Company Vision Benefit Plan a Clear Path to Better Health

Employees who enroll in and use a voluntary or employer paid vision benefit plans can significantly reduce their out-of-pocket costs for eye care and eyewear.

Many do not realize that they also receive the added benefit of potentially diagnosing ocular and systemic conditions early on, which can result in optimal health outcomes plus a reduction of overall health plan costs.

A comprehensive eye examination from an eye care professional can detect the signs and symptoms of many medical conditions. National Vision Administrators has seen this firsthand, as we analyzed a sample of our 2017 diagnosis codes and discovered that a significant proportion were for non-ocular systemic diagnoses.

The main systemic conditions discovered in this data were diabetes, high blood pressure and high cholesterol (heart disease and diabetes alone cost the U.S. $564 billion per year, according to studies). Early identification of patients with signs of chronic disease drives early intervention, improving quality of life and reducing health care expenditures.

Making the connection for employees between eye examinations and overall health is an important factor, but so is the high cost of eyeglasses. According to the National Association of Vision Care Plans, the average cost of eyeglasses (lenses and frames) is more than $260.

Tack on the cost of a comprehensive eye examination ($110) and you’re looking at a total cost nearing $400. Most vision benefit plans cover comprehensive eye examinations in full or with a minimal copay when an in-network eye doctor is used.

As open enrollment time is rapidly approaching, help your employees value their vision benefit plan with these three suggestions.

1. Encourage employees to be active participants in understanding their vision benefit. Enrolling in a vision benefit plan typically outweighs the cost, even in voluntary programs. Understanding what’s covered and what is not makes for a smarter consumer. Here’s what an employee may find on a vision carrier’s website, open enrollment portal or member brochure:

• Frame Allowance — A set dollar amount or percentage covered by the vision plan toward the purchase of frames. The frame allowance may completely cover the frame of choice or reduce the employee’s out-of-pocket costs.
• Lens Benefit — A set amount or percentage covered by the plan toward the purchase of prescription lenses. This may be covered in full or may cover the majority of the cost, depending on plan design and network considerations.
• Lens Options Pricing — A set amount or percentage covered by the vision plan toward the purchase of lens options. Examples of options include anti-reflective coatings, photochromic (light sensitive) lenses, UV coatings and tints.
• Contact Lens Allowance — A set amount or percentage covered by the vision plan toward the purchase of contact lenses. The ever-changing costs associated with contact lenses and various types of contacts make it difficult to determine the exact cost, so employees should discuss this option with their eye care professional.
• Discounts — Cost reductions for related items such as non-covered lens options, Lasik refractive surgery, online eyewear purchases and hearing aids.

2. Suggest the use of flexible spending account dollars to cover eye care and eyewear out-of-pocket expenses. No one wants to see money go to waste. Employee flexible spending account dollars must be used by the end of the year or they lose them. Employees can use the money toward the purchase of vision care services or products such as contact lenses, Lasik surgery and eyeglasses. 

3. Communicate the importance of an eye exam and its overall health benefits. According to one survey, millennials and members of Generation Z do not know the difference between a vision screening and a comprehensive eye examination. The proliferation of online vision screenings will likely expand that confusion. At the same time there is a global epidemic of myopia (nearsightedness) cases among millennials and younger generations. Nearly half of young adults in the United States are nearsighted. Small amounts of myopia, along with many other conditions, may not be identified during a vision screening alone.

Most vision benefit plan administrators offer communication materials to share with employees. With their help and the use of multiple methods and different outlets, benefits and HR practitioners can mount a successful education campaign. It’s well worth the effort.

David S. Karlin is an insurance industry veteran with 30 years of management experience in vision and prescription drug plan administration. He currently serves as president of National Vision Administrators, Benecard Services, and Heartland Fidelity Insurance Co. Comment below or email editors@workforce.com.