/depts/,/depts/uwhealth/,/depts/uwhealth/benefits/,/depts/uwhealth/benefits/open-enrollment/,/depts/uwhealth/benefits/open-enrollment/uwhc-open-enrollment/,/depts/uwhealth/benefits/open-enrollment/uwhc-open-enrollment/vsp-vision-care/,/depts/uwhealth/benefits/open-enrollment/uwhc-open-enrollment/vsp-vision-care/resources/,

/depts/uwhealth/benefits/open-enrollment/uwhc-open-enrollment/vsp-vision-care/resources/New-UWHC-Employees-MBS-2018.pdf

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Departments & Programs,UW Health,Benefits,UW Health Open Enrollment,UWHC Open Enrollment,VSP Vision Care,Resources

VSP Benefit Summary

VSP Benefit Summary - Departments & Programs, UW Health, Benefits, UW Health Open Enrollment, UWHC Open Enrollment, VSP Vision Care, Resources


Get access to the best in eye care and
eyewear with University of Wisconsin
Hospital & Clinics and VSP® Vision Care.
Why enroll in VSP? As a member, you’ll receive access to care
from great eye doctors, quality eyewear, and the affordability
you deserve, all at the lowest out-of-pocket costs.
You’ll like what you see with VSP.
High Quality Vision Care. You’ll get the best care from a VSP network
doctor, including a WellVision Exam®—the most comprehensive exam
designed to detect eye and health conditions.
Choice of Providers. The decision is yours to make—choose a VSP
network doctor, a participating retail chain, or any out-of-network provider.
Great Eyewear. It’s easy to find the perfect frame at a price that fits your
budget.
With VSP
Coverage
Without VSP
CoverageSave with VSP Coverage
$15$156Eye Exam
$25
$130Frame
$85Single Vision Lenses
$70$111Photochromic Adaptive Lenses
$69$114Anti-reflective Coating
$78.48N/AEmployee-only Annual Contribution
$257.48$596Total
Comparison based on WI averages for comprehensive eye
exams and most commonly purchased brands Average Annual Savings with a
VSP Provider: $338.52
NOTE: Dollar amounts in the savings chart are estimates
and don't reflect additional discounts from current VSP
offers and promotions.
Enroll in VSP 10/02/2017 - 10/27/2017. You’ll be glad you did.
Contact us. 800.877.7195
stateofwiemployees.vspforme.com
Using your VSP benefit is easy.
Create an account at vsp.com. Once your plan
is effective, review your benefit information.
Find an eye doctor who’s right for you. Visit
vsp.com or call 800.877.7195.
At your appointment, tell them you have VSP.
There’s no ID card necessary. If you’d like a
card as a reference, you can print one on
vsp.com.
That’s it! We’ll handle the rest—there are no
claim forms to complete when you see a VSP
provider.
Choice in Eyewear
From classic styles to the latest designer frames,
you’ll find hundreds of options. Choose from
featured frame brands like bebe®, Calvin Klein,
Cole Haan, Flexon®, Lacoste, Nike, Nine West,
and more.1 Visit vsp.com to find a Premier
Program location that carries these brands. Plus,
save up to 40% on popular lens enhancements.2
Prefer to shop online? Check out all of the brands
at eyeconic.com®, VSP's online eyewear store.
Life is
better in
focus.
TM

Your VSP Vision Benefits Summary
University of Wisconsin Hospital & Clinics and VSP provide you with an affordable
eye care plan.
Open Enrollment: 10/02/2017 - 10/27/2017
VSP Coverage Effective Date: 01/01/2018 VSP Provider Network: VSP Choice
FrequencyCopayDescriptionBenefit
Your Coverage with a VSP Provider
Every calendar year$15WellVision Exam Focuses on your eyes and overall wellnessAvailable twice every calendar year for dependent children
See frame and lenses$25Prescription Glasses
Every other calendar year
Included in
Prescription
Glasses
Frame
$150 allowance for a wide selection of frames
$170 allowance for featured frame brands
20% savings on the amount over your allowance
$80 Costco® frame allowance
Available every calendar year for dependent children
Every calendar year
Included in
Prescription
Glasses
Lenses
Single vision, lined bifocal, and lined trifocal lenses
Polycarbonate lenses for dependent children
Every calendar year
$0
Lens Enhancements
Scratch Resistant Coating
$0UV Protection
$55Standard progressive lenses
$95 - $105Premium progressive lenses
$150 - $175Custom progressive lenses
Average savings of 20-25% on other lens enhancements
Every calendar yearUp to $40Contacts (instead ofglasses)
$150 allowance for contacts; copay does not apply
Contact lens exam (fitting and evaluation)
As needed$20Primary Eyecare
Treatment and diagnosis of eye conditions like pink eye, vision loss
and monitoring of cataracts, glaucoma and diabetic retinopathy.
Limitations and coordination with medical coverage may apply. Ask
your VSP doctor for details.
Glasses and Sunglasses
Extra Savings
Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details.
20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12
months of your last WellVision Exam.
Retinal Screening
No more than a $39 copay on routine retinal screening as an enhancement to a WellVision Exam
Laser Vision Correction
Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted facilities
$6.54 Employee only $13.08 Employee + spouse/domestic partner $14.73 Employee + child(ren) $23.54 Employee +
family
Your Monthly
Contribution
Your Coverage with Out-of-Network Providers
Get the most out of your benefits and greater savings with a VSP network doctor. Your coverage with out-of-network providers will be less or you’ll
receive a lower level of benefits. Visit vsp.com for plan details.
Exam .............................................................................. up to $45
Frame ............................................................................ up to $70
Single Vision Lenses ........................................... up to $33
Lined Bifocal Lenses ........................................... up to $50
Lined Trifocal Lenses ......................................... up to $66
Progressive Lenses ............................................. up to $50
Contacts .................................................................... up to $105
Coverage with a participating retail chain may be different. Once your benefit is effective, visit vsp.com for details. Coverage information is subject to change. In the event of a conflict between this
information and your organization’s contract with VSP, the terms of the contract will prevail. Based on applicable laws, benefits may vary by location. In the state of Washington, VSP Vision Care, Inc.,
is the legal name of the corporation through which VSP does business.
Contact us. 800.877.7195 | stateofwiemployees.vspforme.com
1. Brands/Promotion subject to change.
2. Savings based on network doctor's retail price and vary by plan and purchase selection; average savings determined after benefits are applied. Available only through VSP network doctors to VSP
members with applicable plan benefits. Ask your VSP network doctor for details.
©2017 Vision Service Plan. All rights reserved.
VSP, VSP Vision care for life, eyeconic.com, and WellVision Exam are registered trademarks, and "Life is better in focus." is a trademark of Vision Service Plan. Flexon is a registered trademark of Marchon
Eyewear, Inc. All other company names and brands are trademarks or registered trademarks of their respective owners.