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California State University, Long BeachCalifornia State University, Long Beach

CSU Vision Plan

Program

A group vision care plan is offered to all eligible employees and their eligible dependents. Vision Service Plan (VSP) currently administers the employer-paid vision benefits and all service claims.

Monthly Premium

Currently, the full monthly premium is paid by the CSU. However, premium costs are subject to change.

Eligibility

Employees are eligible if appointed half-time or more for a period of more than six (6) months.

Lecturers and Coaches appointed for a minimum of one semester or two consecutive quarters at .4 timebase or greater are eligible for benefits. Coaches and Lecturers (Non-academic calendar year) are eligible for benefits if appointed half-time or more for a period of more than six (6) months. View faculty benefits eligibility details.

Employees appointed on an hourly, intermittent basis do not qualify for benefits.

Enrollment

All eligible employees will be automatically enrolled for self and eligible family members. Eligible family members include your legal spouse, registered domestic partner and dependent child(ren) who are age 26 and under. Plan services may be obtained when the deduction description VIS-VSP appears on your pay warrant stub.

Explanation of Vision Care

Effective January 1, 2016, VSP Provider Network will be VSP Advantage, group #30059426

To receive the full plan benefits you must obtain services from a participating provider. A list of participating doctors
is available on VSP website. You may obtain services from a non-participating provider, however, at a reduced benefit.

How to use the Plan

No ID cards. No claim forms.

  1. Find a VSP network doctor at vsp.com or call 800-877-7195.
    T.D.D. number for the hearing impaired is 800-428-4833.
  2. Make an appointment and tell the doctor you are a VSP member.
  3. Your doctor and VSP will handle the rest.

If you elect to use a non-VSP provider you must submit an itemized receipt along with a VSP Out-of-Network Reimbursement Form to VSP in order to receive reimbursement based on the out-of-network allowances.

Basic Benefits

Item Basic Benefits
Co-payment $10.00, payable at the time of service.
Comprehensive Examination Once every calendar year.
Lenses

One pair every other calendar year or every year if a prescription change (as defined in the Group Master Policy) is indicated.

Single vision, lined bifocal and lined trifocal lenses.

Polycarbonate lenses for dependent children.

Frames One frame every other calendar year.
Lens Enhancements Every other calendar year.
Contacts
(instead of glasses)
Every other calendar year.
Contact Lenses

Medically necessary contact lenses when required for anisometropia or keratoconus, or following cataract surgery, or when visual acuity cannot be corrected to 20/70 in the better eye, except through the use of contacts.

One pair of contact lenses for cosmetic reasons when provided in lieu of other eyewear once every other calendar year or every year if a prescription change (as defined in the Group Master Policy) is indicated.

Low Vision Benefit

The Low Vision Benefit is available for severe visual problems that are not correctable with regular lenses, subject to the following limitations: 1) Prior Authorization, 2) 25% co-payment, 3) Maximum Benefit - $1,000 (excluding co-payment) every 2 years for approved Low Vision care.

Video Display Terminal (VDT) Benefit

A claim form is still required for VDT benefits whether using a VSP Select Network doctor or non-VSP Provider. Employees must meet the CSU requirements to be eligible for VDT coverage and obtain the VDT benefit form from Benefits Services (Brotman Hall 353).

All active employees who utilize a video display terminal for at least 4 hours per day on a regular basis as provided in their CSU job description shall be eligible for the VDT program as follows:

Item Benefit

Co-payment

$10.00 payable at the time of examination. This deductible is separate from the Basic Benefit co-payment. .

Supplemental Examination

Provider shall perform additional tests during the examination to determine visual needs in relation to the use of a VDT.

Lenses

Lenses One pair once every other calendar year or every calendar year if a prescription change (as defined by the Group Master Policy) is indicated.

Frames

New frames will be provided once every other calendar year.

Laser Vision Correction

Average 15% off the regular price or 5% off the promotional price; discounts only available from contracted centers.

Contact Lens

15% off cost of contact lens exam (fitting and evaluation).

Glasses and Sunglasses

Extra $20 to spend on featured frame brands. Go to vsp.com/specialoffers for details.

20% savings on additional glasses and sunglasses, including lens enhancements, from any VSP provider within 12 months of the last WellVision Exam.

Schedule of Allowances

The allowable amount depends on whether you obtain services from a participating or non-participating provider.

Examination

Service Participating Provider Non-Participating Provider
Comprehensive Opthalmologic Covered $50.00
Comprehensive Optometric Covered $50.00

Frames and Lenses

Product Participating Provider Non-Participating Provider
Frame

$95.00
on wide selection

$115.00
on featured frame brands

20% savings on amount over allowance

Up to $60.00
Single Vision Lenses Covered Up to $45.00
Lined Bifocal Lenses Covered Up to $65.00
Lined Trifocal Lenses Covered Up to $85.00
Lens Enhancements

$55.00 standard progressive

$95.00-$105.00 premium progressive

Not Covered
Aspheric Monofocal Covered Up to $125.00
Aspheric Multifocal Covered Up to $125.00
Lenticular Monofocal Covered Up to $125.00
Lenticular Multifocal Covered Up to $125.00
Contact Lenses- Cosmetic $120.00 Up to $110.00
Contact Lenses- Medically Necessary $250.00 Up to $250.00

Exclusions

  1. Orthoptics or vision training, subnormal vision aids (except as authorized under the Low Vision Benefit) or non-prescription lenses;

  2. Coated lenses, no-line bifocal (blended type) lenses or oversized lenses exceeding the Allowable Amount;

  3. Replacement or repair of lost or broken lenses or frames except at the normal intervals;

  4. Eye examination required by an employer as a condition of employment;

  5. Medical or surgical treatment of the eyes;

  6. Contact lenses, except as specifically provided; or

  7. Conditions covered by Workers' Compensation law.

Continuation of Group Coverage

If you become ineligible because of a change in employee status or timebase, or your dependent becomes ineligible, coverage may be continued under provisions of COBRA. Please contact Benefits Services at (562) 985-7141 for further assistance.

Direct Pay

If you are on a Leave of Absence Without Pay or are otherwise in an approved non-pay status, you may elect to continue your vision coverage by paying the full premium for your coverage via the Direct Pay method. You should complete the necessary documents prior to your Leave. Please contact Benefit Services at (562) 985-7141 for further assistance.

CSU Hearing Aid Discount Program

TruHearing is making hearing aids affordable for all VSP Vision Care members by providing free enrollment ($108 value) in the TruHearing Member Plus Program. A TruHearing membership provides:

  • Access to a national network of more than 4,000 licensed hearing aid professionals.
  • Selection of more than 90 digital hearing aids in 400 styles.
  • Savings of up to $1,300 per hearing purchase.
  • Deep discounts on additional batteries.

TruHearing is the first and only state-approved discount health medical organization (DHMO) for hearing; it is not insurance. There is no additional cost for TruHearing. To take advantage of TruHearing® Discounts VSP members can call TruHearing at 877-396-7194. (Members must identify themselves as being with VSP).