Economic Evaluation Group, Inc.
A Concierge Employee Benefits Consulting & Brokerage Firm
Working with an experienced professional from Economic is the best way to ensure that your company will have the right type of vision benefits. We represent every major carrier and will help find the plan that suits your needs. The information below is intended to provide a basic understanding of how vision plans are structured and to introduce you to some commonly used terminology.
Traditional vision plans reimburse you for all or a portion of the usual and customarycharges. After receiving services from the ophthalmologist of your choice, you must file a claim. If your doctor is a member of the network, you may be charged an even lower rate due to a negotiated discount rate between the doctor and the provider. If you incur a charge for a service or supply that is considered higher than the usual and customary charge in your geographic area, only the usually and customary charge is covered.
Generally, a charge by your doctor or by any other vision provider is considered usual and customary if it does not exceed the usual and customary charge for the service or supply by others of similar profession in the same geographic area. The specific benefits of each plan vary from provider to provider, but as a general rule, traditional plans are reimbursement plans usually subject to a deductible and coinsurance. It is also common for a traditional plan to have a maximum benefit. Most plans will cover the cost of frames, lenses and exams on an annual basis, but again are subject to deductibles and coinsurance.
With discount plans, vision carriers negotiate a reduced fee with the doctors inside their networks helping you save on the regular prices. As a general rule, discount plans are not subject to deductibles or coinsurance and have no annual maximums or minimums. There are no claim forms required, waiting periods or pre-existing condition exclusions. Although there are no out of network benefits covered, there is usually no referral necessary to see a specialist. Discount dental plans tend to be very affordable and sometimes offer limited vision benefits as well as basic prescription drug coverage.
Economic Evaluation Group, Inc.
© 2018 Economic Evaluation Group, Inc.
Copyright© 2018 Economic Evaluation Group Inc. Revised: 08/04/2018 Content subject to change at any notice. Not responsible for typographical errors.
Economic Evaluation Group, Inc. Specializes in Group Health Insurance (Group Medical Insurance). EE Group is located in Melville, Long Island, New York and service all over the United States and Canada.
Economic Evaluation Group is currently Licensed in Arizona (AZ), Arkansas (AK) California (CA), Connecticut (CT), District of Columbia, (DC), Florida (FL), Georgia (GA), Illinois (IL), Kentucky (KY), Maryland (MD), Massachusetts (MA), Maine (ME), Michigan (MI), Minnesota (MN), Missouri (MO), New Hampshire (NH), Nebraska (NE), New Jersey (NJ) , New York (NY) , North Carolina (NC), Oklahoma (OK), Pennsylvania (PA), Texas (TX), Vermont (VT), Virginia (VA). NOTE: If your state is not listed we can easily add the state license.