Vision Coverage for the Employees of: University of North Alabama
Effective June 1,2009
Thank you for considering HumanaVision plans. Let us help
preserve and improve your sight.
The choice for vision care is clearly simple: HumanaVision plans.
One price. HumanaVision plans make eye care affordable. Benefits are the same at all participating providers in the network, no matter where they're located or what their typical retail charges are. Wholesale pricing ensures affordable frames, lens options and upgrades for all members at the same price.
More choices, more convenience. You have access to one of the largest vision networks in the United States, with more than 22,500 participating optometrists and ophthalmologists. Every one accepts new patients, and many have evening and weekend hours.
HUMANA.
Service excellence. We make it easy for your employees, too. They can: o Call Humana Customer Care at 1-866-537-0229 from
8 a.m. - 8 p.m. Monday - Thursday and 8 a.m. - 6 p.m. Friday, Eastern time.
o View benefits, check claims and access other services at HumanaVisionCare.com.
Humana will add tremendous value to your benefits package.
Proprietary to Humana Insurance Company
HUMANA. Specialty Benefits
Focus on wellness
With all of the choices available regarding your benefits, vision care is a relatively simple yet valuable benefit, and is important for your well-being and overall health. Humana is dedicated to preserving employees' eye health and wellness, while focusing on choice and value.
Early detection of vision problems is critical The leading causes of irreversible blindness-glaucoma, diabetic retinopathy, cataracts, and muscular degeneration-advance without pain and other symptoms in their earliest stages. Eighty percent of the world's blindness is preventable, according to the lnternational Agency for the Prevention of Blindness.
Focusing on the facts of vision P A vision plan is one of the top five most-desired benefits, after medical insurance, by employees . I
P More than 75 percent of U.S. residents between age 25 and 64 require some sort of vision correction.' P Vision problems affect 120 million ~mericans.~ P More than 70 percent of Americans reported loss of eyesight as "1 0" on a scale of 1 - 10, with 10
being the worst thing that could happen to them. It means a loss of independence, mobility and quality of life.4
Vision health impacts overall health Periodic eye examinations are an important part of routine preventive healthcare. Because many eye and vision conditions have no obvious symptoms, our employees may be unaware of problems. Early diagnosis and treatment are important for maintaining good vision and preventing permanent vision loss.' Eye exams can detect symptoms of diseases such as diabetes, hypertension, multiple sclerosis, brain tumors, osteoporosis and rheumatoid a r t h n t i ~ . ~
' LMRA International Jobson's Optical Research ' Vision Council of America
National Eye Institute and Lions Clubs International Foundation American Optometric Association Thompson Media Inc.
Employee Rates:
Employee Only $ 4.44 $ 8.88
I Employee + Family $11.88 $23.76 I
Proprietary to Humana Insurance Company
* Material co-pay is required for a complete palr of eyeglasses, lenses or frames. ** I f a member prefers contact lenses, the plan provides an allowance for contacts in lleu of lenses.
Vision care services
Exam/materials co-pay*
Exam with dilation as necessary 100% after co-pay $35 allowance
Wholesale frame allowance $100-$150 approximate retail value
Lenses Single vision Blfocal Trifocal Progressive (levels 1-4)
Frames
Contact lenses* * Elective (conventional and disposable) Medically necessary
Frequency (based on date of service) Examination Lenses or contact lenses Frame
Retail value may dlffer and Is based on two to three tlmes the wholesale cost.
How does the wholesale frame allowance work?
100% after co-pay 100% after co-pay 100% after co-pay 100% after co-pay
$50 wholesale frame allowance
$150 Contact lens allowance 100%
Once every 12 months Once every 12 months Once every 24 months
Benefits include a wholesale frame allowance. I f the wholesale cost exceeds the frame allowance, members pay twice the wholesale difference. They never pay full retail. - -
$25 allowance $40 allowance $60 allowance Not Covered
$40 retail allowance
$150 Contact lens allowance $210 allowance
Once every 12 months Once every 12 months Once every 24 months
Lasik and PRK procedures Members receive substantial reductions when procedures are done by network providers. Members can expect to pay no more than $1,800 per eye for conventional Lasik procedures and $2,300 per eye for custom Lasik or they can use designated TLC Vision Lasik Advantage Centers that have the following fixed prices:
Conventional Lasik Custom Lasik Custom Lasik with IntraLase
$ 895 per eye $1,295 per eye $1,895 per eye
Additional plan discounts Members receive additional fixed co-payments on lens options including: anti-reflective and scratch-resistant coating, etc. The contact lens allowance applies to professional services (evaluation and fitting fee) and materials. Members receive a 15% discount on professional services. The discount for professional services is available for 12 months after the covered eye exam. Members also receive a 20% retail discount on a second pair of eyeglasses. This discount is available for 12 months after the covered eye exam and available through the VCP network provider who sold the initial pair of eyeglasses. After co-pay, standard polycarbonate available a t no charge for dependents less than 19 years old.
Proprietary to Humana Insurance Company
Progressive lenses are covered in full with your materials
Lens Type Level 1 Progressive Level 2 Progressive Level 3 Progressive Level 4 Progressive
Average Multi focal Cost - Retail Your Cost with vision plan $165.00 $20 Materials co-payment $1 80.00 $20 Materials co-payment $1 90.00 $20 Materials co-payment $295.00 $20 Materials co-payment
HUMANA.
Progressive Availability Level 1 Image Kodak Navigator Navigator Short
Level 2 A 0 Compact A 0 Omni Essilor Natural Kodak Concise Pentax AF Pentax AF Mini Silor Adaptar Sola Max VIP XL Hoyalux GP
Level 3 A 0 Outlook Essilor Ovation Kodak Precise Rodenstock AT Rodenstock XS Sola Percepta Varilux Comfort Varilux Liberty Zeiss Gradal Top Hoyalux Wide
Level 4 A 0 B'Active Hoya Summit CD Hoya Summit ecp Hyperview KbCo Fusion 2 KbCo Fusion 1 Rodenstock Life 2 Varilux Eclipse Varilux Panamic
HUMANA.
You can save money two ways with VisionCare
First, the cost of plan services and materials is discounted and prepaid. So except for any copays, you have no out-of-pocket expenses for covered services and supplies. Second, if you are under a Section 125 program you pay for coverage on a pre-fax basis. Your coverage costs are deducted from your pay before any federal income or FICA taxes are taken out. This makes your taxable wage base lower, so you would pay less tax. Here's an example of how the plan helps you save over the course of a year:
If You Get: Eye exam Frame (fashion style) Lenses: Varilux Comfort Progressive Bifocals* Option (pink tint # I or #2) Copayment: $20 examl$20 materials Premium ($8.88 per month x 12 months)
Total Cost Pre-tax payment: Tax savings (assuming 18% tax bracket & 7.65% FICA)
Net Cost
You Pav: VisionCare Doctor Typical Retail*
0 $ 85.00 0 $120.00 0 $1 90.00 0 $ 15.00
$40.00 lVlA $1 06.56 NIA $146.56 $410.00
YOUR TOTAL SAVINGS THROUGH VISIONCARE: 70% OFF RETAIL
In this example, you would have saved $290.77 in vision care costs with VisionCare Plan. Keep in mind, however, that your actual savings will depend on your plan allowances, your actual premium, the doctors and materials you select, and your own tax situation.
Vision health impacts overall health Routine eye exanis can lead to early detection of vision problen~s and other diseases such as diabetes, hypertension, multiple sclerosis, high blood pressure, osteoporosis, and rheumatoid arthritis.'
I Thornpso~i Media lnc.
Use your HumanaVision VCP benefits HumanaVisionVCP options have you covered and make eye care affordable.You have access to one of the largest vision networks in the United States, with more than 22,500 participating optometrist and ophthalmologists. In addition you'll enjoy:
> The same benefits at aU participating providers, no matter where they're located
> Wholesale pricing on frames, avoiding high retail markups
> Simple access to plan information, provider search, Custonler Care and other automated services at HumanaVisionCare.com
How it Works 1. After signing up for thevision Care Plan, members
will receive an ID card in the mail 2. Prior to scheduling your appointment, select a
network provider through the Custonier Care Center, autonnted information line, or HumanaVisionCare.com
3. Schedule an appointnient, providing your name, the patient's name and employer
4. Sign your provider'sVCP form after your exam, you'll pay any copayments and/or costs of any upgrades at this time
Questions? Check out HurnanaVisionCare.com
Call Customer Care at 1-866-537-0229 from 8 a.m. - 8 p.m., Monday - Thursday,
and 8 a.m. - 6 p.m. Friday, Eastern time.
Know what your plan covers Attached is a summary of HumanaVisioliVCP benefits that are described in detail in your certificate.You can find your certificate on HumanaVisionCare.com or call 1-866-537-0229, Here's what you can expect:
> Quality routine eye health care from independent eye care professionals
> Services and materials provided on a prepaid basis, and the plan pays in-network providers directly, you also have the fieedom to use out-of-network providers if you prefer
> Life without claim forms! With HuinanaVision VCP, you pay your eye care professional directly for copayments and any extra cosmetic options selected at the time of service
> Select a vision provider from our network simply by visiting HumanaVisionCare.com, if you prefer, call us at 1-866-537-0229
Know what your plan doesn't cover Some items and services not included in HumanaVisionVCP are:
> Orthoptics or vision training, subnormal vision aids or Plano (non-prescription) lenses
> Replacement of lost or broken lenses, except at the regularly-scheduled plan intervals
) Medical or surgical treatment of eyes
> Care provided through or required by any government agency or program, including Workers' Compellsation or a similar law
Specialty Benejts
Vision products insured by Humana Insurance Company or CompBenefits Insurance Company
This is not a complete disclosure of plan qualifications and limitations. Check with your local Humana or HumanaDental sales office to verify product availability.
HUMANA INSURANCE COMPANY VISION PROVIDERS FOR THE STATE OF ALABAMA
The pmvlders llsed In lhls brochure were partlclpallng wllh Ule plan a1 lhe tlme of prlnling. Please check wlth the doctor of your cholce or call our Customer Care department at 1-800-749-5855 when maklng your appoinlmenl to make certaln he or she Is currently a member doctor. You may visit our webslte at w.compbenefl ts.wm for a nalionwlde llsllng of prwlden.
You must recelve servlces from oneof our partlcipating pmvlders In order to recelm full beneflls (as oullllwd In your vklon care bwklel). If you recelve service fmm a pmvlderwho does not parllclpale In the plan, you wlll receive reimbursement acmrdlng to the non-panel relrnbursement schedule eslablished by your gmup.
~ l l l l o r d L 1005 W Markel SI Sle 2 35611 (256)233-2340
I , : I 8 - 3368 Highway 280 Sle 215
me S 2100 Dala Pak Cir 35244 (205)982-5000 I AbbwIIh
mllaker. OD. Lemne L 309 W Markel SI 35611 (256)232-2409
Atmom - 212 S Main SI
35010 (256j329.9064
Amos. OD. John F 1716 UNIVERSITY Blvd 35294 (205)975-2020
pnderson. OD. Michelle 1716 UNIVERSITY Blvd 35294 (205)975-2020
Echds. OD. Clvde G 2525 Cenler Pan1 Pkwy 35215 (205)854-6080
- 112OAirpwlDrSle104 35010 (256)32944M
%%gk%h 35010 (256)32%80W
Allcavllle
EEP-- 35442 (205)373&374
Andalrnlr
Bladtslon. OD. Kmnv R 106 Hllkrssl Dr 36420 f3341222-5325
609 Ozark Rd 36310 (334j5859626
Adamavllh 1 Marboura. OD. R M 2820 Velfrm M d Ch Sle 100 35005 (205j79B9786
Elland. MD. Susan H 2700 101h Ave S Sle 404 35205 (205)933-2340
elanie S 1716 UNIVERSITY Blvd 35294 (205)975-2020
S 1716 UNNERSITY Blvd 35294 (205)975-2020
35005 (205)674-5002 - 2820 Velerans M d . 4 Dr Sle 1 00
B a l l s l l . i m m v D 1716 UNIVERSITY Blvd 35294 (205)975-2020
EEi$%eF 35294 (205)975-2020
1716 UNNERSITY Blvd 35294 (205)975-2020
I Abel 2206 Cshsba Vdley Ch Sle B 35242 (205)981-9441 35954 (256)538-9903
A u h m
Basden. OD. &ell A. 333 N Cdlege SI 36830 (334)887-6621
2531 Rocky Wge Rd Sle 116 35243 (205)978-4088 - 5590 Chalkwlle Rd Sla B 35235 (205)520-9002
avid G 2427 W C SI Sle 202 36201 (256)23&1100
- 644 2nd St NE Sle 107 35007 (205)621-1020
Hdland.OD.TovS 300 l s l SI N 35007 (205)663-4932
alrioia 110520hSIS 35205 (205)328-2020
2531 M y Ridge Rd Sle 116 35243 (205)976-4088 -
1105 ChiSne Ave 36207 (256)23€4300
425 E 10th SlSleC 36207 (256)224-7516
519 Lmghlm Aw 36207 (256)237-4881
- 778 N DeanRd Sle 100 36830 (334)887-2224 h iamin. OD. Palricia
9709 Parlmay E Sle A B 35215 (205)836-2020
E$ackbum. OD. Mihael D 4960Valleydale Rd Sle201 35242 (rn5j980-5152 - 9709 Pakway E Sle A B 35215 (205)836-2020
Flemina. OD. Joseph B 1716 UNNERSITY Blvd 35294 (205)975-2020
-11 L 333 N Cdlege SI 36830 13341887-6621 Frazier. 00. Chad A
2200 Bssmer Rd 35208 (205)786-3409
Marcela 1716 UNNERSITY Blvd 35294 (205)975-2020
. . I ASHLAND I
McClintock. OD. MarkD. 300 161SlN 35007 (205)663-4932
Chanbion. OD. Emasl J 83745 Hwy 9 Prolassional Bldg 36251 (256)354-2010
pwell. MD. James 0 644 2nd SINE Sls 107 35007 (205)621-1020 - 300lcISIN 35007 (205)663-4932
James 63745 Hwy 9 Prolahsional Bldo 36251 12561354.2010
1825 Tin Valley Cir Sle A 35235 (205)661-2020 2427 W C SI Sle 202
36201 (256j23a1100
Svensen. OD. Robarl 425 E lOB SISle C 36207 (256)236-7516
Wlczek. OD. Dam D. 1105 Chrislina Ave 36207 (256)2360300
Anb
r 35016 (256)586-4171
Swll. OD. Gina R 7 12BAwNW
- 625 Monlgomery Hwy 35216 (205)823-4555 - 3165 Grmn Vdley Rd 35243 (205)967-2103 - 5510 Highvay 280Sle 213 35242 (205)981-0103
2525 Cmler Panl Pkwy 35215 (205)854-6080
Anoie 1716 UNNERSITY Blvd 35284 (205)975-2020 - 1716 UNMRSlTYBlvd 35294 (205)975-2020 - 252 lnvemers Cmler Dr 35242 (205)991-W20
Gulierrez. OD. Hdlv 1716 UNIVERSITY Blvd 35294 (205j975.2020
H- 21W Daa Pak Cir 35244 (205)982-5000
5590 ChalUUe Rd Sle B 35235 (205)520-9002
- 1811 Hand Aw 36507 (251)937-7643
ZW3 Medical Cmler Dr 36507 (251)9376582 - 1811 Hand Aw 36507 (334)937-7631
Bsasamr
Carboni. OD. Michml J 7419 US Highway431 35950 (205)96B9196
Chadwell. OD. Chales 428 N Carlisla SI Sle C 35950 (256)894-5955
Cam. OD. Jamie 1716 UNIVERSITY Blvd 35294 (205)975-2020 35016 (256)5864171
I Athna
pans. OD. Chad L 110 Cdlege SI Sle B 35611 (256)2332393
pudlev. OD. Parisa T 3985 Parkwood Rd Sle 101 35022 (m5)4269608
Chaiwakob. MD. Jell 52 Medical Park Dr E Sle 21 1 35235 (205)8383696
Chsndrasekara.D~eeoaT 1716 UNNERSITY Blvd 35294 (205)975-2020 -
1431 2nd Ave N 35020 (205j4255182 - 1431 2nd Aw N 35020 (205j4255182 - 5031 Ford Pkwy Sle 113 35022 (205)424-2733
Blrmlnoham I
35213 (205)591-2311
John G 1716 UNNERSlTYBlvd 35294 (205)975-2020
1716 UNlVERSlTYBlvd 35294 (205)975.2020
- 418 MmUing Rd 35951 (256)878-1201
-11 H. 31 1 N Broad SI 35950 (256)878-9181
Kennedv.OD.ThensaP 110 College SI Sle B 35611 (256j2332393
ael 725 W Mahel SI 3561 1 (256)232-4747
- 9709 Parlmay E Sle A B 35215 (205)836-2020 - 1716 UNIVERSITY Blvd 35294 (205)975-2020
acle M 1825 Tin Valley a r Sle A 35235 (B5P61-2020
3439 Cdmnade Pkwy Sle 1000 35243 (205)967-2020
- 123 N Marion SI 35611 (256)232.7000
S- 600 S Clinlon SI 35611 (256)232-8240
Bums. W. Frank M 3368 Highway 280 Sla 215 35010 (256)329rJOM
Cumminas. OD. Slacie M 2525 Cenler Panl Pkwy 35215 (205)8546080
Henimlon. OD. Amv 9709 Parlmay E Sle A 0 35215 (205)836-2020
1120 Airpul Dr Sla 104 35010 (256)3298400
February, 2009
Robm 2801 Highway 150 Sle 149M 35244 (205)985-7MO
1716 UNIVERSITY L d 35284 (205)975-2020
- 9709 Pukway E Sle A B 35215 (205)8362020
1716 UNNWSITY Blvd 35284 (205)975-X)20
35055 (256)737-9109 - 1850 Char& Avo SW Sle D 35055 (256)775-0499
- 301 Sainl J w h Ave 36426 (251)8578881
106WJsekmSl
bl&llhews. O D & a m E 2014 Morris Ave 35203 (205)32817U
D. 3240 Edwsrds Lake Pkvy Sle 100 35235 (205)9492020
!2%s%E+ 35294 (205)975-2020
!EEiZ%e 35214 (205)7887MI)
%E%zi%+ 35214 (205)79876m
Mdows. OD. Lisa L 1716 UNIVERSlTY W 35284 (205)975-2020
!%%EEr 35211 ( 2 0 5 ) M r n
Ihc 2870 Md R&y Wge Rd Sle 10 35243 (205)8241257
1716 UNNERSlTYBlvd 35284 (205)975-2MO
56526 (251)621-1211
M 27800 N Main St Sle 1 36526 (251)521-1211
W 279m N Mpin SI Sle 1 56526 (251)621-1211
lellv. MD. Chrlslooher L 1830 14h Ave S 35205 (205)9332250
Kdlv. MD. James 8. 3240 Edwuds bk8 Pkwy Sle 100 35235 (205)8492020
35042 (205)9264816
C h l u a - 18233 Highvmy 280 Sle C 35043 (205)67&2MO
%%EP- 35043 (205)5782565
Chlldanburp
5%%&%F 35044 (25533785507
Clanion
EEif-- 35045 ( W W
700 7ul SIS 35045 (20532800034
1W Medicalhbr Dr 35045 (205)755-2296
tiiuse Chridl c. 7007ulSIS 35045 (205)uKU1034
%%%!%- 35045 (205)755-1351
eJ 638 Clmh M d e l PI 35045 (205)755-3636
7 m 7ul SI S 35045 12051-
56526 (251)9281941
k%k%%+ 36526 (251)621-1211
I Doutur
dwin D 1616 Paldine Rd SW 35601 (256)355-9645
MmLU. OD. Dwalas L. 2208 bnville Rd SW 35601 (255)351-0041
S l m c n . r a l d 833 Rirmh Ave SW 35211 (205)2068320
R 1716 UNNWSITY Blvd 35291 (205)975-2020
%%%$Er 35235 (205)661-2020
A 97W P h a y E SleA 8 35215 (205)8362020
dC 2737 Highway 280 S Sb 191 35223 (205)802-2020
vid C 97W P h a y E SleA B 35215 (205)8362020
- 9709 Pahay E Sle A B 35215 (205)836-2020
Sleele. OD. Elizabeth A 1716 UNMRSITY Blvd 35284 (205)975-2020
Kirk. OD. Sheila W 4x10 valleydk ~d sle 7m 35242 (205)99607M1
pdr. OD. Kenwul C 3532 Venn Rd Sle 102 35235 (205)655-1335
Kirkmier. QB. Lenh P 790 Manidsir Rd Sle 100 35213 (205)592-3911
hP 840 Monldair Rd Sle 722 35213 (205)591-2311
1716 UNlMRSlTY Bhd 35294 (205)975-2020
Rice M. 790 Manldpir Rd Sle 100 35213 (205)592-3911
eM 3165 Green Valley Rd 35243 (205)867-21M
eM 55lOHighway280Sle213 35242 (205)9814103
Laurenl. OD. John 1716 UNMRSlTY Wd 35291 (205)975-2020
1716 UNIVERSITY W 35294 (205)975-2020
2EEEEF- 35244 (205)982SWO - 840 ManWar Rd St8722 35213 (205)591-2311
%%zk%k 35294 (205)975-2020
i%Ez%K+ 35213 (205)591-2311
9709 P h a y E SleA B 35215 (205)@362020
2700 10th Avo S Sle 4M 35205 @5)933WO
9709 Pahay E Sle A B 35215 (205)8362020
%E2ikzE 35213 (205)592-3911
Yelazauez. MD. Andrew J 780 Monlelair ~d sle im 35213 (205)592-3911
36732 (334-~:1008
I M a n
Badham. OD. D&d W 151 W Main SI 36301 (334)793-2633
Hdland. OD. Tov S 112SMIS I 35051 (205)859.4131
Cullmm
EEE%P- 35055 (256)739.4000
-410 3KE4 (256)7393605
601 Guhmn SI SW Sle A 3x155 (256)734-8514
35244 (205)987-2020 - 9709 Parkway E Sle A B 35215 (205)836-2020
1716 UNNERSlTYBlvd 35294 (205)9752020
llon F 1716 UNMRSlTY Blvd 35294 (205)975-2020
2401 15h Ave N Sle 160 35234 (205)502-3937
9709 Parhay E Sla A B 35215 120518382020
l a 9709 P&ay E SleA B 35215 (205)8362020 k A
510 N Main St 35957 (256j5951986