Employer Sponsored Groups

Eye Care Benefits

Your Total Eye Care Solution℠

Ocular Benefits, your single contracting partner, has flexible contracting capacity to meet the unique needs of our partners.  While we offer integrated solutions, we are also able to easily accommodate vision only or medical-surgical only options.

Total Eye Care -   The use of our extensive network of routine vision, medical eye care specialists, facilities, anesthesiologists and in-office ophthalmic pharmacy has demonstrated significant lower overall costs for our partners.  In addition to delivering efficiencies and cost containment, added benefits of the total eye care model include:

• Increased member satisfaction.  Member’s have a single integrated eye care network for all of their needs.
• Seamless administration.  Our Health Plan partners have a single vendor to contract and work with on a day to day basis when using Ocular Benefits fully integrated eye care model.
• Improved HEDIS scores.  When considering best practices, working with Ocular Benefits and using a consolidated data set has proved to yield better HEDIS scores.  Ocular Benefits works with each plan annually to increase HEDIS scores through member mailings, PCP education and streamlined reporting.

Routine Eye Care – Ocular Benefits provides routine visions services with full flexibility

Ocular Benefit’s subsidiary company Group Vision Service leverages over 50 years of experience to integrate people, technology, processes and quality eye care doctors in order to deliver the very best routine eye care coverage.

Eye Exams – Ocular Benefits offers full coverage for routine eye exams that are performed by licensed and fully credentialed Doctors of Optometry, (O.D.), or Ophthalmologist (M.D.).

Eyewear - We provide excellent coverage for basic eye-wear materials, including eyeglasses or contact lenses or custom benefit packages that include coverage for high-end fashion frames, high tech-lenses and advanced contact lenses.

LASIK - Discounted LASIK benefits at no additional cost!

Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.

43,000 PPO Network Providers! Because we have partnered with Luxottica Corporation, a 6.4 billion dollar global organization we are able to deliver our customers one of the largest vision care networks in the USA with more than 43,000 private practices and retail optical provider locations nationwide including: LensCrafters, PearleVision, JC Penny, Sears Optical, and, Target Optical.  This large and diverse network of eye care providers deliver exceptional access to local or multi-state employer groups! Plus, we can also administer out of network benefits, so members can see any doctor they like.

Additional Savings Program - Members have access to eyewear discounts in addition to their covered benefits!  Discounts include:  lens up-grades/options and additional pair purchases.  Members may access this discount program as often as they want during their enrollment in the vision care program.  Discounts are available from network provider only.

Mail Order Contact Lenses – Replacement contact lens mail order program allows member to order directly online!

Customer Care – Members have access to live customer service representatives 7 days a week located in a U.S. call center:

• Monday through Saturday: 8:00 a.m. to 11:00 p.m.; Sunday 11:00 a.m. -8:00 p.m. EST

• Monday through Sunday: 24 Hours/day IVR system is available.

Medical and Surgical Eye Care -   Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures.

Ocular Benefit’s subsidiary company, Premier Eye Care, leverages over 17 years of experience in delivering medical surgical ophthalmic services.  Through Premier, Ocular Benefits is licensed as a Third Party Administrator and Fiscal Intermediary.  In addition, we hold a Medical Review License by AHCA and are compliant with HIPAA, AHCA, and CMS guidelines.

Ocular Benefits offers an integrated medical network that includes ophthalmic primary eye care doctors, specialists and subspecialists and eye surgeons.   In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.

Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.

Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers.  We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model.  The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.

Funding Arrangements – We provide services on either an ASO or fully-insured basis.

INSURED

Group Vision Service Plans are underwritten and insured by Fidelity Security Life Insurance Company (FSL) which holds an A- (‘Excellent’) rating from AM Best. Fidelity Security Life Insurance Company’s conservative investment philosophy enables us to offer quality insurance products that are among the most secure in the industry.

Taft-Hartley Eye Care Benefits

Your Total Eye Care Solution℠

Group Vision Service is a subsidiary company of Ocular Benefits and has a long standing history and understanding working with Taft-Hartley groups and a high sensitivity to the process required to negotiate unique plans and benefits to serve labor organizations.  Group Vision Service has unparalleled experience with plan implementation, administration, and providing a high level of these unique benefit packages, including fully-insured or ASO.  We are unique in our ability to provide a total eye care solution that includes both routine vision and medical surgical services.

Ocular Benefits, your single contracting partner, has flexible contracting capacity to meet the unique needs of our partners.  While we offer integrated solutions, we are also able to easily accommodate vision only or medical-surgical only options.

Total Eye Care -   The use of our extensive network of routine vision, medical eye care specialists, facilities, anesthesiologists and in-office ophthalmic pharmacy has demonstrated significant lower overall costs for our partners.  In addition to delivering efficiencies and cost containment, added benefits of the total eye care model include:

Ocular Benefit’s subsidiary company Group Vision Service leverages over 50 years of experience to integrate people, technology, processes and quality eye care doctors in order to deliver the very best routine eye care coverage.

• Increased member satisfaction.  Member’s have a single integrated eye care network for all of their needs.
• Seamless administration.  Our Health Plan partners have a single vendor to contract and work with on a day to day basis when using Ocular Benefits fully integrated eye care model.
• Improved HEDIS scores.  When considering best practices, working with Ocular Benefits and using a consolidated data set has proved to yield better HEDIS scores.  Ocular Benefits works with each plan annually to increase HEDIS scores through member mailings, PCP education and streamlined reporting.

Routine Eye Care – Ocular Benefits provides routine visions services with full flexibility

Dedicated Account Management – We provide dedicated account customer service representatives that are highly experienced in working with the specific needs of each Taft-Hartley group.

Custom Plan Design -  We can accommodate almost all requests from a standard book rated product to custom plan designs with flexible benefit allowances and co-payments.  We will work with you to develop a benefits package to meet your specific needs!

Eye Exams – Ocular Benefits offers full coverage for routine eye exams that are performed by licensed and fully credentialed Doctors of Optometry, (O.D.), or Ophthalmologist (M.D.).

Eyewear - We provide excellent coverage for basic eye-wear materials, including eyeglasses or contact lenses or custom benefit packages that include coverage for high-end fashion frames, high tech-lenses and advanced contact lenses.

LASIK - Discounted LASIK benefits at no additional cost!

Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.

43,000 PPO Network Providers! Because we have partnered with Luxottica Corporation, a 6.4 billion dollar global organization we are able to deliver our customers one of the largest vision care networks in the USA with more than 43,000 private practices and retail optical provider locations nationwide including: LensCrafters, PearleVision, JC Penny, Sears Optical, and, Target Optical.  This large and diverse network of eye care providers deliver exceptional access to local or multi-state employer groups! Plus, we can also administer out of network benefits, so members can see any doctor they like.

Additional Savings Program - Members have access to eyewear discounts in addition to their covered benefits!  Discounts include:  lens up-grades/options and additional pair purchases.  Members may access this discount program as often as they want during their enrollment in the vision care program.  Discounts are available from network provider only.

Mail Order Contact Lenses – Replacement contact lens mail order program allows member to order directly online!

Performance Measures - We take performance seriously, ensuring exceptionally high levels of responsiveness and accuracy.

•  Financial Accuracy:        99.7%

• Clean Claims processed in 10 working days:     99.8%

• Claims Turnaround:     99.8% within 10 business days

• Average Speed of Answer Phone:   within 16 seconds or less

Phone abandonment Rate:    1.6%

Customer Care – Members have access to live customer service representatives 7 days a week located in a U.S. call center:

• Monday through Saturday: 8:00 a.m. to 11:00 p.m.; Sunday 11:00 a.m. -8:00 p.m. EST

• Monday through Sunday: 24 Hours/day IVR system is available.

Medical and Surgical Eye Care -   Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures.

Ocular Benefit’s subsidiary company, Premier Eye Care, leverages over 17 years of experience in delivering medical surgical ophthalmic services.  Through Premier, Ocular Benefits is licensed as a Third Party Administrator and Fiscal Intermediary.  In addition, we hold a Medical Review License by AHCA and are compliant with HIPAA, AHCA, and CMS guidelines.

Ocular Benefits offers an integrated medical network that includes ophthalmic primary eye care doctors, specialists and subspecialists and eye surgeons.   In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.

Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.

Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers.  We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model.  The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.

Ocular Benefits, through its subsidiary, Group Vision Service has unparalleled experience at lowering cost while improving quality, along with a long standing history and understanding working with Taft-Hartley groups.

Funding Arrangements – We provide services on either an ASO or fully-insured basis.

INSURED

Group Vision Service Plans are underwritten and insured by Fidelity Security Life Insurance Company (FSL) which holds an A- (‘Excellent’) rating from AM Best. Fidelity Security Life Insurance Company’s conservative investment philosophy enables us to offer quality insurance products that are among the most secure in the industry.

Health Insurance Exchange

Your Total Eye Care Solution℠

The Health Insurance Exchange is one-stop health insurance shopping marketplace for consumers, including, individuals, couples, families and small businesses that will offer affordable high-quality health insurance options.

It is intended to provide relief to families who have no insurance or do not get adequate insurance at work and cannot afford to buy it in the more costly individual insurance market. It is also for small businesses that cannot afford small group health insurance.

For workers at big companies with group coverage, if you lose your job, move, or decide to leave that company, you will know that there will be a high-quality affordable health insurance option available for you on the Exchange.

It will help consumers easily find available plans, compare premium rates, benefit features and help consumers make an informed choice.

Ocular Benefits is well positioned and prepared to provide the most affordable and highest quality vision plan benefit solution on the Health Insurance Exchange.   We are now opening discussions with health plans and health care leaders to be on the cutting edge of health care reform and to help lead the way to build the most integrated eye care delivery system on the Exchange.

Ocular Benefits, your single contracting partner, has flexible contracting capacity to meet the unique needs of our partners.  While we offer  integrated solutions, we are also able to easily accommodate vision only or medical-surgical only options.

Total Eye Care -   The use of our extensive network of routine vision, medical eye care specialists, facilities, anesthesiologists and in-office ophthalmic pharmacy has demonstrated significant lower overall costs for our partners.  In addition to delivering efficiencies and cost containment, added benefits of the total eye care model include:

• Increased member satisfaction.  Member’s have a single integrated eye care network for all of their needs.
• Seamless administration.  Our Health Plan partners have a single vendor to contract and work with on a day to day basis when using Ocular Benefits fully integrated eye care model.
• Improved HEDIS scores.  When considering best practices, working with Ocular Benefits and using a consolidated data set has proved to yield better HEDIS scores.  Ocular Benefits works with each plan annually to increase HEDIS scores through member mailings, PCP education and streamlined reporting.

Routine Eye Care – Ocular Benefits provides routine visions services with full flexibility

Ocular Benefit’s subsidiary company Group Vision Service leverages over 50 years of experience to integrate people, technology, processes and quality eye care doctors in order to deliver the very best routine eye care coverage.

Eye Exams – Ocular Benefits offers full coverage for routine eye exams that are performed by licensed and fully credentialed Doctors of Optometry, (O.D.), or Ophthalmologist (M.D.).

Eyewear - We provide excellent coverage for basic eye-wear materials, including eyeglasses or contact lenses or custom benefit packages that include coverage for high-end fashion frames, high tech-lenses and advanced contact lenses.

LASIK - Discounted LASIK benefits at no additional cost!

Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.

43,000 PPO Network Providers! Because we have partnered with Luxottica Corporation, a 6.4 billion dollar global organization we are able to deliver our customers one of the largest vision care networks in the USA with more than 43,000 private practices and retail optical provider locations nationwide including: LensCrafters, PearleVision, JC Penny, Sears Optical, and, Target Optical.  This large and diverse network of eye care providers deliver exceptional access to local or multi-state employer groups! Plus, we can also administer out of network benefits, so members can see any doctor they like.

Additional Savings Program - Members have access to eyewear discounts in addition to their covered benefits!  Discounts include:  lens up-grades/options and additional pair purchases.  Members may access this discount program as often as they want during their enrollment in the vision care program.  Discounts are available from network provider only.

Mail Order Contact Lenses – Replacement contact lens mail order program allows member to order directly online!

Customer Care – Members have access to live customer service representatives 7 days a week located in a U.S. call center:

• Monday through Saturday: 8:00 a.m. to 11:00 p.m.; Sunday 11:00 a.m. -8:00 p.m. EST

• Monday through Sunday: 24 Hours/day IVR system is available.

Medical and Surgical Eye Care -   Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures.

Ocular Benefit’s subsidiary company, Premier Eye Care, leverages over 17 years of experience in delivering medical surgical ophthalmic services.  Through Premier, Ocular Benefits is licensed as a Third Party Administrator and Fiscal Intermediary.  In addition, we hold a Medical Review License by AHCA and are compliant with HIPAA, AHCA, and CMS guidelines.

Ocular Benefits offers an integrated medical network that includes ophthalmic primary eye care doctors, specialists and subspecialists and eye surgeons.   In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.

Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.

Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers.  We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model.  The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.

Whether it is routine vision benefits, complex medical-surgical eye care, or total eye care services, Ocular Benefits™ will serve as a strong partner for you!

Medicaid Eye Care Benefits

Your Total Eye Care Solution℠

Ocular Benefits, your single contracting partner, has flexible contracting capacity to meet the unique needs of our partners.  While we offer integrated solutions, we are also able to easily accommodate vision only or medical-surgical only options.

Total Eye Care -   The use of our extensive network of routine vision, medical eye care specialists, facilities, anesthesiologists and in-office ophthalmic pharmacy has demonstrated significant lower overall costs for our partners.  In addition to delivering efficiencies and cost containment, added benefits of the total eye care model include:

• Increased member satisfaction.  Member’s have a single integrated eye care network for all of their needs.
• Seamless administration.  Our Health Plan partners have a single vendor to contract and work with on a day to day basis when using Ocular Benefits fully integrated eye care model.
• Improved HEDIS scores.  When considering best practices, working with Ocular Benefits and using a consolidated data set has proved to yield better HEDIS scores.  Ocular Benefits works with each plan annually to increase HEDIS scores through member mailings, PCP education and streamlined reporting.

Medical and Surgical Eye Care -   Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures.

Ocular Benefit’s subsidiary company, Premier Eye Care, leverages over 17 years of experience in delivering medical surgical ophthalmic services.  Through Premier, Ocular Benefits is licensed as a Third Party Administrator and Fiscal Intermediary.  In addition, we hold a Medical Review License by AHCA and are compliant with HIPAA, AHCA, and CMS guidelines.

Ocular Benefits offers an integrated medical network that includes ophthalmic primary eye care doctors, specialists and subspecialists and eye surgeons.   In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.

Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.

Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers.  We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model.  The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.

Whether it is routine Medicaid vision benefits or complex medical-surgical eye care, Ocular Benefits will deliver innovative cost-saving eye care solutions and will serve as a strong partner for your organization!

Commercial Group Eye Care Benefits

Your Total Eye Care Solution℠

Ocular Benefits, your single contracting partner, has flexible contracting capacity to meet the unique needs of our partners.  While we offer integrated solutions, we are also able to easily accommodate vision only or medical-surgical only options.

Total Eye Care -   The use of our extensive network of routine vision, medical eye care specialists, facilities, anesthesiologists and in-office ophthalmic pharmacy has demonstrated significant lower overall costs for our partners.  In addition to delivering efficiencies and cost containment, added benefits of the total eye care model include:

• Increased member satisfaction.  Member’s have a single integrated eye care network for all of their needs.
• Seamless administration.  Our Health Plan partners have a single vendor to contract and work with on a day to day basis when using Ocular Benefits fully integrated eye care model.
• Improved HEDIS scores.  When considering best practices, working with Ocular Benefits and using a consolidated data set has proved to yield better HEDIS scores.  Ocular Benefits works with each plan annually to increase HEDIS scores through member mailings, PCP education and streamlined reporting.

Routine Eye Care – Ocular Benefits provides routine visions services with full flexibility.

Ocular Benefit’s subsidiary company, Group Vision Service, leverages over 50 years of experience to integrate people, technology, processes and quality eye care doctors in order to deliver the very best routine eye care coverage.

Eye Exams – Ocular Benefits offers full coverage for routine eye exams that are performed by licensed and fully credentialed Doctors of Optometry, (O.D.), or Ophthalmologist (M.D.).

Eyewear - We provide excellent coverage for basic eye-wear materials, including eyeglasses or contact lenses or custom benefit packages that include coverage for high-end fashion frames, high tech-lenses and advanced contact lenses.

LASIK - Discounted LASIK benefits at no additional cost!

Quality - Fully credentialed doctor network that parallels NCQA (National Committee of Quality Assurance) Standards.

43,000 PPO Network Providers! Because we have partnered with Luxottica Corporation, a 6.4 billion dollar global organization we are able to deliver our customers one of the largest vision care networks in the USA with more than 43,000 private practices and retail optical provider locations nationwide including: LensCrafters, PearleVision, JC Penny, Sears Optical, and, Target Optical.  This large and diverse network of eye care providers deliver exceptional access to local or multi-state employer groups! Plus, we can also administer out of network benefits, so members can see any doctor they like.

Additional Savings Program - Members have access to eyewear discounts in addition to their covered benefits!  Discounts include:  lens up-grades/options and additional pair purchases.  Members may access this discount program as often as they want during their enrollment in the vision care program.  Discounts are available from network provider only.

Mail Order Contact Lenses – Replacement contact lens mail order program allows member to order directly online!

Customer Care – Members have access to live customer service representatives 7 days a week located in a U.S. call center:

• Monday through Saturday: 8:00 a.m. to 11:00 p.m.; Sunday 11:00 a.m. -8:00 p.m. EST

• Monday through Sunday: 24 Hours/day IVR system is available.

Medical and Surgical Eye Care -   Ocular Benefits provides comprehensive medical-surgical eye care from medical exams to complex ocular surgical procedures.

Ocular Benefit’s subsidiary company, Premier Eye Care, leverages over 17 years of experience in delivering medical surgical ophthalmic services.  Through Premier, Ocular Benefits is licensed as a Third Party Administrator and Fiscal Intermediary.  In addition, we hold a Medical Review License by AHCA and are compliant with HIPAA, AHCA, and CMS guidelines.

Ocular Benefits offers an integrated medical network that includes ophthalmic primary eye care doctors, specialists and subspecialists and eye surgeons.   In addition, we provide ambulatory surgical centers, anesthesia and in-office pharmacy.

Ocular Benefits accepts full health plan delegation for claims management, provider credentialing, network management and utilization management.

Ocular Benefits provides complete flexibility to our partners in order to effectively accommodate the individual needs of our partner health plans and government payers.  We can customize all benefits to the specific needs of the Health Plan, including the medical-surgical delivery model.  The customized delivery models range from straight fee-for-service to full capitation with variations and hybrids in between.