Background

The VSP Vision Plan provides partial payment to help you offset the costs of annual eye exams (which are also covered under Uniform Benefits), frames, lenses and contact lenses. It also provides discounted refractive eye surgery at select locations. See one of the following brochures for more information.

2013 VSP Brochure

• Compare 2013 VSP insurance benefits and premium to the vision insurance offered with EPIC Benefits+.

VSP Certificate (Evidence of Coverage)

Eligibility

You must be eligible for immediate or future employer contribution to the State of Wisconsin Health Insurance Program to participate. Unclassified faculty, academic staff and short-term academic staff appointees, classified employees (including LTE's covered by the retirement system), graduate assistants, fellows and scholars and employees in-training are eligible to enroll in this vision plan.

Eligible dependents of these employees may enroll as dependents of the employee. Domestic partners and their children are eligible under this plan provided a Domestic Partner Affidavit has been properly filed. For more information, click here.

Rehired annuitants receiving a Wisconsin Retirement System benefit are not eligible for this program.

WRS annuitants who are not covered under VSP at the time of retirement may enroll during the open enrollment period by applying through the Department of Employee Trust Funds.

Enrollment

The initial enrollment period for new employees is 30 days from the employment begin date. Coverage will begin on the first of the month on or after your campus benefits office receives your completed application.

If you do not enroll during your initial enrollment deadline, you may enroll during an open enrollment period. Open enrollment periods are offered annually to coincide with the It's Your Choice health insurance enrollment period.

Coverage  

If you use a VSP vision provider (in the VSP Choice network) this plan will cover:

• One WellVision exam every calendar year after a $10 copayment.
• Prescription glasses (you can choose glasses instead of contacts) after a $25 copayment:
  • Any frame of your choice up to $130 is covered after copay every other calendar year, plus 20% of any amount over the allowance.
  • One pair of single vision, lined bifocals and lined trifocals are fully covered after copay every calendar year. Polycarbonate lenses for children are covered when visiting a VSP doctor.
• Contact lens coverage (you can choose contacts instead of glasses)
  • You have a $105 allowance on your contact lens exam (fitting and evaluation) and contacts every calendar year.
  • No copayment for contacts lenses.
• Extra discounts and savings when you receive services from a VSP provider:
  • Average 20-25% savings on all non-covered lens options
  • 20% off additional glasses and sunglasses
  • 15% off cost of contact lens exam
  • Average 15% off the regular price or 5% off the promotional price of laser vision correction (discounts available only from contracted facilities)

You may also see a non-VSP vision provider but you will likely experience higher out of pocket costs. You will also have to pay the charges at the time of service and file a claim with VSP within six months to receive reimbursement.

If you use an Out-of-Network provider, the following reimbursement amounts apply:

• Exam: Up to $40.00
• Single Vision Lenses: Up to $33.00
• Lined Bifocal Lenses: Up to $50.00
• Lined Trifocal Lenses: Up to $66.00
• Frame: Up to $45.00
• Contacts: Up to $105.00

If you or your covered family members use a VSP vision provider, simply tell the provider that you have coverage and the provider will confirm eligibility directly with VSP.

To locate a VSP provider near you, go to VSP's online provider search. You can either login as a member or prospective member.

Important Note: If you enroll in VSP Vision Insurance, you must remain in the plan for the remainder of the calendar year. To cancel coverage, you must submit an application to cancel coverage before December 1st. Coverage will end on December 31. Mid-year cancellation is only possible due to termination of employment or death.

Premiums  

The monthly premiums for the VSP Vision Plan are:

Employee Only:	$ 5.24
Employee + Spouse/DP:	$10.49
Employee + Child(ren):	$11.23
Employee + Family:	$17.93

Premiums are deducted on pre-tax basis. At this time, due to IRS regulations, the premium for LTEs and employees who enroll with a domestic partner cannot be taken pre-tax.

Premiums are paid one month in advance of the coverage month. For classified, the premiums will be deducted from the A payroll.

Applications

Print the application and submit the completed application to your staff benefits office within 30 days of eligibility.

Upon termination, you may be able to continue your VSP vision insurance. You can request a continuation form from your staff benefits office.

Annuitants may continue their VSP coverage for up to 18 months. Following the 18 month continuation period, or earlier if you choose to terminate the continuation coverage, you may enroll for the annuitant VSP plan during the annual fall enrollment period. Be aware, however, that the annuitant rates are higher than those charged for active employees and those on continuation coverage.

Related Information:
Domestic Partner Affidavit

This document was last revised on February 21, 2013