VCP Network. HumanaVision
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1 VCP Network HumanaVision
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3 Feel good about choosing a HumanaVision plan Thank you for considering a HumanaVision plan. It s important your employees keep their eyes healthy and get routine care. A comprehensive eye health exam can help prevent vision loss, and also detect more serious diseases such as diabetes, hypertension, multiple sclerosis, and brain tumors. A vision plan is one of the top five most desired benefits, after medical insurance, by employees. 1 You can feel good knowing HumanaVision plans encourage prevention, early diagnosis, and treatment. Feel even better knowing: More than 35,000 participating optometrist, ophthalmologist, and national retail locations and all accept new patients. Employees build relationships with providers who know their health and family histories so they can detect conditions such as diabetes and hypertension. Employees receive a wholesale frame allowance they never pay full retail plus substantial savings on lenses, lens options, contact lenses, and Lasik procedures. You can offer a voluntary HumanaVision plan without increasing your benefits budget. You and your employees can expect friendly, personal service. In fact, 9 out of 10 calls are resolved to the customer s satisfaction on the first call. 2 1 LIMRA International 2 HumanaVision member satisfaction survey, 2008
4 According to the Vision Council of America, vision problems affect 120 million Americans and cost businesses an estimated $8 billion annually because of reduced productivity. Vision health impacts overall health Eye health exams are an important part of routine preventive healthcare. Because many eye and vision conditions have no obvious symptoms, your employees may be unaware of problems. Early diagnosis and treatment are important for maintaining good vision and preventing permanent vision loss. 1 Vision care is essential to maintaining a healthy lifestyle. Eye exams can detect symptoms of diseases such as diabetes, hypertension, multiple sclerosis, brain tumors, osteoporosis, and rheumatoid arthritis. 2 National network provides real savings Employees have access to one of the largest vision networks in the United States, with more than 35,000 participating provider locations. They ll be able to use their benefits at some of the top names in eye care, including LensCrafters, Pearle Vision, Sears Optical, Target Optical, and JCPenney Optical in addition to the many independent optometrists and ophthalmologists. Plus, your employees save on eyewear. They pay the wholesale price for frames, avoiding high retail markups, and will benefit with fixed pricing for most lens options including anti-reflective and scratch-resistant coatings. What does this mean to your employees? There are no hidden charges. With fixed pricing, employees will pay the same price for eyewear at any provider location. Personalize your HumanaVision plan You ll work with your broker and our own vision expert to design a plan that best fits you and your employees needs. You can: Choose voluntary or employer-sponsored plans Talk directly with a Customer Care specialist at and/or manage your plan online at HumanaVisionCare.com Use the enrollment option that works best for you: Web, list enrollment, or paper 1 American Optometric Association 2 Thompson Media, Inc. Affordable frames Benefits include a wholesale frame allowance. If the wholesale cost exceeds the frame allowance, employees pay twice the wholesale difference. They never pay full retail. Retail price * Wholesale price Wholesale allowance Member pays Savings $125 $50 $50 $0 $125 $ $75 $50 $50 ($75-$50=$25x2=$50) $ * Retail costs may differ and are based on 2½ times the wholesale cost. Actual savings may vary. JCPenney Optical
5 Vision Care Plan Exam Plus 5 See a participating provider See a nonparticipating provider See a participating provider Exam with dilation as necessary 100% after copay $35 allowance $10 copay Lenses Single Bifocal Trifocal 100% after copay 100% after copay 100% after copay $25 allowance $40 allowance $60 allowance 20% retail discount Members receive additional fixed copayments on lens options including anti-reflective and scratch-resistant coatings. After copay, standard polycarbonate available at no charge for dependents less than 19 years old. Frames Wholesale frame allowance $40 retail allowance 20% retail discount Contact lenses 1 Elective (conventional and disposable) 2 Medically necessary Frequency (based on date of service) Option 1 Option 2 Copay and allowance options Contact lens allowance 100% Examination Exam/material 3 copay options $10/$15 $15/$20 $15/$15 $20/$20 Wholesale frame allowance options Approximate retail value: $40 $80 $120 $45 $90 $135 $50 $100 $150 Contact lens allowance $210 allowance Lenses or contact lenses Frames Once every 12 months Once every 12 months Once every 12 months Once every 12 months Once every 12 months Once every 24 months Not available Not available Elective contact lens allowance 4 $110 $150 Other discounts Members receive a 20 percent retail discount on a second pair of eyeglasses. This discount is available for 12 months after the covered eye exam and available through the network provider who sold the initial pair of eyeglasses. 15% discount on professional services (evaluation and fitting fee) 6 Once every 12 months 1 If a member prefers contact lenses, the plan provides an allowance for contacts in lieu of all other benefits (including frames) (Vision Care Plan only). 2 The contact lens allowance applies to professional services (evaluation and fitting fee) and materials. Members receive a 15 percent discount on in-network professional services. The discount for professional services is available for 12 months after the covered eye exam. 3 Material copay is required for a complete pair of eyeglasses, lenses or frames. 4 Contact lens allowance must be used at one time; no amount will be carried forward. 5 Not available in Connecticut or Massachusetts. 6 Discount does not apply to contact lens materials. HumanaVision Lasik discount We have contracted with many well-known facilities and eye doctors to offer Lasik procedures at substantially reduced fees. Your employees can take advantage of these low fees when procedures are done by network providers. The network locations listed below offer the following prices (per eye): TLC (designated locations only) LasikPlus QualSight LASIK *with IntraLase TM Conventional / Traditional $695* LasikPlus free enhancements for 1 year $895 QualSight free enhancements for 1 year Custom $895 $1,295 $1,895* $1,395* LasikPlus free enhancements for life $1,295 with QualSight Lifetime Assurance Plan $1,895* LasikPlus free enhancements for life $1,320 $1,995* with QualSight Lifetime Assurance Plan You can also use independent Lasik provider network doctors to receive a 10% discount from usual and customary prices and pay no more than $1,800 per eye for Conventional Lasik and $2,300 per eye for Custom Lasik.
6 HumanaVision plan guidelines Eligibility Using HumanaVisionCare.com, you can: Find a network provider View benefits Check eligibility Plus, your employees can quickly find network providers and check the status of claims. Employer contribution Participation Employer-sponsored at least 75% 10 or more enrolled* Voluntary less than 75% 10 or more enrolled* * 2 9 considered if sold with Humana medical or dental insurance plans with a minimum of 25% participation and no fewer than 2 enrolled. All case sizes not available in all markets. Limitations In no event will coverage exceed the lesser of: 1. The actual cost of covered services or materials; 2. The limits of the policy, shown in the Schedule of Benefits; or 3. The allowance as shown in the Schedule of Benefits. Materials covered by the policy that are lost or broken will only be replaced at normal intervals as provided for in the Schedule of Benefits. We will pay only for the basic cost for lenses and frames covered by the policy. The insured is responsible for extras selected, including but not limited to: 1. Blended lenses; 2. Progressive multifocal lenses; 3. Photochromatic lenses; tinted lenses, sunglasses, prescription and plano; 4. Coating of lens or lenses; 5. Laminating of lens or lenses; 6. Groove, drill or notch, and roll and polish; unless otherwise specifically listed as a covered benefit in the Schedule of Benefits. Exclusions We will not cover: 1. Orthopic or vision training and any associated supplemental testing; 2. Two pair of glasses, in lieu of bifocals, trifocals or progressives; 3. Medical or surgical treatment of the eyes; 4. Any services and/or materials required by an employer as a condition of employment; 5. Any injury or illness covered under any Workers Compensation or similar law; 6. Sub-normal vision aids, aniseikonic lenses or non-prescription lenses; 7. Charges incurred after: (a) the policy ends; or (b) the insured s coverage under the policy ends, except as stated in the policy; 8. Experimental or non-conventional treatment or device; 9. Contact lenses, except as specifically covered by the policy; 10. Hi index, aspheric and non-aspheric styles; 11. Oversized 61 and above lens or lenses; 12. Cosmetic items, unless otherwise specifically listed as a covered benefit in the Schedule of Benefits.
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8 Insured by Humana Insurance Company, CompBenefits Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, CompBenefits Company, or The Dental Concern, Inc. This is not a complete disclosure of the plan qualifications and limitations. Specific limitations and exclusions as contained in the Regulatory and Technical Information Guide will be provided by the agent/broker. Please review this information before applying for coverage. The amount of benefits provided depends on the plan selected. Premiums will vary according to the plan selection. GN51511HV 1/12 Policy number: VGRP-CERT.002
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