CSUDH-HRM:Benefits, Vision

New CSU Vision Plan Carrier Effective January 1, 2007

We are pleased to announce that effective January 1, 2007, Vision Service Plan (VSP) will provide administration of vision benefits and claims on behalf of the employer-paid California State University (CSU) Vision Plan. VSP is replacing Medical Eye Services (MES)/Blue Shield, which will administer CSU vision benefits through December 31, 2006. Current and new employees will be automatically enrolled into this plan.

WHAT WILL VSP PROVIDE?

§ More Convenient Customer Service Hours

VSP offers extended customer service hours, and their representatives are available Monday - Friday, 5:00 a.m. to 7:00 p.m. and on Saturday, 6:00 a.m. to 2:30 p.m. via their toll-free telephone number: (800) 877-7195.

§ Account Information Access

VSP has an automated Interactive Voice Response (IVR) system and Website that is available 24 hours a day, for the purposes of providing personalized information on eligibility, plan coverage, past service, online messaging to customer service, as well as information regarding doctors in the VSP Select Network. The VSP website is: http://www.vsp.com.

§ Commitment to Eye Health

VSP has developed a comprehensive Eye Health Management Program that includes: eye education, Patient Eyecare Report, Diabetes Awareness Program, communication with participants’ Primary Care Physician (PCP), and Eye on Health, an annual eye wellness newsletter.

Beginning in 2007, the following benefit plan enhancements will be offered to eligible CSU employees:

§ Benefit Plan Enhancements

- The in-network frame allowance increases from $90.00 to $95.00;

- The out-of-network frame allowance increases from $45.00 to $60.00;

- The in-network contact lens allowance increases from $110.00 to $120.00;

- Polycarbonate lenses are covered for dependent children in-network up to age 23, instead of age 12; and

- Discounts of approximately 15% for laser correction surgery are available.

§ Frequency of Benefits Access Now Based on Calendar Year Perspective

All benefits eligible employees and their dependents can access vision services through VSP, effective January 1, 2007, even if benefits were accessed under the MES/Blue Shield plan.

Effective also in 2007, the frequency of benefits will be based on a calendar year perspective, and not on a rolling basis calculated from the last date of service. For example, if an employee has an eye exam in February 2007, he/she will be eligible for another eye exam on January 1, 2008, or thereafter.

§ Ease of Claims Processing

Claim forms are no longer required when using standard in-network benefits. Employees that choose to use a non-VSP provider must submit an itemized bill to VSP in order to receive reimbursement based on out-of-network allowances. A claim form, however, is still required for video display terminal (VDT) benefits whether using a VSP Select Network doctor or a non-VSP provider. Employees who meet the CSU requirement for VDT coverage must obtain the form from the campus Benefits Office.

How do I access my benefits?

- Choose a VSP doctor at VSP.com or call 800-877-7195.

- Make an appointment and tell the doctor you are a VSP member.

- That's it! No ID cards or filling out claim forms.

How much will it cost me?

Eye exam every calendar year.

Covered in full with a $10.00 co-pay

Click here for summary sheet of co pays, discounts and savings.

Vision Group Number & Contact Information
VSP has assigned the CSU the following group number: 12292796.

Effective January 1, 2007, employees will be able to complete an online member registration enrollment to create a user identification (ID) and password, for the purpose of viewing his/her vision benefits at www.vsp.com. If employees access the website prior to January 1, they will not be able to register online, research VSP Select Network doctors, or view benefit information. However, they can contact the VSP Customer Service Department at (800) 877-7195, to ask questions regarding the VSP Select Network and vision benefits.

As previously stated, claim forms are not necessary for employees wishing to access standard vision benefits through either a VSP Select Network provider or a non-VSP provider. For employees who utilize a non-VSP provider, an itemized receipt along with a completed VSP Out-of-Network Reimbursement form should be mailed to the following address:

A personalized Out-of-Network Reimbursement form also can be downloaded from the VSP website when the employee logs onto the VSP website using his/her personal information. Upon receipt of the documents, VSP will reimburse the employee based on the out-of-network allowances.

VSP Select Network providers will communicate directly with VSP if an employee is deemed eligible for medically necessary contact lenses. If an employee utilizes a non-VSP provider, that information should be reflected on an itemized statement. Therefore, no additional forms are needed.

The Video Display Terminal (VDT) benefit is designed to meet the specific eye care needs of those who regularly work with video display terminals. An active employee who utilizes a video display terminal four (4) or more hours per day on a regular basis as provided in his/her CSU job description, is eligible to receive a supplemental vision examination and eyewear specifically for VDT use.

The VDT Confirmation form must be completed by the employee and submitted to the eye care provider, whether or not the provider is in-network or out-of- network. Employees who qualify for the VDT benefit must contact the campus Benefits Office to obtain a VDT claim form.

California State University, Dominguez Hills • 1000 E. Victoria Street • Carson, California 90747 • (310) 243-3696
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Last updated: Wednesday, November 22, 2006 10:27 AM (AP)