Employee Matters

This column is prepared by staff of the Employee Compensation and Benefits Services office. E-mail the office at employee@bussvc.wisc.edu, or call 263-7556 or 262-5650. For information, visit http://www.bussvc.wisc.edu/ecbs/ ecbs.html.

New benefit plan in 2007: Vision Care

What is the plan?

A new plan, Vision Benefits, will be offered to UW employees in 2007. The plan is insured by Spectera, a UnitedHealth Group company. This plan will cover costs including eye examinations, standard spectacle lenses, frames and contact lenses.

The information provided below regarding the benefits payable are from the 2006 plan year. There could be changes to these benefits for the 2007 plan year.

Examples of various benefits:

An eye examination performed by an in-network provider would be paid at 100 percent after a $10 co-pay or paid up to $40 if performed by an out-of-network provider. Standard spectacle lenses (single, bifocal, trifocal, lenticular) would be paid at 100 percent if obtained from an in-network provider or paid up to $40 if obtained from an out-of-network provider.

For contact lenses, the fitting/evaluation fees, contacts (including disposables) and up to two follow-up visits are covered in full (after applicable co-pay) for many popular brands if the services are provided by an in-network provider. If covered disposable contact lenses are chosen, up to four boxes are included when obtained from a network provider.

A $105 allowance is applied toward the fitting/evaluation fees and purchase of contact lenses outside of Spectera’s covered-in-full contacts.

Spectera’s participants receive access to discounted refractive eye surgery from numerous provider locations throughout the United States as well. To find a participating laser eye surgeon in your area, visit http://www.spectera.com.

How do I find out about the provider network?

The in-network providers can be found at http://www.spectera.com or by calling Spectera’s provider locator service at (800) 839-3242.

What is the cost of this plan?

The monthly premium rates from 2006 were $5.40 for employee only, $10.50 for employee and spouse, $11 for employee and children, and $16.50 for employee and family.

How can I enroll in this plan?

There will be an open enrollment opportunity this fall for coverage effective Jan. 1. The open enrollment will coincide with other fall enrollments. Watch for more information.

How do I determine whether I should enroll?

It is important to determine your needs, what is paid by your health plan (if anything), who your preferred provider of services is and whether contributing to the Employee Reimbursement Plan may be a better option, etc., as all of these benefits work together.