Page 9 - ASMS Employee Guide 2017

Vision Insurance

Anthem| Blue View Vision Plan
The Anthem Blue Cross 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 Anthem Blue Cross.
Blue View Vision is the only vision plan that gives members the ability to use their in-network Note
benefits at 1-800 CONTACTS, or choose a private practice eye doctor, or go in store to LensCrafters,
Sears Optical, Target Optical and JCPenney Optical locations. Anthem Blue Cross
Vision provides you
ANTHEM BLUE CROSS access to a large
Plan Features PPO Plan network of private-

Network Non-Network practice eye care
doctors as well as
Copay contracts with
- Examination $10 Copay N/A LensCrafters, Sears
- Materials $25 Copay N/A Optical, Target
Examination 100% $49 Benefit Optical, and JCP
Optical locations.
Lenses Please note,
- Single Vision 100% $35 Benefit benefits may vary at
- Bifocal 100% $49 Benefit affiliate locations.
- Trifocal 100% $74 Benefit
Frames $130 Benefit $50 Benefit 1-800 CONTACTS
offers a huge in-
Contact Lenses (in lieu of frames/lenses) stock inventory,
- Cosmetic / Elective $130 Benefit $92 Benefit unbeatable prices,
- Medically Necessary 100% $250 Benefit outstanding
Frequency customer service
- Examination 12 Months and free shipping.
- Lenses 12 Months
- Frames 24 Months
- Contact Lenses 12 Months

FINDING A VISION PROVIDER:
Go to www.anthem.com/ca or call 1 (866) 723-0515 to find a provider near you.
To search, please click on MENU, then click: > FIND A DOCTOR
Refer to your applicable network:
Vision: Blue View Vision

Basic Life and AD&D Insurance

Anthem Blue Cross| Basic Life and AD&D
Life insurance protects your family or other beneficiaries in the event of your death while you are
still actively employed with Advanced Sleep Medicine Services. Advanced Sleep Medicine Services
pays for coverage, offered through Anthem Blue Cross, in the amount of one $25,000. If your death
is due to a covered accident or injury, your beneficiary will receive an additional amount through
Accidental Death and Dismemberment (AD&D) coverage.

A beneficiary is the person or entity who you designate to receive your death benefits. Choosing a
beneficiary and keeping your beneficiary up-to-date is an essential part of owning life insurance.
Please remember to review your beneficiary designation as new situations arise, such as the birth
or adoption of a child, marriage or divorce. You may call the Human Resources Department for a
copy of the Beneficiary Designation Form as needed. You may login to ADP to update your
beneficiary as needed.

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