Page 12 - Premier EE Guide 12-17 - Texas Final
P. 12

VISION INSURANCE





         Blue View Vision through Anthem Blue Cross | PPO Vision Plan
         The Blue View Vision plan provides professional vision care and high quality lenses and frames through a broad network of optical
         specialists.  You  will  receive  richer  benefits  if  you  utilize  a  network  provider.  If  you  utilize  a  non‐network  provider,  you  will  be
         responsible to pay all charges at the time of your appointment and will be required to file an itemized claim with Blue View Vision.

                                                            Blue View Vision                       Note
         Plan Name                                               PPO                               Blue View Vision’s

         Network                                   Network                 Non-Network             network includes
                                                                                                   access to more than
         Vision Benefits                                                                           44,000 providers

         Copay                                                                                     and provider
          - Examination                           $25 Copay                    N/A                 locations including
          - Materials                                N/A                       N/A                 independent
                                                                                                   ophthalmologists
         Examination (Every 12 Months)            No Charge             $49 Reimbursement          and optometrists, as
                                                                                                   well as
         Lenses (Every 12 Months)
                                                                                                   LensCrafters®,
          - Single Vision                         No Charge             $35 Reimbursement          Target Optical, Sears
          - Bifocal                               No Charge             $49 Reimbursement          Optical, JCPenney
          - Trifocal                              No Charge             $74 Reimbursement
                                                                                                   Optical and most
         Frames (Every 24 Months)             $130 Allowance, 20%       $50 Reimbursement          Pearle Vision retail
                                                                                                   stores.
         Contact Lenses (Every 12 Months)               In Lieu of Frames and Lenses
          - Cosmetic / Elective               $130 Allowance, 20%       $92 Reimbursement
          - Medically Necessary                   No Charge             $250 Reimbursement
         Laser Vision Correction                Discounts Apply            Not Covered



                       Finding In-Network Vision Providers
                       Go to www.anthem.com/ca or call (866) 723-0515. Refer to the “Blue View Vision” network when prompted.





         EMPLOYEE ASSISTANCE PROGRAM



         Anthem Blue Cross | Resource Advisor
         The Resource Advisor Employee Assistance Program (EAP) through Anthem Blue Cross provides you and your household members
         with  free,  confidential  assistance  to  help  with  personal  or  professional  problems  that  may  interfere  with  work  or  family
         responsibilities and obligations. Services are available 24 hours a day, 7 days a week via a toll-free nationwide number. You and
         your household members can receive up to 3 counseling sessions for  each concern, face-to-face or as an online session using
         Resource Advisor.



                       Accessing the EAP
                       To access EAP benefits, go to www.resourceadvisorca.anthem.com (Program Name: ResourceAdvisor) or you
                       may call (888) 209-7840 to be immediately connected to an EAP counselor.










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