Voluntary Benefits – There’s An Eye Care Experience for Every Member

(And They Won’t Be Happy If It’s Not in Network!)

by Jason Rome

Vision benefits are getting a second look. There is renewed interest in this affordable, value-added ancillary benefit thanks to the Affordable Care Act (ACA), an aging workforce, more time spent working on computer screens, tablets and smart phones, and the eyewear industry’s success in blending medical utility with fashion.

A strong network is at the core of any solid managed care benefit; and vision is no different. When evaluating a vision network, it’s important to focus on what really matters to members and understand the full range of what is available in this dynamic area of healthcare. Most brokers prefer a vision network that can satisfy members across a diverse book of business. The following are some areas that deserve your focus when selecting a go-to vision plan:

The main purpose of eyewear is to meet a clinical need, but glasses are worn on our faces. Eyewear used to be just a medical device that people wore reluctantly. Now prescription eyewear is becoming such a desirable fashion accessory that many members purchase more than one pair. Still, there are also many employees and dependents who are cost-conscious and prioritize practical purchases.

Choice in a vision network is closely correlated to member satisfaction. Look for vision networks that provide access to quality customer experiences at every price point. It usually takes a mix of independent providers and retail optical locations to drive healthy enrollment across clients with diverse workforces.

Those of us in the vision benefit industry sometimes oversimplify network options by sorting all providers as independent or retail. But independently owned and operated practices run the gamut from tony eyewear boutiques in high-end shopping districts to neighborhood practices serving generations of the same family. And not all retail is created equal. National retailers offer a wide selection of designer frames along with the latest technology; some retailers are suited to young families; some focus on the economy buyer; and several regional chains have built strong brand identities and loyal customers through service and selection.

A Strong Network Offers Access to Innovation and Technology

A wave of innovation is just beginning with digital eye exams, ultra precise eyeglass fitting devices, frame try-on booths and virtual shopping apps. This wave of innovation will redefine what patients expect from their annual eye exams and eyewear selection. Watch for more providers and dispensaries using tablets to explain vision health, lens options and insurance coverage to their patients. Many members are satisfied and well served by a basic eye exam once a year in a very traditional practice, but many others appreciate having access to the latest advances. These members often associate technology with quality of care. Be sure to ask how many in-network locations offer access to technology that improves the clinical and dispensary experience.

Employees Want Vision Care That Fits Their Schedules

Nearly half of employees prefer evening and weekend vision appointments, according to a 2010 study from EMI Online Research Solutions, commissioned by EyeMed Vision Care. Members who want extended hours might want different vision care and eyewear shopping experiences. Many employees will not find their needs met by networks that only offer a few retail options for the economy shopper or networks with weekend and evening hours that are skewed toward higher-end providers. The optimal networks offer extended hours at a variety of locations.

Not Every Vision Plan Member Wants One-Stop Shopping

You might be surprised to learn that 69% of vision plan members prefer to get their exam at one location and then get their prescription glasses or contact lenses at another in-network location, according to The Vision Council. So, having a network with a variety of eyewear shopping experiences can be as important as a network with the most access points.

Many members have a long relationship with an independent vision provider, but prefer the selection of designer frames at a national retail chain. Some members want to complete exams for the whole family on one day at one network location, but choose different dispensaries for various family members. As ordering prescription eye glasses over the Internet becomes more common, I expect more vision benefits to include in-network online options.

Disruption Can Be a Good Thing In Vision Networks! Expect and Embrace It

Most brokers who deal with medical and dental benefits know that disruption is often a deterrent to employers considering a move to a new carrier or plan. In vision, disruption can be a good thing. When you give people more choice, they often exercise it. If an employer’s plan does not offer enough choice to meet the demands of a diverse workforce, switching to a plan with a more diverse network will often boost enrollment. Employees who are enrolled in the former plan are encouraged to shop around for an in-network option that better fits their priorities and preferences.  Of course, employees are likely to be dissatisfied if you try to move them from a vision network with ample choice to a network with fewer locations with extended hours and less access to the latest technology. If you must choose a smaller network to contain costs, I recommend looking into network options that still offer a wide variety of choices even if there are fewer in-network locations.

The Best Networks Make It Easy For Members to Find Their Vision Care Match

Employees are accustomed to using online or interactive tools when searching for consumer services, so why wouldn’t they want the same tools for selecting an in-network provider or dispensary? It just isn’t enough any more to offer an online directory that lists the names of participating network providers that can be searched by zip code. More search tools are widely available from vision benefit companies, showcasing the best that every network provider can offer, including hours of operation, available frames, and break-through technology for exams or eyewear selection. Members especially appreciate turn-by-turn directions to provider offices, as well as online scheduling. q

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Jason Rome is a vice president of EyeMed Vision Care. He is passionate about creating new ways that vision benefits can help brokers and EyeMed clients achieve their HR and business goals. Before joining EyeMed, Jason was Vice President of Sales Operations for Staples, Inc., leading its $7 billion Contract B2B Division.  With more than 36 million members, EyeMed Vision Care is the nation’s second largest vision benefits company and the fastest growing. EyeMed contracts with more providers and provider locations than any other vision benefits company in the U.S., offering members a robust selection of independent providers as well as access to several top national optical brands, including LensCrafters, Pearle Vision, Target Optical, Sears Optical and JC Penney Optical.

Six questions to ask when evaluating vision networks

Brokers don’t have the bandwidth for vision that they do for medical or dental, but you can’t afford not to make a solid recommendation. Ask the following questions to gauge how well a vision network would satisfy members across your book of business:

1. Does the network offer a large selection of private practitioners and retail options?
2. Does the network offer choices for different -consumers? Consider the members who prioritize designer frames and selection as well as the economy shoppers. Don’t forget those who want to have their exam in one location, but shop for frames and lenses somewhere else.
3. Are there in-network options within 10 to 20 miles of most residences in your territory?
4.Does the network offer ample locations open during evenings and weekends?
5.Does the network offer broad access to the latest technology in eye exams, fittings and lenses?
6.Does the provider locator give members the full picture about nearby network providers through a robust online tool? Can they access the provider information they want through a convenient app?