Routine eye exams and eyewear are provided by all three medical plans for you and your family. Your vision plan benefits depend on which medical plan you have elected.
|If your medical plan is:||Your vision care program is:|
|Kaiser Permanente HMO||Kaiser Vision (and also National Vision Administrators)|
|BlueChoice HMO||Davis Vision|
|CareFirst PPO||Davis Vision|
If you are enrolled in the Kaiser Permanente HMO Plan, you will be able to use the Kaiser Vision and National Vision networks for vision coverage. Eye exams require a $15 copay. You may also receive discounts on frames and lenses from in-network providers.
If you are enrolled in the CareFirst PPO Plan or the BlueChoice HMO Plan, you are eligible for vision benefits through Davis Vision.
Under the CareFirst PPO Plan, you must pay a $15 copay for an eye exam. You are limited to one eye exam annually. You can also receive discounts on frames and lenses when you use a Davis Vision provider.
Under the BlueChoice HMO Plan, you can have eye exams through Davis Vision for a $15 copay. Ophthalmologist visits through the HMO are free of charge with a referral from your primary care provider.
|Your Vision Benefits|
|Plan Coverage||NVA (included with Kaiser)||DAVIS VISION (included with BlueChoice)||DAVIS VISION (included with CareFirst PPO)|
|Vision Coverage (Active Employees)||Exams through HMO: $15; discounted lenses and frames through National Vision Administrators (NVA)||Exams through Davis Vision: $15 co-pay Ophthalmologist visits through HMO: $0 co-pay with referral from PCP; discounted frames and lenses through Davis Vision||Eye exam through Davis Vision: $15 One eye exam per calendar year; discounts on frames, lenses and contacts when you use a Davis Vision provider|
|Vision Coverage (Retired Employees)||Exams through HMO: NVA discounts are not available to retired employees and widows||Exams through Davis Vision: $15 co-pay Ophthalmologist visits through HMO: $0 co-pay with referral from PCP; discounted frames and lenses through Davis Vision||One eye exam per calendar year; discounts on frames, lenses and contacts when you use a Davis Vision provider|
|Eye Exams||$15 co-pay||$15 through Davis Vision $0 through HMO with referral from PCP||$15 co-pay at participating Davis Vision providers|
|Frames||You select any frame type from a participating provider and pay the wholesale price plus 50%. (You save because retail price is often 3 times the wholesale cost.)||Up to $70 retail: You pay $40 Over $70 retail: You pay $40 plus 90% of the amount over $70||Up to $70 retail: You pay $40 Over $70 retail: You pay $40 plus 90% of the amount over $70|
Prescription Safety Glasses are now available to ATU Local 689 members.
Am I eligible for Safety Glasses?
If you work in Maintenance or Construction, you are eligible for Prescription Safety Glasses. The members are eligible for this benefit once a year.
How do I get the Safety Glasses?
If you are eligible, you will need to complete an order form. You can download an order form or pick one up at the Transit Employees' Health & Welfare Plan office. Present the order form along with your vision prescription (including pupil distance) from your physician to the Transit Employees' Health & Welfare Plan.
Safety Glasses can be delivered directly to your home or to the Transit Employees' Health & Welfare Plan Office for pick-up.
What is the cost for this benefit?
The basic benefit, which includes single vision and lined bifocals, is offered at no cost to members. However, you are responsible for the extras.
For example, here are the costs of some common extras that can be ordered:
Where do the Safety glasses come from?
The Plan has an agreement with Safe Vision, LLC from St. Louis, MO to provide made-in-the-USA, ANSI-certified safety glasses. A representative from the company will be at the Plan Office the first three days of Open Enrollment. More details will be made available on this website as soon they are available.
Refer to the benefit booklet from your carrier or contact your carrier for limitations and exclusions to vision care services.
If you are not working, but you are still eligible for Plan coverage under the collective bargaining agreement, you may continue your coverage under the Plan by making monthly payments to the Plan during your period(s) of leave. You must notify the Health and Welfare office when you return to work.
If you are out on Workers’ Compensation, you must also make your monthly payments directly to the Health & Welfare Plan because they are not deducted from your paycheck or from your Workers’ Compensation benefits.
Payments are due on the first of the month. It is your responsibility to make your Health & Welfare payments on time. The Plan does not send notices of delinquent payments, nor will it send you a bill. If you do not make your payments on time, your coverage under the Plan will end. Consider permitting the Plan to deduct payments from your bank account. Contact the Plan for more information.
Coverage will retroactively end as of the monthly premium payment due date if the required monthly premium payment is not paid within 30 days from the due date (e.g., if the monthly premium payment for September, which is due on September 1, is not paid by September 30th, coverage would be terminated as of September 1). If coverage is terminated due to non-payment of the required monthly premium payment, you may again become covered (on a prospective basis) by sending in the required monthly premium payment for future coverage. Your coverage will re-start as of the first day of the month following receipt of the required monthly premium payment. You will not be permitted to retroactively reinstate coverage for any period of coverage that terminated due to non-payment of the required monthly premium payment.
If you are on a leave of absence for military duty, you are permitted to continue medical, dental, prescription drug, and vision benefit coverage under this Plan for you and your covered dependents in accordance with the Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA). Please see the “If You Enter Military Service” section on the Life Events page for more information.
If your coverage ends due to termination of your employment with METRO, you may be eligible for COBRA for you and your family. Although METRO will notify the Health & Welfare Plan of your termination, you are also encouraged to inform the Health & Welfare Plan to avoid any delay.
If you lose Plan coverage due to the termination of your employment or any other reason, you may want to look into purchasing health coverage through a Health Insurance Marketplace.