VSP Vision Insurance

You are eligible to enroll in, make changes and cancel coverage for VSP Vision during the Annual Benefit Enrollment period from October 6 to October 31, 2014. Visit the Annual Benefit Enrollment (ABE) website for more information on upcoming changes and enrollment opportunities for 2015.

Plan Summary

The VSP Vision Insurance plan provides coverage towards an annual eye exam*, prescription glasses, and contact lenses. It also provides discounted laser vision correction at select locations. You can see the eye care provider of your choice, but you will receive a higher level of benefits when you use a VSP provider.

VSP In-Network Coverage Includes:

  • One well-vision exam every calendar year after a $15 co-payment. Note: Does not include cost of contact lens exam.
  • VSP will provide partial coverage for glasses or contacts during a calendar year:
    • $130 frame allowance every other year after a $25 co-payment. One pair of single vision, lined bifocals, or lined trifocals every year after a $25 co-payment.
    • $130 contact lens allowance that can be used towards a contact lens exam and contact lenses.
  • Discounts on additional glasses and sunglasses and laser vision correction, as well as discounts on some services and materials not covered under this policy.
  • KidsCare Program
    • Two exams per year
    • Impact resistant lenses
    • Lenses replaced annually or as needed
    • Frames replaced annually or as needed

See the VSP brochure (Brochure for 2015) for detailed coverage information.

*An annual eye exam is also covered by State Group Health Insurance (except the Standard Plan).

Eligibility

Employee

You must meet the following requirements to be eligible for this plan:

  • Eligible for State Group Health Insurance; and
  • Are not receiving a Wisconsin Retirement System (WRS) annuity.

Dependents

An eligible dependent includes:

  • Spouse
  • Domestic partner
  • Children
    • Your or your spouse’s or domestic partner’s unmarried or married children under age 26. Children remain eligible for coverage until the end of the month in which they are 26 years old.
    • Your child may remain eligible beyond age 26 if he/she is incapable of self-support due to a physical or mental disability.
  • Grandchildren
    • If born to a covered child under age 18.
    • Grandchildren remain eligible for coverage until the end of the month in which the grandchild’s parent turns 18.

For detailed information regarding dependent eligibility, see UWSA’s Dependent Eligibility Grid.

Eligibility to Continue Coverage when Employment Ends

You and your family members may be eligible to continue coverage when eligibility or employment ends. See Employment Changes for additional information.

Enrollment

Employee

  • You may enroll within 30 days of the start of your first benefits-eligible appointment. Coverage is effective on the first of the month on or following receipt of your application, either through eBenefits or paper application.
  • You may enroll during the Annual Benefit Enrollment period (occurs every fall) for coverage effective January 1st of the following year.
  • You may enroll within 30 days of a change in family status (ex. marriage or domestic partnership) or loss of other comparable group vision coverage.
  • You may enroll within 60 days of the birth or adoption of a child.
  • If you were initially eligible for coverage when you were not covered by the Wisconsin Retirement System (WRS), you may enroll within 30 days of your WRS coverage begin date.

Dependents

  • If you have dependents when you enroll in coverage, you may enroll your dependents at the same time you enroll.
  • You may add a spouse or domestic partner within 30 days of marriage or establishing a domestic partnership for benefit purposes (may add spouse’s or domestic partner’s children at same time).
  • You may add a child within 60 days of gaining a child due to birth or adoption.
  • You may add a spouse, domestic partner, or child within 30 days of their loss of coverage under a comparable group vision plan.
  • You may add dependents to your existing coverage during the Annual Benefit Enrollment period for coverage effective January 1st of the following year.

Note: Once you are enrolled in VSP, you must remain enrolled for the calendar year. You may cancel coverage or remove dependents for the following year by submitting an application to your benefits office by December 1st.

Premiums

Monthly Premiums
Employee Only Employee
+ Spouse/DP
Employee
+ Child(ren)
Family
$ 6.35 $12.70 $14.30 $22.85

The University does not contribute toward the premium.

Selecting a Provider

If you use a VSP vision provider, simply tell the provider that you have VSP coverage. The provider will confirm enrollment directly with VSP. No ID card is needed. If you prefer to have an ID card, you can print it directly from VSP.

To locate a VSP provider near you, go to VSP’s Provider Search and select the VSP Choice network.

You may receive out-of-network services but you will have higher out-of-pocket costs. You will also have to pay for services and materials at the time of service and file a claim with VSP within six months to receive reimbursement.

Forms & Publications

  • Application (2014) - Complete and submit to your institution’s benefits office to enroll in the plan.
  • Application (2015) - (for coverage beginning 1/1/15 and later) Complete and submit to your institution’s benefits office to enroll in the plan.