How To Maximize Vision Benefits For All Workers

Vision care was recognized as a necessary healthcare standard when it was included as one of the 10 essential benefits mandated by the Patient Protection and Affordable Care Act (PPACA) of 2010. As such, vision care benefits have become part of the triad of an employer benefit package: health, dental and vision.

That’s a good thing since, according to the National Eye Institute, more than two-thirds (66 percent) of US workers 18 and over report that they wear eyeglasses, contacts or both. Whether offered as voluntary or employer-paid, vision benefits can significantly reduce out-of-pocket costs for eye exams and corrective lenses. With the average national cost of eyeglasses at about $196 a pair, employers that offer a comprehensive plan with coverage for annual vision examinations and eyewear benefit levels can save workers hundreds of dollars a year.

Past research by the Vision Council discovered that the average employer achieves a return of $7 for every $1 invested in vision benefits. While vision benefits are relatively low cost for employers to offer, they can be high value to both workers and even the company’s bottom line.

One of the critical drawbacks is not the benefit itself, but getting more workers to use it. While healthcare is considered a must and adults have long accepted that they need two dental checkups a year, they are less apt to recognize the value of an annual eye exam. However, there are vital reasons to promote it. 

Productivity

Myopia, also known as nearsightedness, affects approximately 42 percent of the US population. When it goes undiagnosed, it can cause mistakes and safety issues. Even in the best case scenario, a worker who does not realize his vision is compromised may not be able to meet his full potential on the job. In fact, he may not realize that symptoms such as headaches, fatigue from eyestrain, and visual discomfort can stem from vision problems. Unfortunately, even slightly flawed vision can diminish productivity by as much as 20 percent.

Without even realizing their symptoms emanate from vision problems, workers are more likely to take sick days due to these issues. All of this can lead to substantial productivity loss. According to a study in the American Academy of Ophthalmology, productivity loss associated with myopia costs $8 billion per year in the US, and $244 billion worldwide.

Health

Eye exams can reveal more than vision problems. They also can detect general symptoms of medical conditions such as multiple sclerosis, STDs, Alzheimer’s, tumors, thyroid disease, high cholesterol, diabetes, high blood pressure, and even brain tumors and certain cancers. Consider that a general physician does not have the equipment available to detect underlying symptoms such as blurred vision, which is one of the first signs of diabetes.

To encourage utilization, employers have a number of tools available to help workers maximize this benefit so that it is easier to understand, easier to afford, and easier to access. 

Stay In Network

It’s important to know your workforce, including such details as where they live, shifts they work, and languages spoken. This can help you choose a vision benefit provider with a network of eyecare professionals that meet your workers’ needs in terms of proximity, hours, languages spoken, and types of services offered. While some vision plans include limited coverage for out-of-network providers, it’s important to promote in-network usage so that members can take full advantage of their benefit to save out-of-pocket costs.

Perks

Remember that while all workers and their families can benefit from annual eye exams, many will not have flawed vision and may feel they do not need to enroll for vision benefits. Consider sweetening the offer by providing sunglasses coverage; that way workers who don’t need corrective lenses can use their frame allowance for non-prescription eyewear.

Help Explain Coverage

It’s important that members understand their vision benefits before they see a provider, so it doesn’t become a negative experience when they are required to pitch in their share of the cost. Provide an easy-to-access and easy-to-read description of coverage that defines terms such as co-pays and coverage limits per plan year, as well as the member’s share of costs for:

• Basic preventive care such as eye exams and vision tests
• Contact lenses (including any coverage for daily disposable contact lens)
• Eyeglass lenses
• Eyeglass frames
• Lens protection for glasses, such as scratch-resistant coating
• Corrective eye surgery such as Lasik
• Preventive care options, such as blue light protection on lenses to reduce the impact of light emitted from digital devices

Offer an FSA

By now, many workers are familiar with a flexible savings account (FSA) used for healthcare expenses. However, they may not realize they can use those savings for vision care services or products such as contact lenses, Lasik surgery and eyeglasses. Even if the member sets up a plan for specific ongoing healthcare expenses, she may have excess money in the account that she’ll lose if not used by year-end. Be sure to promote using FSA funds for vision expenses, particularly in the fourth quarter so members can take full advantage of both vision coverage and their FSA savings. 

Discounts

Some employers may choose to offer a vision discount plan rather than vision insurance. Vision discount plans generally cost less than vision insurance, but impose higher out-of-pocket expenses on members for visits and eyewear. However, in addition to eye exams and eyeglasses, many vision discount plans offer significant savings on services that a limited insurance plan may not cover, such as Lasik surgery.

Telemedicine

Thanks to stay-home orders due to the coronavirus pandemic, telemedicine is fast becoming a prevalent healthcare trend, even for vision care. Some vision providers have begun to offer virtual eye exams that can check basic visual acuity and help determine the need for eyewear via do-it-yourself applications.

Campaign Reminders

Just offering vision benefits is not enough; employers should actively promote them to increase utilization rates. Send periodic exam reminder emails and/or text alerts to enrolled workers. Offer information about what to expect during an eye exam and a list of questions to ask.

It’s a good idea to align your promotional reminders with certain times of the year. For example, near year-end when FSA participants could use excess funds for an extra pair of eyeglasses. Or, remind members to schedule an eye exam for their children during the summer months in preparation to go back to school. Remind them of the importance of eye exams at every age, from young children to the elderly – and those all-important teenage years when many are first diagnosed with myopia. Undetected vision problems can lead to poor performance in school; often times no one realizes the reason is related to vision.

As for adults, the Mayo Clinic offers the following recommendations for eye exam frequency:

• Ages 20-39 – Every five to 10 years
• Ages 40-54 – Every two to four years
• Ages 55-64 – Every one to three years
• Ages 65+ – Every one to two years

A recent study found that while most people rate vision as their most important sense, only half had had an eye exam in the past year. Like healthcare, the purpose of vision benefits is twofold. The first is reactive; many people will seek out an eye exam whenever they experience vision problems. However, the second is preventive. It’s important to diagnose ocular and systemic conditions early on for better overall health outcomes. Additional benefits include higher worker productivity and reduced healthcare expenses.

While relatively low in cost, vision benefits traditionally have been under-valued in terms of the high return on investment they offer. The key is achieving high utilization rates by promoting and maximizing vision benefits for all workers.

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