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Nice to see you! We’re EyeMed August 2014 1
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Why we’re here Meet EyeMed and see the difference Lets talk about your vision And how we support that vision – choice for your employees Using the benefit is so easy! We’re here to serve! How do you get the word out to employees? 2 August 2014
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Let’s run through the plan summary 3
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In a nutshell… 4 Coverage elected during the annual enrollment period of October 1 st to November 1st begins January 1, 2015 Benefits are calendar year Exam and Lenses or Contact Lenses: once per calendar year Frame: Once per every two calendar years. Four Tier 100% Voluntary Rates Two plan choices: Basic or Expanded Extra savings on Expanded plan: 35% savings on anti-reflective 55%-65% savings on progressive lenses Savings on both plans: 40% off additional complete pair eyewear purchases – unlimited! August 2014
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5 Basic Plan ServiceIn-NetworkOut-of-network Routine Eye Exam$0 copay$30 reimbursement Frame Allowance$50 allowance; 20% discount off amount over allowance $50 total frame and lens reimbursement Standard Lenses$50 allowance; 20% discount off amount over allowance $50 total frame and lens reimbursement Eyeglass Standard Lens Options (Upgrades) 20% off retail priceN/A Exam for Contact Lenses15% DiscountN/A Contact LensesMedically Necessary: $150 allowance Elective: $50 allowance Medically Necessary: $75 reimbursement Elective: $25 reimbursement LASIK/Refractive Surgery Discount15% off usual and customary fees N/A 21 % of State employees chose Basic in 2014 *Rates are subject to change August 2014 Premium Rates Per Month : Employee $3.35 Employee + Child(ren)$6.69 Employee + Spouse$6.35 Employee + Family$9.83
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6 Expanded Plan ServiceIn-NetworkOut-of-network Routine Eye Exam$10 copay$45 reimbursement Frame Allowance$115 allowance; 20% discount off amount over allowance $70 reimbursement Standard Lenses$15 copayment includes glass or plastic, single vision, lined bifocal, trifocals and lenticular lenses Single vision: $30 reimbursement Lined bifocal: $50 reimbursement Lined trifocal: $65 reimbursement Eyeglass Standard Lens Options (Upgrades) Maximum Copayments: Standard Progressive: $55 Premium Progressive: $75- $100* Standard Anti-Reflective: $45 Premium Anti-Reflective: $57-$68 Polycarbonate: $30 or $0 for dependents 18 and under Photochromics: $70 Scratch resistance coating: $15 UV Coating: $10 Tints: $25 20% discount on all other lens options Maximum Reimbursements Standard Progressive: $50 Premium Progressive: $50 Standard Anti-Reflective: N/A Premium Anti-Reflective: N/A Polycarbonate: $5 Photochromics: $5 Scratch resistance coating: N/A UV Coating: $5 Tints: N/A No discount out-of-network 79% of State employees chose Expanded in 2014 *Rates are subject to change August 2014
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7 Expanded Plan (continued) ServiceIn-NetworkOut-of-network Exam for Contact LensesCopayment not to exceed $60N/A Contact LensesMedically Necessary: covered at 100% Elective: $130 allowance Medically Necessary: $100 reimbursement Elective: $50 reimbursement LASIK/Refractive Surgery Discount15% off usual and customary fees N/A 79% of State employees chose Expanded in 2013 *Rates are subject to change August 2014 Premium Rates Per Month : Employee $5.86 Employee + Child(ren)$11.72 Employee + Spouse$11.14 Employee + Family$17.23
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What the plans don’t cover: Treatment of injury or illness covered by Workers’ Compensation or Employer’s Liability Law Services received without cost from any federal, state or local agency. This exclusion will not apply if prohibited by law. Cosmetic surgery or procedures for purely cosmetic reasons. Charges by any hospital or other surgical treatment facility and any additional fees charged by the vision for treatment in any such facility. Services by a vision provider beyond the scope of his or her license. Vision Services for which the patient incurs no charge. 8 August 2014
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It’s your vision and your vision plan …see how we make it amazing! 9
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10 Using the benefit as easy as 1…2…3 1. Locate a Provider 2. Set an Appointment 3. Receive Services In-Network 1. Set an Appointment 2. Pay for Services 3. Submit OON Claim Form with Receipts Out-of-Network (OON) August 2014
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Access to our doctors & providers 11 100 % urban access to 2 providers within 10 miles 100 % suburban access to 2 provider within 15 miles 98% Rural access to 1 provider within 20 miles And there’s more… 1135 providers at 443 locations in State of TN – more than in 2013! 85% Private Practice; 15% Retail Chain Provider nomination forms available online at www.eyemedvisioncare.com/stofTN August 2014
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Member web is easy & fast 12 Online exam scheduling* Linked directly from our provider locator at www.eyemedvisioncare.com/stoftn or at www. eyemed.com www.eyemedvisioncare.com/stoftn Self service on the web Locate a provider Download printable ID cards and EOB View benefits and eligibility status Contact EyeMed Find answers to common questions View vision wellness information Review LASIK information #1 used feature on our member web is the provider locator tool! In a world of instant gratification, our members can manage their vision care when and where they need to *Based on EyeMed web analytics research *Available at participating providers August 2014
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There’s an app for that 13 Available today for iPhone users, coming soon for Android users. Members get fingertip access to: provider locations and driving directions benefits eligibility in-network benefit details ID card FAQs help line Accessing ID card has never been easier Log into app, shake phone for ID Card! EyeMed is the first Managed Vision Care to introduce a member app! August 2014
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14 Award-winning service day & night 362 days a year, we’re here Monday – Saturday: 6:30 – 10 p.m. CT Sunday: 10 – 7 p.m. CT 99.5 % 1 st call resolution rate 4 sec. avg. speed of answer Skill-based routing so your calls are answered by the right vision benefits expert every time Certified Center of Excellence by Benchmark Portal 3 years in-a-row We are accessible,helpful,& great at what we do. Call EyeMed toll free 855-779-5046 August 2014
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From the very beginning, we’ll support every step of the way 15
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Helpful communication 16 handbook open enrollment August 2014 Eyemedvisioncare.com/stofTN
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17 EyeMed Supports ABCs One-stop reference library, videos and downloadable materials to use in conjunction with the State of TN wellness initiatives. Regularly updated materials to incorporate in communications and conversations with employees about the State’s wellness topics. EyeSight On Wellness Open Enrollment and Health Fair Support Live EyeMed Representatives available for locations of 200+ employees and 30 day notice Signage, materials and giveaways mailed to locations with 2 week notice Email event date, time and number of attendees to openenrollment@eyemed.com and we will contact you about your event!openenrollment@eyemed.com August 2014
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Finally, lets just talk Any questions? 18
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