Vision Insurance

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Delta Vision of Wisconsin
EyeMed Vision Care Select Network
PO Box 828

Stevens Point, WI  54481
Vision Provider Search

Eligibility
Employees hired to work at least 30 hours per week
Coverage begins first of the month following date of hire
Dependent eligibility – Spouse and Dependents up to age 26

DELTAVISION HIGHLIGHTS

In-Network Provider Benefit

  • $200 allowance to use on glasses OR contacts every 12 months
    • Glasses: $200 plus 20% any additional balance
    • Contacts: $200 plus 15% for conventional,
      • $200 for disposable;
      • PAID IN FULL when medically necessary and with authorization from vision doctor when some conditions are present - contact plan for more information
  • Additional Discounts
    • 40% off complete SECOND pair of glasses
    • 20% off non-covered items (except safety glasses)
    • 15% off LASIK or PRK

Non-Network Provider Benefit

  • $100 allowance to use on glasses
  • Contact Lens Allowances
    • $160 Conventional
    • $160 Disposable
    • $200 - Medically Necessary (must have authorization from vision doctor when some conditions are present - contact plan for more information

Important Notes

  • Allowances are based on DOS
  • Allowances are single-use allowances
MONTHLY RATES
•$7.68 employee only coverage
•$19.12 family coverage
 
FAST, EASY, MOBILE!
Visit eyemed.com or the mobile app which provide all-encompassing, user-friendly tools:
  • Locate a provider
  • Online exam scheduling (at participating providers)
  • View ID card
  • View benefits
  • Contact EyeMed 1-844-848-7090
  • Find answers to common questions

Enrollment is offered at hire or annually for new plan year participation.  Plan year runs from 1/1 through 12/31 annually.

Annual Open Enrollment will be from 11/1 through 11/30.

ANNUAL OPEN ENROLLMENT INSTUCTIONS - VISION PLAN

ENROLLMENT FORM

DELTA VISION ENROLLMENT GUIDE