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Why we’re here
Meet EyeMed and see the difference
Lets talk about your vision
And how we support that vision – choice for your employees
Using the benefit is so easy!
We’re here to serve!
How do you get the word out to employees?
2 August 2014
Let’s run through the plan summary
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In a nutshell… Coverage elected during the annual enrollment period of October 1st to
November 1st begins January 1, 2015
Benefits are calendar year
Exam and Lenses or Contact Lenses: once per calendar year
Frame: Once per every two calendar years.
Four Tier 100% Voluntary Rates
Two plan choices: Basic or Expanded
Extra savings on Expanded plan:
35% savings on anti-reflective
55%-65% savings on progressive lenses
Savings on both plans:
40% off additional complete pair eyewear purchases – unlimited!
August 2014
5 May 2014
Basic PlanService In-Network Out-of-network Routine Eye Exam $0 copay $30 reimbursement
Frame Allowance $50 allowance; 20% discount off amount over allowance
$50 total frame and lens reimbursement
Standard Lenses $50 allowance; 20% discount off amount over allowance
$50 total frame and lens reimbursement
Eyeglass Standard Lens Options (Upgrades)
20% off retail price N/A
Exam for Contact Lenses 15% Discount N/A
Contact Lenses • Medically Necessary: $150 allowance
• Elective: $50 allowance
• Medically Necessary: $75 reimbursement
• Elective: $25 reimbursement
LASIK/Refractive Surgery Discount
15% off usual and customary fees
N/A
21%of State
employees chose Basic in
2014
*Rates are subject to change
August 2014
Premium Rates Per Month:
Employee $3.35Employee + Child(ren) $6.69Employee + Spouse $6.35Employee + Family $9.83
6 May 2014
Expanded Plan Service In-Network Out-of-network Routine Eye Exam $10 copay $45 reimbursement
Frame Allowance $115 allowance; 20% discount off amount over allowance
$70 reimbursement
Standard Lenses $15 copayment includes glass or plastic, single vision, lined bifocal, trifocals and lenticular lenses
• Single vision: $30 reimbursement
• Lined bifocal: $50 reimbursement
• Lined trifocal: $65 reimbursement
Eyeglass Standard Lens Options (Upgrades)
Maximum Copayments:• Standard Progressive: $55• Premium Progressive: $75-
$100*• Standard Anti-Reflective: $45• Premium Anti-Reflective: $57-
$68• Polycarbonate: $30 or $0 for
dependents 18 and under• Photochromics: $70• Scratch resistance coating:
$15• UV Coating: $10• Tints: $25
20% discount on all other lens options
Maximum Reimbursements• Standard Progressive: $50• Premium Progressive: $50• Standard Anti-Reflective:
N/A• Premium Anti-Reflective:
N/A• Polycarbonate: $5
• Photochromics: $5• Scratch resistance coating:
N/A• UV Coating: $5• Tints: N/A
No discount out-of-network
79%of State
employees chose
Expanded in 2014
*Rates are subject to change
August 2014
7 May 2014
Expanded Plan (continued)
Service In-Network Out-of-network Exam for Contact Lenses Copayment not to exceed
$60N/A
Contact Lenses • Medically Necessary: covered at 100%
• Elective: $130 allowance
• Medically Necessary: $100 reimbursement• Elective: $50
reimbursement
LASIK/Refractive Surgery Discount 15% off usual and customary fees
N/A
79%of State
employees chose
Expanded in 2013
*Rates are subject to change
August 2014
Premium Rates Per Month:
Employee $5.86
Employee + Child(ren)$11.72Employee + Spouse$11.14Employee + Family$17.23
What the plans don’t cover:
Treatment of injury or illness covered by Workers’ Compensation or Employer’s Liability Law
Services received without cost from any federal, state or local agency. This exclusion will not apply if prohibited by law.
Cosmetic surgery or procedures for purely cosmetic reasons. Charges by any hospital or other surgical treatment facility and any
additional fees charged by the vision for treatment in any such facility.
Services by a vision provider beyond the scope of his or her license. Vision Services for which the patient incurs no charge.
8 August 2014
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It’s your vision and your vision plan…see how we make it amazing!
10 May 2014
Using the benefit as easy as 1…2…3
1. Locate a Provider
2.Set an Appointment
3.Receive Services
In-Network
1. Set an Appointment
2.Pay for Services
3.Submit OON Claim Form with Receipts
Out-of-Network (OON)
August 2014
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Access to our doctors & providers
100%urban access to 2 providers within 10 miles
100%suburban access to 2 provider within 15 miles
98%Rural access to 1 provider within 20 miles
And there’s more… 1135 providers at 443 locations in State of TN – more than in 2013! 85% Private Practice; 15% Retail Chain Provider nomination forms available online at
www.eyemedvisioncare.com/stofTN
August 2014
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Member web is easy & fast
Online exam scheduling* Linked directly from our provider locator at
www.eyemedvisioncare.com/stoftn or at www. eyemed.com
Self service on the web Locate a provider Download printable ID cards and EOB View benefits and eligibility status Contact EyeMed Find answers to common questions View vision wellness information Review LASIK information
#1used feature on our member web is the provider locator tool!
In a world of instant gratification, our members can manage their vision care when and where they need to
*Based on EyeMed web analytics research
*Available at participating providers
August 2014
There’s an app for that
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Available today for iPhone users, coming soon for Android users.
Members get fingertip access to: provider locations and driving directions benefits eligibility in-network benefit details ID card FAQs help line
Accessing ID card has never been easier Log into app, shake phone for ID Card!
EyeMed is the first Managed Vision Care to introduce a member app!
August 2014
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Award-winning service day & night
362days a year, we’re here
Monday – Saturday: 6:30 – 10 p.m. CTSunday: 10 – 7 p.m. CT
99.5%1st call resolution rate
4sec. avg. speed of answer
Skill-based routing so your calls are answered by the right vision benefits expert every time
Certified Center of Excellence by Benchmark Portal 3 years in-a-row
We are accessible, helpful, & great at what we do.
Call EyeMed toll free 855-779-5046
August 2014
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From the very beginning, we’ll support every step of the way
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Helpful communication
handbook
open enrollment
welcome packet
August 2014
Eyemedvisioncare.com/stofTN
17 May 2014
EyeMed Supports ABCs
One-stop reference library, videos and downloadable materials to use in conjunction with the State of TN wellness initiatives.
Regularly updated materials to incorporate in communications and conversations with employees about the State’s wellness topics.
EyeSight On Wellness
Open Enrollment and Health Fair Support Live EyeMed Representatives available for
locations of 200+ employees and 30 day notice
Signage, materials and giveaways mailed to locations with 2 week notice
Email event date, time and number of attendees to [email protected] and we will contact you about your event!
August 2014
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Finally, lets just talkAny questions?
![EyeMed Summary[1]](https://img.dokumen.tips/doc/110x75/543c6625afaf9fe7338b48b4/eyemed-summary1.jpg)
