Frequency. Whether lenses and frames renew every twelve or twenty-four months changes real value for families more than a dollar of premium does.
- Bundling. Where a carrier writes dental and vision together, we look at whether bundling improves rates or administration – and say so when it does not.
- Service. Enrollments, terminations and dependent changes on vision run through the same AIS service desk as every other line.
Usually, because the per-employee cost is small and take-up is high. Even on a
fully voluntary basis it gives employees group pricing and a network discount
they cannot get on their own.
Many carriers now include participating online retailers, and some reimburse
out-of-network purchases up to a schedule. It varies by carrier, so check
before ordering rather than after.
Most plans give an allowance for one or the other in a benefit period, though
a few designs allow both at a higher rate. If many employees wear contacts daily
and keep glasses as backup, that is worth pricing.
Elective refractive surgery is generally not an insured benefit, though many
vision plans include a negotiated discount at participating surgeons. It is a
discount, not coverage, and we describe it that way.
Dependent children are enrolled on the family tier of the group vision plan.
Note that pediatric vision is an essential health benefit on ACA individual and
small group medical plans, so check what the medical plan already includes
before duplicating it.
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