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FLEXIBLE BENEFITS

2009
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VISION
OPTUMHEALTH
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VISION INSURANCE
VISION

• Coverage level available
• Single or Family
• Pre-tax premiums
• Network of eye care providers
• Benefits available for in-network
  out-of-network services

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VISION INSURANCE
VISION

• Frequency
• Routine Eye Exams every 12 months
• Lenses every 12 months
• Frames every 24 months
• Contacts every 12 months

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VISION INSURANCE
BENEFITS CHART
Only a one time 20 material copay applies per
benefit period.
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VISION INSURANCE
BENEFITS CHART
Only a one time 20 material copay applies per
benefit period.
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VISION INSURANCE
Only a one time 20 material copay applies per
benefit period.
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VISION INSURANCE
MEDICALLY NECESSARY CONTACTS

• OptumHealth Vision must establish that an
  eligible member has any of the following
• Keratoconus or irregular astigmatism
• Anisometropia of 3.50 diopters or more
• Post cataract surgery without intraocular lens
• Visual acuity in the better eye of less than
  20/70 with spectacles, but better than 20/70 with
  contacts

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VISION INSURANCE
BENEFITS CHART
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VISION INSURANCE
REMINDERS

• If you use in-network providers, you are
  responsible only for your portion of cost.
• If you decide to use a non-network provider, you
  pay everything and seek the out-of-network
  benefits payments schedule
• Payment is made at the time of service

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VISION INSURANCE
REMINDERS

• To be reimbursed for an non-network service,
  receipts must be submitted to OptumHealth
• Receipts must be submitted together for services
  and materials purchased on different dates to
  receive reimbursement

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VISION INSURANCE
REMINDERS

• Mailing address for non-network services
• OptumHealth Vision Claims Dept.
• P.O. Box 30978
• Salt Lake City, UT 84130
• The following must be included
• Itemized receipts
• Social Security Number
• Patients Date of Birth

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VISION INSURANCE
EXCLUSIONS LIST

• The Vision plan does not cover
• Replacement of lost lenses or frames
• Medical or surgical treatment of eye conditions
• Amounts above the schedule of benefits or
  allowances
• Services or materials not included as eligible
  expenses by the Vision Plan
• Cosmetic extras such as no line multifocal
  lenses, tints, UV coatings, etc.

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VISION INSURANCE
VISION

• To locate a participating provider near you,
  contact Spectera toll free 1-800-638-3120
• You may go online www.myoptumhealthvision.com

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VISION INSURANCE
IMPORTANT NOTES

• If a dependent is not listed under an employees
  record with OptumHealth, a provider may deny
  services
• It is important for employees to complete and
  submit the Dependent Enrollment Form
• Employee must be enrolled in Family coverage for
  dependent eligibility

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VISION INSURANCE
IMPORTANT NOTES

• Employees may fax the completed form to 1
  [phone]
• Employees may mail the completed form to
• OptumHealth Vision
• Liberty 6, Suite 200
• 6220 Old Dobbin Lane
• Columbia, MD 21045
• Forms will be processed within 14 days after
  receipt

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VISION INSURANCE
CLAIM FORMS
Located in the Forms section on Team Georgia
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BENEFIT OPTIONS AFTER RETIREMENT
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VISION INSURANCE
VISION

• Continue under COBRA up to 18 months
• Premium is increased by 2 from active employee
  rate
• Limited to 18 months of coverage
• Notification to SPA required within 60 days

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VISION INSURANCE
SPA CONTACT INFORMATION

• Agencys website www.spa.ga.gov
• Information Regarding Flexible Benefits
  http//team.georgia.gov/portal/site/FLEX
• Phone Numbers
• Local 404-656-2730
• Toll Free 1-888-968-0490

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