Vision Plan
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What It Is Eligibility Features Payment Options How To Apply/Use Contact |
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What It IsThe Vision Care Plan provides 1 complete eye exam (including glaucoma testing and, when professionally indicated, dilation) and 1 pair of eyeglasses (lenses and frames) or contact lenses per benefit period, paid-in-full according to plan specifications from participating providers. The NYSUT Member Benefits Trust-endorsed Vision Care Plan is provided and administered by Davis Vision. The Davis Vision Voluntary Vision Plan is a NYSUT Member Benefits Trust (Member Benefits)-endorsed program. Member Benefits has an expense reimbursement/endorsement arrangement of 6.4% of premium for individual coverage and 4.78% of premium for family coverage. All such payments to Member Benefits are used solely to defray the costs of administering its varioius programs and, where appropriate, to enhance them. Member Benefits acts as your advocate; please contact Member Benefits at (800) 626-8101 if you experience a problem with any endorsed program. Agency fee payers to NYSUT are eligible to participate in NYSUT Member Benefits Trust-endorsed programs.
EligibilityIn-service and retiree members of NYSUT are eligible to enroll. Members have the choice of individual or family coverage. Family coverage includes spouse or domestic partner and unmarried, dependent children under age 25. Unmarried, dependent children ages 19 to 25 are eligible for benefits only if they are full-time students. Unmarried children 19 years of age or older who are incapable of self-support because of mental or physical disability are covered, provided that the disability began before age 19.
FeaturesThe plan year runs from January 1 through December 31. You may enroll at any time throughout the plan year; however, the premium will be the full annual amount and you will have the balance of the plan year to use the full benefit. The plan’s benefits include an annual eye exam, including glaucoma testing and dilation when professionally indicated, and one pair of eyeglasses (lenses and frames). Contact lenses may be chosen in lieu of glasses. These benefits are paid-in-full. A few options are available with discounted co-payments. Members will receive the maximum benefit when utilizing an in-network provider. Providers are highly qualified optometrists. Review the participating providers, which include all Davis and Empire Vision Centers, before enrolling in the plan. Use this link Davis Vision to obtain information on participating providers or call Davis Vision toll-free at (877) 923-2847. Use control code 4482 to gain access to the Web site or phone system. If using the Web site link, click on “find a provider” in the upper right hand corner of the home page and enter the control code. Included in the plan: Members selecting contact lenses from the formulary below will receive an assessment fitting and follow-up care in addition to the following materials:
Note: Formulary subject to change. Options available at member co-payments:
This program has a 30-day free-look period. If you're not completely satisfied after reviewing the plan, you may request a full refund. If any of the services are used within the 30-day period, the opportunity for a refund will be waived.
Payment OptionsThe plan costs $130 per year for individual coverage and $230 per year for family coverage. Payment can be made by check or money order, made payable to NYSUT Member Benefits Trust. The plan year runs from January 1 through December 31. You may enroll at any time throughout the plan year; however, the premium will be the full annual amount and you will have the balance of the plan year to use the full benefit. Most covered individuals will leave a participating provider’s office with an eye-care package that retails anywhere from $300 to $500.
How To Apply/UseTo enroll in the plan, print out the PDF of the enrollment form below and submit it with payment to NYSUT Member Benefits Trust. Or you can contact Member Benefits by phone (800) 626-8101 or e-mail benefits@nysutmail.org to request an enrollment form. Upon receipt of your form, your enrollment will be processed and a confirmation of vision plan enrollment will be sent to you (in approximately 2 weeks). Once you’re confirmed, call an in-network provider, identify yourself with your name and Social Security number (HIPAA-protected by Member Benefits and Davis Vision) or NYSUT ID number (see your NYSUT membership card), make an appointment and use all of the plan benefits at that visit (exam and glasses cannot be split in two appointments). The provider’s office will contact Davis Vision and verify your eligibility for benefits. No claim forms or ID cards are needed.
ContactFor information about participating providers, which include all Davis and Empire Vision Centers, use this link Davis Vision or call Davis Vision toll-free at (877) 923-2847. Use control code 4482 to gain access to the Web site or phone system. If using the Web site link, click on “find a provider” in the upper right hand corner of the home page and enter the control code. For other questions, call Davis Vision at (877) 923-2847. Or contact Member Benefits at (800) 626-8101 weekdays from 9 a.m. to 5 p.m. Eastern Time, or e-mail us at Member Benefits. The NYSUT Member Benefits Trust-endorsed Vision Care Plan is provided and administered by Davis Vision.. |