Vision Care Plan

When you are eligible in the Health & Welfare Plan, you and your eligible dependents are automatically enrolled in the Vision Service Plan (VSP). There is no need to complete an enrollment form.

Vision Service Plan (VSP)

If you or your dependent need vision care, use the Vision Service Plan (VSP). The Fund will provide benefits for:

Vision Examination: Every 12 months.
Lenses: Every 24 months only if needed.
Frames: Every 24 months only if needed.

Second Pair Benefit (for the Active Operating Engineer only)

Lenses: Every 24 months only if needed.
Frames: Every 24 months only if needed.

The second pair benefit covers the same wide selection of quality frames as the standard first pair benefit.  Contact lenses may be chosen in lieu of the second pair of spectacle lenses and frames.  There is a $60 co-payment on materials for the second pair benefit.

You may call VSP at (800-877-7195) for more information, or check the Vision Service Plan website for a directory of participating providers.

BENEFITS

The following is a list of benefits available:

  • Vision Examination: A complete analysis of the eyes and related structures to determine the presence of vision problems, or other abnormalities.
  • Lenses: The VSP Panel Doctor will order the proper lenses (only if needed).
  • Frames: The Plan offers a wide selection of frames, however, if you select a frame which costs more than the amount allowed by your Plan (or a large frame that requires oversized lenses) there will be an additional charge.
  • Contact Lenses: Contact lenses are furnished under VSP when the VSP Panel Doctor secures prior approval for the following conditions:
    1. Following cataract surgery
    2. To correct extreme visual acuity problems that cannot be corrected with spectacle lenses
    3. Anisometropia
    4. Keratoconus

    When VSP Panel Doctors receive approval for such cases, they are fully covered by VSP.
    When patients choose contact lenses for other reasons, VSP will make an allowance of $150 toward their cost in lieu of all other benefits for that year.

AMOUNT PAYABLE

This Plan covers the visual care described herein (examination, professional services, lenses and frames). There is a $15 deductible for the exam and a $25 deductible for materials (frames and/or lenses) which is your out-of-pocket expense. Any additional care, service and/or materials not covered by this Plan may be arranged between you and the doctor.

HOW TO USE THE VISION PLAN

  1. You do not need a form to obtain Vision Care Benefits.
  2. Select the doctor of your choice from the Vision Service Plan list and make an appointment for an examination. Tell them you are covered by Vision Service Plan and they will determine your eligibility.
  3. When the examination has been completed, the doctor will have you sign your name in the space provided. Pay only the deductible to the doctor for the services described herein. VSP will pay the panel doctor directly according to their agreement with the doctor.
  4. Selecting a doctor from the VSP list assures direct payment to the doctor and a guarantee of quality and cost control. However, if you seek the services of a doctor who is not a VSP Panel Member, you should pay the doctor his full fee. You will be reimbursed in accordance with the reimbursement schedule below. There is no assurance that the schedule will be sufficient to pay for the examination or the glasses. Reimbursement benefits are not assignable.

NOTE: When you obtain service from a doctor who is not a VSP Panel Member, and/or obtain glasses from a dispensing optician, be sure to send your itemized statement of charges to VSP. You will be reimbursed according to the following schedule after satisfaction of the deductibles:

Vision exam $ 40.00
Single lenses, up to $ 40.00
Bifocal lenses, up to $ 60.00
Trifocal lenses, up to $ 80.00
Lenticular lenses,up to $125.00
Frames, up to $ 45.00
Contact lenses, necessary $250.00*
Contact lenses, elective $150.00*
*In lieu of all other Plan benefits
Extra Cost
This plan is designed to cover your visual needs rather than cosmetic materials. If you select any of the following and your VSP doctor doesn’t receive prior authorization, there will be an extra charge: (a) Oversize lenses; (b) coated lenses; (c) contact lenses; (d) blended lenses; (e) multi-focal plastic lenses; or (f) a frame that costs more than the Plan allowance.