91ÇÑ×Ó

Administered by VSP

Group # 30016102-0001
(800) 877-7195

91ÇÑ×Ó’s Vision Plan is administered by VSP. The plan offers access to a large network of participating optometrists and ophthalmologists plus several retail chains. Your benefits include annual eye exams and coverage for lenses, frames and contact lenses.

• VSP also offers discounts for LASIK surgery if you use a participating in-network eye doctor.

The Vision Plan is designed to cover eye care needs that are visually necessary. You may have to pay extra if you choose certain cosmetic or elective eyewear options. Before selecting your eyewear, ask your provider what items are fully covered by the plan.

The Vision Plan is available to part-time and full-time faculty and staff. You have the opportunity to enroll yourself, your spouse, and eligible children. It is extremely important that you understand the eligibility criteria and enroll only those individuals that meet the following criteria.

• Your spouse and your unmarried, dependent children until 25^th birthday (regardless of student status). "Children" are defined as your natural children, stepchildren, legally adopted children, and children under your legal guardianship.

You can locate In-Network Ophthalmologists and Optometrists in your area by visiting the .

Out-of-Network Vision Claims

If you use an ophthalmologist or optometrist who is not in the VSP network, you can print and complete the VSP Out-of-Network Claim Form or complete the form online at .

How do I file an out-of-network vision claim?

Although Vision plan participants will always get the best value by using VSP in-network providers, you do have the option to use out-of-network eye care and eyewear providers. You can upload images of your receipts when completing the Member Reimbursement form on VSP.com. This will replace having to mail in the out-of-network claim form with copies of your receipts. You can also login to your vsp.com account to check the status of your claims. Follow the steps below to file an out-of-network claim:

• Go to vsp.com and log in to your account.
• Once logged in, click on “Benefits & Claims” under the “Members” tab.
• Select the “Claims & Reimbursement” box.
• Click the “Submit and Out of Network Claim” bar to view form information and then click “Start New Claim".
• On the form, select the patient and then enter the practice information, services received and costs.
• Upload up to three receipt images. If you have more than three receipts or want to mail it instead, you can print it at this step to mail in.
• Click “Submit” and you’re done! You will receive a check in about 10 days.

Important: VSP has teamed up with market leaders in the eye care industry to provide VSP members exclusive offers. These offers are in addition to VSP plan coverage and can be combined with coverage or used separately. Learn more about the offers on the Rebates and Special Offers section on . New offers will be added often so be sure to check back frequently.

Vision Plan Resources

• Out of Network Claim Form
• Vision Benefits Summary