Page 11 - Inglewood USD Benefits Guide 2019 - ACTIVES_FINAL

BENEFITS

Vision Insurance

VSP | PPO
The VSP 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 use a non‐network provider, you will be
responsible for paying all charges at the time of your appointment and will be required to file an itemized claim with VSP.

VSP Note
Plan Name PPO VSP has the largest
network of
Network Name VSP Signature Non-Network
private-practice eye
Vision Benefits care doctors in the
industry. VSP’s
Copay network includes
- Examination $0 Copay N/A 50,000 access points
- Materials $0 Copay N/A
nationwide. VSP also
Examination (Every 12 Months) 100% $50 Reimbursement contracts with
Costco Optical,
Lenses (Every 12 Months) Visionworks, and
- Single Vision 100% $50 Reimbursement other affiliate retail
- Bifocal 100% $75 Reimbursement
providers. Please
- Trifocal 100% $100 Reimbursement
note, benefits may
Frames (Every 24 Months) $150 Allowance $70 Reimbursement vary at affiliate
locations.
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
- Cosmetic / Elective $140 Allowance $105 Reimbursement

Laser Vision Correction Discounts Apply Not Covered

RESOURCES AND CONTACTS

Below is a list of insurance carrier contacts should you require assistance with your benefit questions following open enrollment. If you are unable
to resolve your issues or questions with the insurance carriers, please contact the Benefits Department at (310) 419-2760.
Inglewood Unified School District Contacts - BenefitsRisk@inglewood.k12.ca.us

Audrey Velasco, Employee Benefits Specialist…………..……………………………………….. (310) 419-2760
Tiffany Egan, Director of Benefits & Risk Management..…………………………………….. (310) 419-2760
District Website, Benefits page…………………………………………………………………………... https://www.inglewoodusd.com
Medical - Kaiser Permanente | Group Number: 234544

Member Services ………………………………………………………………………………..……………... (800) 464-4000
Carrier Website ………………………………………………………………………………………………..… www.kp.org
Medical - Anthem Blue Cross | Group Number: 282443
Member Services ………………………………………………………………………………..……………... (800) 888-8288
Carrier Website ………………………………………………………………………………………………..… www.anthem.com/ca
Dental - Delta Dental | Group Number: 07026

Member Services ……………………………………………………………………………………………….. (800) 765-6003
Carrier Website ………………………………………………………………………………………………..… www.deltadentalins.com
Vision - VSP | Group Number: 30083629
Member Services ……………………………………………………………………………………..………... (800) 877-7195
Carrier Website …………………………………………………………………………………………..……… www.vsp.com
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