Albuquerque Public Schools Open Enrollment Presentation
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Albuquerque Public Schools Open Enrollment Presentation "
Davis Vision Facts"
l Who is Davis Vision?"
– American-owned and 100% US-based operations"
– Subsidiary of HVHC Inc., a Highmark company, covering 56 million Americans"
l Easy to use benefits:"
– Member Welcome Kits for new enrollees"
– No claim forms required at in-network providers"
– Extensive national network of over 40,000 points of access and participating providers"
– Choose from optometrists and ophthalmologists in private practice and retail settings including:"
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l Quality certified by:"
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2
Plan Design"
Plan Feature In-Network Coverage/1
Eye Examination (Every 12 months) Covered in Full after $10 copayment
Eyeglass Benefits
Spectacle Lenses (Every 12 months) Covered in Full after $15 copayment
Frame (Every 24 months)
Non-Collection Allowance $110 retail allowance plus 20% off overage/2"
Davis Vision Collection
Fashion Covered in Full
Designer Covered in Full
Premier Covered in Full
Contacts Lens Benefits (in lieu of eyeglasses) (Every 12 Months)
Contact Lens Evaluation, Fitting & Follow-up
Non-Collection:
Standard: 15% discount
Specialty: 15% discount
Davis Vision Collection: Covered in Full
Contact Lenses
Non-Collection Allowance Up to $110 allowance plus 15% off overage/2
Davis Vision Collection Covered in Full
Disposable: 4 boxes/multi-packs
Planned Replacement: 2 boxes/multi packs
Medically Necessary Covered in Full (prior approval required)
Low Vision Benefits Coverage towards low vision evaluations, aids and follow-up care
Out-of-Network Reimbursement
Eye Examination, up to $35 Single-vision, up to $25 Trifocal, up to $55 Elective Contacts, up to $110
Frame, up to $35 Bifocal, up to $40 Lenticular, up to $80 Medically Necessary contacts, up to $210
1/ In-Network coverage may be applied towards occupational / safety eyeglasses in lieu of dress eyeglasses
2/ Additional discounts not available at Walmart and Sam’s Club locations 3
Select Any Frame in the Provider’s Office"
Largest paid-in-full Candie’s®
Caterpillar®
selection of eyewear available Catherine Deneuve®
Converse®
• No frame limitations: Members have freedom to use
their plan specified allowance toward any frame in the Cosmopolitan®
provider’s office, OR Elizabeth Arden®
GANT®
• Covered-in-full frames: Members can select any
Gloria Vanderbilt®
frame from Davis Vision’s Exclusive Collection, covered
in full, which is an equivalent of up to $225 retail value Harley-Davidson®
Jill Stuart®
• Our Exclusive Collection features over 200 trend- Lauren Hutton®
setting, fashionable frames that are available
Levis®
throughout our nationwide network of independent
NASCAR®
providers and are backed by our one-year breakage
warranty Perry Ellis®
All New Mexico independent providers Scooby Doo®
have received updated Exclusive Skechers®
Collection frames! Stetson®
Steve Madden®
4
Eyeglass Lens Options"
Average Member
Lens Types and Coatings Lens Option Description / Benefits Retail Cost Prices
Clear Plastic Lenses in all Ranges of standard plastic material in single vision and
Prescriptions and Sizes lined bifocal or trifocal lenses prescription $90 Included
Oversized Lenses larger lenses for bigger frames $20 Included
Tinting of Plastic Lenses gradient or solid lens tinting in various colors $20 Included
Scratch Resistant Coating reduces risk of scratches $45 Included
Polycarbonate Lenses* impact / shatter resistant lenses $68 $0-$30
Ultraviolet Coating for protection from the sun’s UVA / UVB rays $28 $12
Intermediate Vision Lenses no-line (invisible) bifocal for computer use $163 $30
Standard Progressives no-line (invisible) bifocal for everyday use $173 $50
Select Progressives no-line (invisible) bifocal for everyday use $248 $70
Premium Progressives (Varilux®, etc.) no-line (invisible) bifocal for everyday use $248 $90
Ultra Progressives (includes digital, free-form styles) no-line (invisible) bifocal for everyday use $462 $195
Plastic Photosensitive Lenses (Transitions®) lenses that darken in the sunlight $123 $65
Polarized Lenses sunglass lenses that also reduce glare $103 $75
Standard Anti-Reflective (AR) Coating for glare reduction $60 $35
Premium AR Coating for glare reduction $80 $48
Ultra AR Coating for glare reduction $113 $60
High-Index Lenses thinner and lighter lenses $120 $55
Scratch Protection Plan (single vision | multifocal) scratched lens replacement coverage $20 | $40
Free one-year eyeglass breakage warranty!
*Polycarbonate lenses COVERED IN FULL for dependent children, monocular patients and patients with prescriptions +/- 6.00 diopters or greater
5
Dual Contact Lens Options"
Davis Vision members have the choice between a contact lens allowance, or one of the largest covered-in-
full contact lens Collections in the industry, which includes some of the most popular brands on the market.
Members selecting contact lenses from the Davis Vision Collection* also receive a paid-in-full
contact lens evaluation, fitting and follow-up care. Our contact lens Collection includes:
TYPE BRAND /STYLE MANUFACTURER
Planned Replacement
Includes two boxes
Biofinity® CooperVision®
(Each box of lenses can last up to one year Frequency® Aspheric CooperVision®
depending on the provider-recommended
wearing schedule)
Disposable 2-Week:
Includes four boxes ACUVUE® 2 Vistakon®
ACUVUE® OASYS® Vistakon®
Biomedics® 55 CooperVision®
(Provides up to a six month supply
depending on the provider-recommended Toric (2-Week):
wearing schedule) ACUVUE® OASYS® for ASTIGMATISM Vistakon®
Biomedics® Toric CooperVision®
Multifocal (2-Week):
ACUVUE® OASYS® for PRESBYOPIA Vistakon®
Daily:
1-day ACUVUE® MOIST® Vistakon®
ClearSight™ 1 Day CooperVision®
Focus DAILIES® CIBA Vision®
* The Davis Vision contact lens Collection is only available at participating Davis Vision independent, private practice providers 6
Examples of How the Benefit Works Within
Davis Vision “Collection” or Plan Allowances"
Eye Examination & Eyeglasses
Service Average Retail Member Pays Member Savings
Eye Examination $100 $10 $90
“Collection” Frame
$150 $0 $150
(any selection)
Single Vision Lenses $80 $15 $65
Standard Anti-Reflective Coating $60 $35 $25
Total $390 $60 $330
Eye Examination & Contacts
Service Average Retail Member Pays Member Savings
Eye Examination $100 $10 $90
Contact Lens Fitting & Evaluation
$60 $0 $60
(with “Collection” Contacts)
“Collection” Contacts
$150 $0 $150
(4 boxes of disposables)
Total $310 $10 $300
• Illustra(ons
shown
are
for
services
within
the
“Collec(on”
or
the
plan’s
Non-‐Collec(on
Allowances.
• Davis
Vision
“Collec(on”
frames
and
contact
lenses
are
Covered-‐in-‐Full
and
are
only
at
independent,
private
prac(ce
doctors.
• Non-‐”Collec(on”
frames
and
contact
lenses
are
Covered-‐in-‐Full
up
to
the
plan’s
Non-‐Collec(on
Allowance.
7
Examples of How the Benefit Works Outside
Davis Vision “Collection” or Plan Allowances"
Eye Examination & Eyeglasses
Service Average Retail Member Pays Member Savings
Eye Examination $100 $10 $90
Non-Collection Frame $150 $32 $118
($40 overage less 20%)
Single Vision Lenses $80 $15 $65
Standard Anti-Reflective Coating $60 $35 $25
Total $390 $92 $298
Eye Examination & Contacts
Service Average Retail Member Pays Member Savings
Exam $100 $10 $90
Contact Lens Fitting & Evaluation $60 $51 $9
($60 retail less 15% discount)
Non-Collection Contacts $34
$150 $116
(4 boxes of disposables) ($40 overage less 15% discount)
Total $310 $95 $215
• Illustra(ons
shown
are
for
services
above
the
plan’s
Non-‐Collec(on
Allowances.
• Non-‐”Collec(on”
frames
and
contact
lenses
are
Covered-‐in-‐Full
up
to
the
plan’s
Non-‐Collec(on
Allowance.
• Frame
illustra(ons
are
for
services
at
independent
providers.
Retailers
use
an
equivalent
retail
value
for
the
wholesale
allowance.
8
Value Added Features"
Free one-year
breakage warranty
• A benchmark mail-order contact • Nationwide credentialed network of renowned All plan eyeglasses come with a
lens replacement program ophthalmologists and eye surgeons at pre-eminent breakage warranty for repair or
endorsed by lens manufacturers Eye Centers of Excellence replacement of the frame and/or
• Purchase replacement contact • Up to 25% off the provider’s Usual and Customary;*
lenses for a period of one year from
lenses at significant savings or 5% off promotional price (whichever is lower) the date of delivery. The one-year
• LENS123® will ship replacement breakage warranty applies to all plan-
• Usual and Customary Fees: $1,000-$2,400 per covered eyeglasses (i.e., spectacle
contact lenses or solution
eye lenses, Davis Vision Exclusive
anywhere the same day
• Davis Vision Typical Pricing: $895-$1,800 per Collection frames and national
eye retailer frames, where our exclusive
*Some centers provide a flat fee equating to these discount levels Collection is not displayed)."
9Questions During Open Enrollment"
For more details about the plan, just log on to the Open Enrollment section of our Member
website at davisvision.com or call 1.877.923.2847 and enter Client Code 2267.
Website (www. davisvision.com) Member Services (toll free 1.877.923.2847)
• Available 24/7 • Automated service available 24 / 7
• Provider locator with mapping capabilities • Live support 7 days a week (Mountain Standard Time):
• Vision plan benefit summaries • Monday – Friday 10 a.m. – 1 a.m.
• View Davis Vision “Collection” frames • Saturday 11 a.m. – 6 p.m.
• Read up on eye health & wellness topics • Sunday 2 p.m. – 6 p.m.
• Spanish language version • Over 300 vision care experts on staff to answer questions
• Link to over 50 other health care websites
10JOIN US!
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