Vision Benefits

All three medical plans offer annual eye exams and eyewear for you and your family. Your vision plan benefits depend on which medical plan you have selected.

If your medical plan is:Your Vision Care Program is:
Kaiser Permanente HMOKaiser Vision (and National Vision Administrators)
Blue Choice HMODavis Vision
CareFirst PPODavis

National Vision HMO (For Kaiser Enrollees)

If enrolled in the Kaiser Permanente HMO Plan, you can use the Kaiser Vision and National Vision network for vision coverage. Eye exams require a $15 copay. You may also receive discounts on frames and lenses from in-network providers.

CareFirst/Davis Vision

If you are enrolled in the CareFirst PPO Plan or the Blue Choice 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 using a Davis Vision provider.

Under the Blue Choice 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.

Vision Benefit by Comparison

Plan CoverageNVA (included with Kaiser)DAVIS VISION (included with Blue Choice)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 a referral from PCP; discounted frames and lenses through Davis VisionEye 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 widowsExams through Davis Vision: $15 co-pay Ophthalmologist visits through HMO: $0 co-pay with a referral from PCP; discounted frames and lenses through Davis VisionOne 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 and $0 through HMO with a referral from PCP$15 co-pay at participating Davis Vision providers
FrequencyAnnuallyAnnuallyAnnually
FramesYou select any frame type from a participating provider and pay the wholesale price plus 50%. (You save because the retail price is often three times the wholesale cost.)Up to $70 retail: You pay $40. Over $70 retail: You pay $40 plus 90% of the amount over $70Up to $70 retail: You pay $40. Over $70 retail: You pay $40 plus 90% of the amount over $70
LensesFor example, per the schedule, your cost would be $31/pair for single-vision plastic lenses.You pay
Single: $35
Bifocal: $55 Trifocal: $65
You pay
Single: $35
Bifocal: $55
Trifocal: $65

Limitations and Exclusions

Refer to the benefits booklet from your carrier or contact your carrier for limitations and exclusions to vision care services

Prescription Safety Glasses

Prescription Safety Glasses for Local 689 members enrolled in Transit Employees Health & Welfare Plan.

If you work in Maintenance or Construction, you are eligible for Safety Glasses. Members are eligible for this benefit once a year.

The primary benefit is offered at no cost to the members. However, members are responsible for extras. For example, Progressive Bifocal is $30; Scratch Resistant Coating is $25; Anti-Glare Coating is $35; Anti-Glare is $40; Black Hard Case is $8.

Please visit www.safevision.net, select a pair of frames from the list below, and send us a copy of your prescription and pupil distance/frame selection for approval to .

SafeVision

Wrap Frames: SV20FS, Battery, Uverse, SV08, Streak, Quantum, Oakleaf

Traditional Frames: SV51, SVSS1, SVSS3, SVSS11, SVSS14, SVSS12.

Open Enrollment

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