Vision Insurance 101

Pair of glasses sitting on top of a vision test chart

One of the most affordable benefits that you can offer your employees is vision insurance. There are many variations when it comes to vision plan design, but the good news is that if you offer a vision plan and your employees use it as intended (hint, hint, they stay in-network), it will save them a good amount of money on their glasses or contacts or both. Most populations tend to have at least 40 – 50% of their employee base that wears glasses and contacts.

Like all employee benefits, there’s no single right way to offer vision. It can be provided on an entirely voluntary basis where the employee pays 100% of the premium (no cost to the company 😊). It can also be offered on a contributory or employer-paid basis where the employer is paying a portion or all of the benefit. We tend not to see too many employers paying for vision 100% as not all employees need glasses or contacts. Yes, everyone should be getting their eyes checked each year, but an annual exam is only about 1/3 of what a vision plan will cover, so the real value comes into play when you are using the rest of the benefits for your glasses contacts or both. 

There are a few moving parts on a vision plan, so I wanted to take a few minutes to walk through them and explain what they are so you have a better understanding of how a vision plan works and the different moving parts so you can tailor one to suit you or your employee’s needs. 

Frequencies – Most vision plans will have a frequency of 12/12/12 or 12/12/24. Our favorite frequency is 12/12/12. This type of plan allows you to get an exam every 12 months, new lenses every 12 months, and frames every 12 months. When you see the 24 out there (which is quite common, unfortunately), that means the policyholder can only get new frames every 24 months.

Frame and Contact Lens Allowances: Most plans have a set dollar amount that people can use towards contact lenses and frames. This amount is usually a wholesale amount, and more often than not, you will see the same amount for contacts and frames. Most vision plans out there let you purchase new lenses for your glasses or contact lenses each year, but NOT both. But here’s a little H|BC secret for you. There are vendors out there that will let you do BOTH in the same year, and guess what? It adds about $1 – $2 of premium, so the benefits double in value for a tiny bit of additional premium.

Copays: Most vision plans have either $0, $10, or $25 copays for the different services such as exams and materials. This is one of the moving parts that can be adjusted to help get pricing up or down, depending on what you are looking for.

LASIK / Corrective Surgery Discounts: One of the ways to get the absolute most money out of your vision plan is to use the discounts available for corrective eye surgeries. The insurance will NOT cover the surgery itself, but you can typically get a 15 – 20% discount off of the surgery. These sometimes can be pretty pricey, so for $6 – $10 a month in premium, you can not only get your glasses and contact, but you can also potentially save hundreds if not thousands on your eye procedure.

Pre-negotiated Add-Ons: Many plans will have additional pre-negotiated items with network providers that allow for things like standard progressive lenses, bifocals, trifocals that have set copays in place. Typically, you will get a discount on add-ons that you do not see specifically in your benefits summary but not a fixed price. Pay attention to these, as many plans have these pre-determined where many other plans do not.

All in all, vision insurance is an excellent addition to an employee benefits program as it can help a good portion of the population and the cost is pretty negligible compared to most traditional insurance programs. 

If any of these terms or concepts are not making sense or if you would like to restructure or even start a vision program for the first time, please don’t hesitate to reach out. We’re here to help!

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