Frequently Asked Questions

Benefits Manager Frequently Asked Questions

Our desire is for each and every member to have a superior experience when interacting with us. In order for that to occur, it is important that employees are fully educated in how the plan their employer has selected works. Understanding their plan will help them in several ways:

• In finding the appropriate provider for their specific personal needs;
• In selecting the benefit options they would like to utilize;
• In understanding the frequency of those benefit options;
• In understanding the claims and reimbursement processes.

Eyecare Providers

1. What should I tell an employee to do if there are no "in-network" providers close to his/her residence?
2. If an employee's current doctor is not listed as a participating "in-network" provider in the provider listing, is there any way to request that the provider be added to the panel?
3. Are our employees have responsible for a co-pay at the provider's office when they utilize their vision benefit?
4. Is it necessary for employees to give Superior Vision the name of the provider they have selected in advance in order to receive vision care services?
5. Are there any situations that would require an employee to pay anything directly to an "in-network" provider?
6. Can our employees get their eye examinations at one location and go somewhere else for their frames or contacts?

How To Use Your Benefits

7. What is the best way for my employees to know which services are offered by the different providers?
8. Does Superior Vision require that an employee obtain an authorization form or a voucher prior to being able to receive services at an "in-network" provider?
9. What is the best way for an employee to utilize his vision benefit when using a provider who is not on the Superior Vision provider list?
10. Are employees required to notify Superior Vision in advance that they want to use their vision benefits or can they just go directly to the provider?
11. Does an employee have to show their Superior Vision I.D. card to the provider when he/she goes in for the examination, or to get glasses or contacts?
12. If one of my employees has a problem or needs assistance in resolving an issue with an "in-network" provider, who should he/she call?
13. If an employee would like to know exactly what is or is not covered by the vision plan, what is the best way to obtain that information?
14. Do an employee's dependents need to have their own I.D. cards to receive benefits?

Frame and Lens Benefits

15. What does the term "covered in full" mean as it relates to our employee's prescription lens benefit?
16. How can an employee who wears progressive power lenses determine whether they are fully covered under our vision plan?
17. How do employees determine what kinds of frames they can select as part of their vision benefit?
18. If an employee selects a frame that is more expensive than the frame allowance that is included in their plan, what does he/she need to do?
19. Does the Superior Vision plan cover tinted eyeglass lenses for our employees?
20. Can employees who wear both contact lenses and glasses use their benefits for both of them within the same benefit period?

Material Discounts

21. Can employees use the discount feature to purchase non-prescription sunglasses?
22. Can an employee apply "discount coupons" in addition to the discount they receive at a provider when they utilize the discount feature of the vision plan?

Eyecare Providers

What should I tell an employee to do if there are no "in-network" providers close to his/her residence?

If an employee's current doctor is not listed as a participating "in-network" provider in the provider listing, is there any way to request that the provider be added to the panel?

Are our employees have responsible for a co-pay at the provider's office when they utilize their vision benefit?

Is it necessary for employees to give Superior Vision the name of the provider they have selected in advance in order to receive vision care services?

Are there any situations that would require an employee to pay anything directly to an "in-network" provider?

1. Any specified co-pay for the eye exam and any specified co-pay for the materials.
2. Any charges over and above the contact lens or frame allowance.
3. Any additional charges for products or services that are not fully covered under your plan. See the Limitations and Exclusions section in your welcome packet.
4. Any time the member takes advantage of an in-store sale or promotion.
5. See your Outline of Benefits for your benefit allowance amounts.

Can our employees get their eye examinations at one location and go somewhere else for their frames or contacts?

How To Use Your Benefits

What is the best way for my employees to know which services are offered by the different providers?

EX = Routine Eye Exam
GL = Eyeglasses
CL = Contact Lenses Exam Fit
DP = Discount Benefit Available
DP8-20 = SVP8-20 Discount Benefit Available
RF = Refractive/LASIK Surgery Discount Available
** = Services Not Available

Does Superior Vision require that an employee obtain an authorization form or a voucher prior to being able to receive services at an "in-network" provider?

What is the best way for an employee to utilize his vision benefit when using a provider who is not on the Superior Vision provider list?

1. First, call Superior Vision Customer Service at 1-800-507-3800 and get an authorization number/eligibility number.
2. Second, see your provider and pay for your examination and/or materials. You do not pay the non-network provider a co-pay.
3. Third, place in an envelope your original itemized billing or receipt, describing all of the services and materials that were provided to you, along with your name, address and the authorization/eligibility number you received from Customer Services and mail to:

   Superior Vision
   P.O. Box 967
   Rancho Cordova, CA 95741

   You will be reimbursed according to the schedule of allowances for out-of-network services, less any required co-pays.

Are employees required to notify Superior Vision in advance that they want to use their vision benefits or can they just go directly to the provider?

Does an employee have to show their Superior Vision I.D. card to the provider when he/she goes in for the examination, or to get glasses or contacts?

If one of my employees has a problem or needs assistance in resolving an issue with an "in-network" provider, who should he/she call?

If an employee would like to know exactly what is or is not covered by the vision plan, what is the best way to obtain that information?

Do an employee's dependents need to have their own I.D. cards to receive benefits?

Frame and Lens Benefits

What does the term "covered in full" mean as it relates to our employee's prescription lens benefit?

How can an employee who wears progressive power lenses determine whether they are fully covered under our vision plan?

Some plans do include coverage of progressive power lenses. Please see your Outline of Benefits schedule.
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How do employees determine what kinds of frames they can select as part of their vision benefit?

If an employee selects a frame that is more expensive than the frame allowance that is included in their plan, what does he/she need to do?

Does the Superior Vision plan cover tinted eyeglass lenses for our employees?

Some plans do cover all tints. Please see your plan outline.
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Can employees who wear both contact lenses and glasses use their benefits for both of them within the same benefit period?

Material Discounts

Can employees use the discount feature to purchase non-prescription sunglasses?

Can an employee apply "discount coupons" in addition to the discount they receive at a provider when they utilize the discount feature of the vision plan?