I nt ro d u c t i o n
Welcome to EyeMed Vision Care                                                    EyeMed brings unparalleled expertise and ...
With EyeMed                             You’ll see the industry’sEYEMED DELIVERS:                             best value• ...
With EyeMed                                                 You’ll see a diverse network of                               ...
With EyeMed                                    You’ll see convenient and knowledgeable                                    ...
With EyeMed                                                         You’ll see an experienced team of                     ...
With EyeMed                                                                                                               ...
With EyeMedYou’ll see focused dedication tocommunity serviceVISION FOR ALLOneSight® (formerly known as the Gift of Sight) ...
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Eye Med Intro


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Introduction to EyeMed Vision Care

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Eye Med Intro

  1. 1. I nt ro d u c t i o n
  2. 2. Welcome to EyeMed Vision Care EyeMed brings unparalleled expertise and passion to vision care and offers a unique approach to delivering vision wellness to members. Because we understand the value of a program that promotes workplace productivity and connects to your overall health care initiatives, we take a holistic approach to vision care through benefit solutions that provide service excellence at all touch points. We provide simple, yet comprehensive vision plans to more than 155 million members and are committed to providing you with the same world-class eye health and vision wellness in the near future. With EyeMed As your vision care partner you’ll see ECONOMIC VALUE As a market leader in the industry, your company and your employees will not find a better value than with EyeMed. Our goal is simple — to improve quality of life through better vision care with Innovative benefits at a great price! Our innovative products deliver competitive premiums, generous discounts, reduced member out-of- pocket and program support at no additional cost. We provide the best value without sacrificing quality. THE BEST ACCESSIBILITY TO CARE With almost 60% of eyewear dollars spent at optical retailers* - EyeMed’s network is built to meet this consumer demand by giving members access to thousands of independent providers as well as the nation’s leading optical retailers such as: No one makes it easier to access network benefits or customer care. Through an automated claims process, state-of-the-art web tools and the longest agent-assisted call center hours in the indus-try—99 hours per week —we deliver the convenience your employees seek. VISION WELLNESS Better vision is what we’re all about! Our plans do more than save members money on eyewear - they encourage annual comprehensive eye exams that are crucial to overall health. An eye exam can detect medical conditions including hypertension, arteriosclerosis, glaucoma, macular degeneration and diabetes. Our vision expertise coupled with no-cost open enrollment and ongoing vision well-ness communication strategies will deliver a program that leads to an overall savings on long-term health care costs. PROFESSIONAL PASSION Our mission is To Serve and Inspire with Excellence. For more than 20 years, we’ve delivered the na-tion’s best vision care experience through innovative products and streamlined implementation and account service models. Our passion for customer service is evident in our internal Key Performance Indicators results. Through insightful plan experience reporting, access to vision industry trend infor-mation and Web-based plan management tools, only EyeMed provides a truly consultative solution for long-term satisfaction. Vision care should be easy. That’s why EyeMed delivers the industry’s best coverage and best experience at a great value. *Jobson, 20092
  3. 3. With EyeMed You’ll see the industry’sEYEMED DELIVERS: best value• Standard 4-year rate guarantees with EyeMed understands the need to save on health care and out-of-pocket costs. Therefore, competitive premiums we deliver flexible vision plan options at the most competitive rates that fit lifestyle and budget needs for even the most diverse employee populations. Here’s how we do it:• Consistent application of benefits and discounts Custom Benefit Solutions at all provider locations We aren’t your average vision plan and recognize that your needs are unique. That’s why EyeMed offers plans with flexible co-payments and allowances for eye exams, frames,• Flexible allowance/ lenses and contact lenses. We support both self-insured and fully-insured funding copay options arrangements with no upfront costs.• 40% discount off Depending on your organization’s geographic location and budget needs, you can unlimited complete choose from one of four diverse network options. Available plan types include fully- pairs of prescription funded, exam-only and materials-only plans. We offer the following options for each eyeglasses plan type:• Fixed, discounted Eye Exam: Frames and Lenses: pricing for popular lens options • Paid-in-Full • Paid-in-Full • Optional Copays • Optional Copays• 20% off any item not • Member Discounts covered by the plan All EyeMed plans include additional discounts once the funded benefit has been used. Regardless of your vision benefit needs, EyeMed is the right solution for you. Reduced Member Out-of-Pocket Costs Only EyeMed extends the most generous discounts to reduce member out-of- pocket costs. Your members will enjoy: • 20% savings on any frame cost above plan allowance • Fixed, discounted pricing for popular lens options • 40% off unlimited complete pairs of prescription eyeglasses after the initial benefit has been used • 20% off any item not covered by the plan • 15% off conventional contact lens cost above plan allowance • Replacement contact lenses at competitive prices through Consistent Application of Benefits We make vision benefits easier to understand. All benefits are calculated using retail cost of services and materials with no confusing wholesale calculations, making it easier to determine out-of-pocket costs up front. Additionally, all providers are contracted to consistently apply plan benefits, including discount schedules. This ensures that no matter which provider is chosen, benefits and discounts are applied the same way nationwide. 3
  4. 4. With EyeMed You’ll see a diverse network of quality providers Because convenience and accessibility to care are so important to members, EyeMed provides four national network solutions to meet their unique needs. All networks include ophthalmologists, optometrists and opticians for a range of care options. Spending at optical retailers comprises more than half of total optical spending.* All of our networks are designed to match these consumer preferences by providing ac-cess to thousands of independent providers and the nation’s leading optical retailers including: Inclusion of optical retailers provides: • Extended evening and weekend hours for both exams and eyewear delivery • Convenient locations inside or nearby major shopping centers EYEMED DELIVERS: • Service without an appointment • Quality independent • On-site labs in many locations for faster eyewear turnaround time and retail providers • Product guarantees designed for customer satisfaction (generally 30–90 days to meet consumer depending on retail chain) demand *Jobson, 2009 • Ophthalmologists, Beyond network composition, your employees want convenient access to provider optometrists and locations. No matter where you live, all of our networks provide exceptional access opticians to care. Adequate mileage to a vision provider should be defined as one to two • NCQA credentialing providers within 10 miles of urban/suburban employees, and one provider within process for network 20 miles for rural employees. providers EyeMed offers multiple network options to meet your specific needs. Contact your • DPA and TPA certified sales representative for further details. providers TOTAL QUALITY OF CARE • A free-to-choose lab Not only do we provide you with the optimal network composition, but we ensure model resulting in faster that your employees receive the quality of care they deserve. An established group turnaround time of ophthalmologists, optometrists and our medical director oversee our quality assurance program that monitors standards of care including credentialing and re-credentialing criteria. All professional providers on our network must complete credentialing upon joining the network and be re-credentialed at least every 36 months. All criteria are verified by an NCQA-certified Credentials Verification Organization (CVO). Our quality assurance program is based on standards established by the American Academy of Ophthalmology in the Preferred Practice Patterns and the American Optometric Association in the Clinical Practice Guidelines.4
  5. 5. With EyeMed You’ll see convenient and knowledgeable customer care EYEMED DELIVERS: • The longest agent-assisted A SERVICE MODEL DESIGNED WITH CLIENTS IN MIND customer care hours in Our dedicated customer care center associates and our Web site, www.eyemedvisioncare.com, the industry—99 hours provide exceptional service to our valued members and clients. EyeMed’s extended service hours, per week interactive phone system and easy-to-use Web capabilities help address important questions within seconds. • Open 7 days per week, 362 days a year Hours of Live Operation: • 24-hour automated IVR Monday through Saturday, 8:00 a.m. to 11:00 p.m. (EST) and Web service Sunday, 11:00 a.m. to 8:00 p.m. (EST) • Standard 25-second speed Members have access to more than 300 trained representatives that specialize in answering of answer and less than 2.5% call abandonment only EyeMed vision plan calls. Our extended hours of live operation also set us apart from rate. our competitors. The chart below describes all available services: Service Client Member Customer IVR Web site Web site Care Center Multilingual Capabilities 3 Provider Locator 3 3 3 3 Plan Benefit Information 3 3 3 3 58% of employees without Next Eligible Date of Service 3 3 3 3 vision care would be Out-of-Network Claim Form 3 3 3 3 Requests (if applicable) interested in coverage, AND ID Card Requests 3 3 3 3 more than 80% of employees Laser Benefit Information 3 3 3 3 feel it’s important to have Laser Provider Locator 3 3 3 3 vision care. Claims and Claims Status 3 —The Vision Council, 2008 Educational Information 3 3 3 about Vision Member Grievance Resolution 3 Order Replacement Contact 3 3 Lenses Update Member Records 3 Download Member Rosters 3 View Invoices (fully insured groups) 3 Review Plan Contact Information 35
  6. 6. With EyeMed You’ll see an experienced team of vision experts IMPLEMENTATION SERVICES EyeMed’s proven transition process and implementation team are second to none. No one will work as closely with you to ensure a streamlined, successful implementation and enrollment process. You’ll be assigned an experienced implementation professional who will provide a consultative approach to implementation discovery and will serve as your primary contact until the plan effective date. This results in an effortless transition to our program. ACCOUNT SERVICE EXCELLENCE Once successfully transitioned to our program, your account service contact will be your vision plan expert and is available as the day-to-day resource for all plan management activities, providing consultative service as follows: EYEMED DELIVERS: • Plan Performance • Oversight of eye health and wellness initiatives • 99% client satisfaction • Utilization and plan reporting • Trend consultation and necessary changes to benefits • Seamless, proven • Resolution of eligibility file, billing or member issues implementation process • Acquisitions of additional companies or employee groups requiring • Flexible eligibility system or structure changes formats • 97% claims processed As part of our service commitment, we recognize that your total plan satisfaction rests in in 5 business days our hands. Your account service contact is passionate about your long-term plan success. • Meaningful plan That’s why our approach to plan experience and trend reporting provides insight to possible reporting and program improvements, while illustrating the important utilization data needed to consultation, including understand plan performance. Depending on your group size, a variety of detailed reporting usage trend analysis and member preference will be provided on the plan’s year-end schedule and will be reviewed with you. insight uncorrected Every year, vision disorders vision can decrease account for more than employee performance $8 billion in lost productivity. by as much as 20% —Vision Council of America, 200976
  7. 7. With EyeMed You’ll see a focus onEYEMED DELIVERS: vision wellness We are passionate about improving the quality of life through better vision. This includes• Vision Wellness delivering comprehensive eye care while driving vision wellness education and awareness programs to drive through: defined populations to receive eye exams No-Cost Education and Wellness Tools Eye exams are not just about visual acuity. Data from the American Optometric Association• No-cost open and the Vision Council of America has proven that comprehensive eye exams help detect enrollment support serious chronic health problems such as hypertension, arteriosclerosis, glaucoma, macular and wellness degeneration and diabetes. communication tools Part of our promise as your vision partner includes educating members on the important• No-cost member role annual eye exams play in an overall health care program. our imple-mentation welcome kits, including professional will partener with you to form a comprehensive communicatino strategy. ID cards for each employee and vision With EyeMed, you’ll receive: Open Enrollment and Health Fair Support wellness information At no additional cost, EyeMed provides vision experts to attend your meetings (depending upon group size) and will support you with a toll-free open enrollment line. We’ll also deliver custom-ized materials for your open enrollment mailings and for open enrollment meetings and health fairs. These materials not only outline plan benefits and contact information, but also increase awareness about the importance of yearly eye exams. For those meetings not attended by EyeMed, an enrollment DVD that describes the vision program and provides instructions on accessing the benefit, will be provided. Our standard communication materials include the following: Announcement Letter The announcement letter describes your benefits, educates your employees about vision wellness and introduces open enrollment, phone and Web support tools. The following is a EyeMed Graphic Support Materials snapshot of materials OPEN ENROLLMENT EVENTS supplied for events: DISPLAY MATERIALS PUBLICATIONS RAY BAN RAFFLE HANDOUTS Vision Care for E NTER T O W IN Everyone POST-IT PADS Discover the facts about BUSINESS CARD your eyesight BENEFIT ANNOUNCEMENT MESSAGE MAGNET Name RAFFLE BALLOT BOX PRE-EVENT POSTER TABLE TOPPER ENTER TO WIN NAME BADGE RETRACTABLE FLOOR BANNER LOCATION DIRECTORY EVENT PAMPHLET RAFFLE BALLOTS PLASTIC BAGS Wellness Communication HEALTH FAIR EVENTS PUBLICATIONS RAY BAN RAFFLE HANDOUTS DISPLAY MATERIALS The no-cost client communication kit provides seasonal Vision Care for E NTER T O W IN Everyone POST-IT PADS There’s clearly a need vision wellness messaging tools such as newsletter for eye exams Seeing clearly. BUSINESS CARD BENEFIT LOCATION EVENT ANNOUNCEMENT DIRECTORY PAMPHLET MESSAGE MAGNET articles, posters and paycheck inserts. We encourage you RAFFLE BALLOT BOX ENTER TO WIN Name NAME BADGE to use this kit throughout the year to establish a strong PRE-EVENT POSTER TABLE TOPPER RETRACTABLE 6 INFORMATIVE BUCKSLIPS / DISPLAYED IN ACRYLIC HOLDER RAFFLE BALLOTS PLASTIC BAGS FLOOR BANNER vision wellness message. Member Welcome Kits with ID Cards The membership brochure provides benefit information, including copay amounts, discounts and allowances, a listing of nearby providers based on employees’ zip codes, customer care contact EMV-401 EYEMED COMMUNICATIONS KIT _ ONE PAGE FLYER_TOPIC : Importance of Eye Exams 8.5” x 11” plus 1/8” bleed all four sides 7-30-08 information and ID cards. It also communicates the value of vision wellness and comprehensive eye care. EMV-401 EyeMed 2008 Communication Kit_PAYROLL STUFFER_TOPIC : Importance of Eye Exams 6-1/2”W x 3-1/2“ H plus 1/8” bleed _ fits in payroll envelope 7-30-087 EMV-401 EyeMed 2008 Communication Kit_POSTER_TOPIC : Importance of Eye Exams 17” x 22” size plus 1/8” bleed all four sides _ folds to 8-1/2 x 11 size to fit in folder 7-30-08
  8. 8. With EyeMedYou’ll see focused dedication tocommunity serviceVISION FOR ALLOneSight® (formerly known as the Gift of Sight) is a LuxotticaGroup Foundation that provides clear vision to those in need.Established by LensCrafters in 1988, the Foundation was built onthe principle that “sight isn’t a luxury, but the right of every humanbeing.” We’ve now given the gift of sight to more than 7 millionpeople through missions and programs across the globe. Thanksto voluntary work by thousands of our employees, providers,vendors and clients, OneSight provides free vision exams anddistributes free eyewear to the disadvantaged inNorth America and abroad.OneSight® activities include: • Cycle of Sight—provides free vision screenings to local school children • Vision Vans—travel the country providing free eye exams and eyewear • International Missions—offer eye exams and eyewear to the disadvantaged • Sight Night—promotes collection of used eyewear during Halloween • Eyewear Recycling Program—accepts donations of used eyewear to be refurbished for use on International Missions • Fundraising Opportunities—includes Eye Run for Vision 5K, the Par for Sight golf event and the OneSight gala EyeMed encourages all of our clients, members and brokers to join our effort. 4000 Luxottica Place Mason, Ohio 45040 888-4-EYEMED eyemedvisioncare.com