Transcript Nice to see you Texas A&M University System

Nice to see you
again Texas A&M
University System
We’re EyeMed
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
Our member experience is off the charts!
Welcome
Packet
Open enrollment with
local captains
2
Accessing the
benefit: day &
night
A network
employees
request
Choice: it’s their style
& their wallet…
They decide!
It’s the vision benefit solution that
members appreciate most!
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
3
The importance of eye exams
From our first steps to our first grandchild, vision affects every aspect of our life, at
every stage in life
Children’s Vision
Glaucoma
•About 80% of learning in a child’s first 12 years
comes through the eyes1, and poor vision can
slow a child’s reading.
•2nd leading cause of blindness
•The American Optometric Association
recommends that every child have a
professional eye exam shortly after birth, by
6months of age and again just prior to entering
school.
•Typically affects people over the age of 40 &
the chances of developing it are increased by
family history, race, extreme nearsightedness
or diabetes..
•A comprehensive eye exam can detect the
onset of glaucoma.
Diabetes
Vision and Aging
•If left untreated, eye diseases such as
retinopathy, cataract, and glaucoma could
develop, blurring vision and eventually causing
blindness.
•As we age, our eyes change.
•If you’re diabetic, regular eye exams are
especially important because they enable your
eye doctor to monitor changes in your eyes,
reducing the likelihood of vision-related
complications.
•Older adults are at risk for specific eye
problems including age-related macular
degeneration (AMD) cataracts, and floaters,
which could be a symptom of a more serious
condition like a detached retina – making the
need for an eye exam even more important.
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
See what comes with our eye exams
EyeMed Vision Care’s panel conducts
comprehensive eye examinations to diagnose or
detect existing conditions of the eye and vision
system.
Tests and procedures of a
comprehensive exam include:
 Case History
 The annual eye exam recognized as a primary
entry point into the health care system
 Evaluation of visual system’s
status
 EyeMed requires the submission of all applicable
ICD-9 diagnosis codes for claims submission
 Binocular Function
 Dilation is a key procedure for diagnosis of
diabetes, hypertension and heart disease
 Dilation is included in all exams at no additional
charge but at the determination of the provider
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
 Refractive Status
 Assessment, diagnosis and
treatment plans
 Contact Lens Exam &
Evaluation (when
appropriate)
We give our members options
Whether you choose a provider based on your schedule, style or value,
PREMIUM
Retail
20%
FUNCTION
FASHION
Independent
80%
ECONOMIC
…no matter what, we have you covered!
5
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
You are free to choose vision care…
When


6
Convenient locations in or
near major shopping
centers with longer hours
on nights and weekends
Appointment times that fit
your schedule
Where

We have you covered from
coast to coast with more than
65,000 provider access
points including over 4,900
retail locations including
Lenscrafters, Pearle Vision,
Target Optical, Sears Optical,
JC Penny’s Optical and many
more!
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
How




No restrictive “collections”
or “formularies”
Choose from either
glasses or contact lenses
Take your RX anywhere
in-network to have it filled
And rest assured, all
benefits & discounts are
applied consistently in our
network
Check out our plan design
In-Network
Co-payments and Coverage Options
Out-of-Network
Reimbursement Schedule
$10 co-pay
Up to $50
Covered in full
10% off Retail, then apply $40 allowance
$40
$40
Frame
$0 Co-pay, $130 Allowance, 20% off balance over $130*
Up to $90
Standard Plastic Lenses:
Single Vision
Bifocal
Trifocal
Lenticular
Standard Progressive
Premium Progressive
$15 Co-pay
$15 Co-pay
$15 Co-pay
$15 Co-pay
$15 Co-pay
$15 Co-Pay, $120 allowance, 20% off remaining balance
Up to $50
Up to $70
Up to $100
Up to $100
Up to $70
Up to $70
Contact Lenses
(in lieu of eyeglass lenses):
Conventional
Disposable
Medically Necessary
$0 Co-pay, $150 Allowance , 15% off balance over $150
$0 Co-pay, $150 Allowance , plus balance over $150
$0 Co-pay, Paid-in-Full
Up to $150
Up to $150
Up to $210
Feature
Eye Examination
Exam Options:
Standard Contact Lens Fit & Follow-Up
Premium Contact Lens Fit & Follow-Up
Frequency
Exam
Lenses or Contact Lenses
Frame
Once every 12 months per plan year
Once every 12 months per plan year
Once every 24 months per plan year
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
See all the details
Covered in full: scratch coating , standard progressive lenses
& polycarbonate lenses for children. Additional benefits include:
Premium Progressive Lenses:
Tint (Solid or Gradient):
UV Coating:
Polycarbonate- Adult:
Standard Anti-Reflective:
Premium Anti-Reflective:
Transition:
$41-$53 copay
$15 copay
$15 copay
$40 copay
$45 copay
$57-$68 copay
$75 copay
Your employees get even more:






Exclusive to EyeMed: 40% off unlimited additional pairs
Up to 60% discount on popular lens options not covered by the plan
40%-60% off contact lens fit & follow-up
20% off any item not covered by the plan
20% off any frame balance
Lasik Discount – 15% off retail pricing or 5% off any promotional price
 at U.S. Laser Vision locations
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
Lens options are
also available at
fixed pricing to
EyeMed
members
Step 1
• Locate a provider at eyemed.com, choose the “SELECT” network of providers in
the drop-down menu. Search by zip code. Provider information is also available by
calling 1-866-804-0982.
Step 2
• Schedule an appointment by either calling the provider directly or scheduling online*
at eyemed.com *(select locations available)
Step 3
• When you arrive, identify yourself as an EyeMed member & present your ID card. No
ID card? No problem, the provider can verify your benefits by using your name & date
of birth.
Step 4
Simple steps to access the benefit
• You pay the provider applicable copays & surcharges based on the lens options you
have selected and the provider does the rest!
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
Helpful communication – including an ID card
benefit summary
open enrollment
welcome packet
eyemed.com
10
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
Award-winning service day & night
362
99.5% 14
days a year, we’re here
1st call resolution rate
sec. avg. speed of answer
Monday – Saturday:
7:30 – 11 p.m. ET
Sunday: 11 – 8 p.m. ET
Skill-based routing so your calls
are answered by the right vision
benefits expert every time
Certified Center of Excellence by
Benchmark Portal 3 years in-a-row
We are accessible,
helpful,
11
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
& great at what we do.
Who knew vision can be easy, fast &…mobile?
Online exam scheduling*
 Linked directly from our provider locator at eyemed.com
*Available at participating providers
Mobile-optimized web





Locate a provider
View ID card
View benefits
Contact EyeMed
Find answers to common questions
Eyesiteonwellness.com
 One-stop reference library, videos & downloadable materials
 Regularly updated materials to incorporate in company
communications
 Wellness calendar allowing employers to customize the
frequency of communications
12
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.
Any questions?
Confidential Notice: This document contains privileged information and is for the sole use of the intended recipient(s). Disclosure or
distribution to and review or use by any unauthorized Luxottica EyeMed associate (s) and external parties is prohibited.