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The Vision Care Plan Benefits Program described on this page is made available to eligible employees and is sponsored by, and administered on behalf of the employees and dependents of the County of Rensselaer.

91³Ô¹ÏÍø's Vision Care Plan Benefits Program is administered by Davis Vision, Inc., a leading national administrator of vision care programs. The vision program has been designed to encourage you to maintain good eye care while keeping eye care expenses at a minimum.

Vision Care Plan Benefit Description (PDF)

Eligibility

Benefits are available to all eligible employees on the effective date of the Vision Plan. New employees become eligible on the first day of the following month after active employment. You must stay enrolled for at least 24 consecutive months.

The Office of Human Resources will determine your eligibility. To determine if you are eligible for this plan, please contact the Office of Human Resources.

Participating Providers

The Vision Care Plan Benefits Program allows you complete freedom of choice in the selection of any licensed network provider in both private practice and retail locations. Please access Davis Vision’s website at and utilize the “Find a Doctor” feature or call 1-800-999-5431.  Please visit their website at www.davisvision.com to find a listing of participating licensed providers. Select "Find A Doctor". By using a plan participating eye care professional, you will be able to minimize any out-of- pocket costs that may be required for your vision care services.

If the eye care professional you go to is participating in the Davis Vision Benefits Plan, it will be required that you inform the participating provider of your enrollment in the College's Plan. To receive services from a provider in the network. You should:

• Call the network provider of your choice and schedule an appointment.
• Identify yourself as a Davis Vision member and The County of Rensselaer employee or dependent.
• Provide the office with the employee’s ID number and the name and date of birth of any covered dependent needing services.

It’s that easy! The provider’s office will verify your eligibility for services, and claim forms or ID cards are not required!

Plan Benefits, Frequencies and Costs

Eye Examination: Every 24 months, including dilation as professionally indicated.
In-Network Copayment: $0
Out-of-Network: Reimbursed up to $20

Eyeglasses: Every 24 months
In-Network Copayment: $0
Out-of-Network: Reimbursed up to $20 for frames, up to $20 for single vision lenses, up to $30 for bifocals, up to $40 for trifocals

Contact Lenses: Every 24 months (in lieu of eyeglasses, you may select contact lenses)
In-Network Copayment: $10
Out-of-Network: Reimbursed up to $75 for elective contact lenses, up to $225 for visually required contact lenses with prior approval

Please see the Vision Care Plan Benefit Description (PDF) or visit Davis Vision’s website at for more details.

Exclusions

The Vision Benefits Plan will not allow benefits for the following:

• Medical treatment of eye disease or injury.
• Vision therapy.
• Special lens designs or coatings, other than those previously described.
• Replacement of lost eyewear.
• Non-prescription (plano) lenses.
• Contact lenses and eyeglasses in the same benefit cycle.
• Services not performed by licensed personnel.
• Two pairs of eyeglasses in lieu of a bifocal.

Termination of Benefits

Vision benefits will cease on the same day of the month you are removed from the payroll, or if you fail to make the required contributions, if any, toward the cost of your benefits. There are no benefits for vision services performed after termination of coverage.

Administration and Questions

For more information, please visit Davis Vision’s website at or call Davis Vision at 1-800-999-5431 to:

• Learn more about your benefits
• Locate a Davis Vision provider
• Verify eligibility
• Print an enrollment confirmation
• Request an out-of-network provider reimbursement form
• Contact a Member Service Representative