Why a Shortfall Exists with Vision Benefits

Jay Rex

Jun 21, 2016

Why a Shortfall Exists with Vision Benefits

 Vision Insurance can be one of the best employee-paid values in the entire benefits suite. But the employee only realizes the value if the benefits are used as designed.

According to three of the top vision carriers, about two-thirds of employees at large companies purchase voluntary coverage when it is offered by their employer. Yet only about one-third of those who enroll use any of their vision benefits each year.

Are employers to blame in not communicating the core benefits to help employees see the value in vision insurance?

Steps to Take

The first step is helping employees understand what vision insurance is and how to use it. Many employees believe vision insurance is the eye version of their medical insurance and fail to realize that medical – and not vision – covers the majority of health-related eye issues and ailments. If an employee gets poked in the eye, it’s medical insurance that’s going to cover the doctor bill, not vision.

In addition, communicating to employees that routine vision care such as annual checkups and vision materials (e.g., eyeglasses, contact lenses) is becoming increasingly important as eye care technology continues to improve. Vision insurance is designed to help defer the costs associated with that routine care.

In the past, annual vision checkups were used primarily for vision wellness. However, regular vision checkups have become an integral part of overall wellness as technology and research has increased optometrists’ and ophthalmologists’ ability to detect pre-symptom stage issues including diabetes, hypertension, various autoimmune disorders, high cholesterol, thyroid diseases, tumors and even certain types of cancers.

The eyes, via a thorough eye exam, are still the only unencumbered, non-invasive view of a person’s blood vessels.

The Value of Vision

An annual eye checkup (with dilation or retinal scan) can cost from $65 at budget retailers to $250 (at an independent optometrist’s office) without insurance. However, many large employers offer good vision plans with an exam co-pay of $10 or less. With low monthly premiums of $6 to $12, employer-sponsored vision plans can be a good financial bet even for those who just want to get a good, thorough eye exam each year.

Another key to finding the value of vision insurance is helping employees reduce the out-of-pocket costs associated with corrective lenses. An employee who is purchasing eyeglasses for the first time could experience significant sticker shock – even if they have insurance – if the employee fails to pay attention to plan provisions.

Using an in-network provider is one obvious way to reduce the cost of those eyeglasses. But there are ways to reduce in-network costs even more.

Many users of vision insurance don’t realize that there can be a significant difference in the price of frames, lenses, contacts and add-ons from provider to provider. Many of the shopping-mall based providers can be the most expensive of the in-network providers due to the convenience of location and quick turnaround times for frames and lenses.

Cost-conscience eyeglass wearers could consider looking at in-network budget-friendly retail environments like the big box department and discount chains and even online retailers for better prices on frames and lenses. Likewise, contact wearers should consider online shopping as well.

One other tip is to always ask the provider if there is a comparable lens or add-on (coatings, etc.) that is less expensive. Providers will sometimes have a preference for certain types or brands of materials or may just not be familiar with how your plan covers various materials. If there is a more price-friendly option with little to no degradation in performance, it may be worth a look.

About the Author

Jay Rex leads Pacific Resources’ Voluntary Benefits practice. Jay’s nearly 20 years of experience in the voluntary benefits industry allows him to offer unique insights into the constantly changing world of employee benefits, particularly life, accident, disability, dental, vision and supplemental health coverages, as well as employee services such as identity theft protection and legal services.