The District-paid vision benefit covers all regular full-time classified, academic, and MSC employees, members of the governing board, and eligible famiy members (IRS dependent children to age 26).
Part time employees may purchase vision at a pro-rated premium. Eligibility is the first day of the month following the employee's date of hire. Upon retirement from the district, a retiree may self-pay to continue coverage under the district's policy providing there is no break in coverage.
Contact Human Resources immediately to report any change in dependent status. A new baby must be added within 31 days of birth. A spouse or domestic partner must be added within 31 days of marriage or the issuance of a Declaration of Domestic Partnership by the State of California, or a similar declaration issued by another state.
Butte Community College #M93E-C-007
OBTAINING SERVICES IS EASY
Follow these simple steps:
Contact Lenses and fitting except as specifically provided; Eyewear when there is no prescription change, except when benefits are otherwise available; Lenses or Frames which are lost, stolen or broken will not be replaced, except when benefits are otherwise available; Lenses such as beveled, faceted, coated or oversize exceeding the allowance for covered lenses; Tints other than pink or rose #1 or #2, except as specifically provided; Two pair of glasses in lieu of bifocals, unless prescribed.
This is a brief outline of the plan and is not to be accepted or construed as a substitute for the provisions of the contract.
SUMMARY OF VISION BENEFITS
|Comprehensive Vision Exam:||One every 12 months|
|Lenses:||One pair every 12 months|
|Frame:||One frame every 12 months|
|Contact Lenses:||One pair every 12 months|
The Policy provides full coverage for Covered Services when you go to a Participating Provider of the MESVision network. If Covered Services are provided by a Non-Participating Provider, charges will be paid, but not to exceed the following Schedule of Allowances.
|Schedule of Allowances|
|Services||Participating Provider||Non-Participating Provider|
|Ophthalmologic Examination||Covered||Up to $ 60.00|
|Optometric Examination||Covered||Up to $ 50.00|
|Single Vision Lenses||Covered||Up to $ 43.00|
|Bifocal Lenses||Covered||Up to $ 60.00|
|Trifocal Lenses||Covered||Up to $ 75.00|
|Progressive Lenses||Up to $89.50||Up to $ 75.00|
|Polycarbonate Lenses*||Up to $85.00||Up to $ 55.00|
|Aphakic or Lenticular Lenses||Covered||Up to $ 120.00|
|Frame**||Up to $90.00||Up to $ 40.00|
|Contact Lenses ***|
|Medically Necessary||Covered||Up to $ 250.00|
|Cosmetic or Convenience||Up to $105.00||Up to $ 100.00|
*Polycarbonate Lenses for dependent children through 18 years.
**Participating Providers allow a selection of frames that retail up to $90.00 with lenses that fit an eye size less than 61 millimeters. If a more expensive frame is selected, you are responsible for the additional cost above $90.00. If the lenses received are 61 millimeters or above, the charge for the oversize lenses is your responsibility. Retail frame benefits will be converted to wholesale equivalent prices at certain provider locations, see our website or provider directory for further information.
***This benefit is in addition to the comprehensive vision examination, but in lieu of lenses and frame. If contact lenses are for cosmetic or convenience purposes, the Policy will pay up to $105.00 toward the contact lens evaluation, fitting costs and materials. Any balance is your responsibility. If contact lenses are medically necessary, they are a fully covered benefit. Approval from MESVision is required. Please refer to your Policy if you require additional information.
Discounts: A 20% discount is available for cosmetic extras, such as tints, coatings and other add-on charges to standard lenses, after Covered Services are rendered. The discount may be applied to charges for the frame or contact lenses (except disposable or replacement contact lenses) over the stated allowances. The 20% discount also applies to additional pairs of glasses and/or pairs of standard contact lenses. To determine whether a provider offers the 20% discount, an insured individual can review their Participating Provider Directory, call MESVision or visit www.MESVision.com. Discounts are available through TLCVision for conventional and custom LASIK procedures with the TLCVision Advantage Program.
If you have any questions about your vision benefits, please contact:
Medical Eye Services
PO Box 25209
Santa Ana, CA 92799
800/877-6372 or www.MESVision.com