Vision insurance

Human Resources

Eligibility	Full and part-time benefit-eligible faculty, staff and retirees who meet University of Delaware age and service requirements
Plan Administrator	National Vision Administrators (NVA) (Sponsor # 51942000001)
Who Can Use this Benefit	Employee, spouse, eligible dependent child(ren)
Benefit	Service	Frequency*	Benefits In-Network	Benefits Out-of-Network
	Comprehensive Eye Exam	Once every plan year	Covered after $15 co-pay	Up to $50
	Standard Lenses	Once every plan year	Covered in full	Single Vision up to $40 Bifocal up to $60 Trifocal up to $80 Lenticular up to $100
	Frames	Once every two plan years	Up to $150 Retail** (20% discount off remaining balance over $150 allowance. Discount does not apply at Wal-Mart/Sam's Club locations.)	Up to $80
	Contact Lenses	Once every plan year in lieu of lenses/frames	Up to $120 Retail** (15% discount (conventional) or 10% discount (disposable) off remaining balance over $120. Discounts do not apply at Wal-Mart/Sam's Club locations or Contact Fill mail orders.)	Up to $120
	Medically Necessary (pre-approval from NVA required)		Covered in full	Up to $225
	Contact Lens Evaluation/Fitting (only covered if you choose contact lenses)		Covered in full	Daily Wear $20 Extended Wear $30
	*Plan Year is the period July 1 through June 30.
	**The insured is responsible for paying any charges in excess of this allowance.
Costs	Through the flexible benefits program, the University provides Flex Credit to cover the premium for full-time employees. Benefits for dependents and retirees are voluntary an available at an additional group-rate cost.
Spousal Coordination	Not applicable to this benefit

Current Plan Rates

Vision Coverage
	Total Monthly Rate	University Share	Employee Share
Vision Plan Administered by National Vision Administrators (NVA) for Active Employees and UD Retirees*
Employee	$4.42	$4.42	$0
Employee & Spouse	$9.50	$4.42	$5.08
Employee & Child(ren)	$7.16	$4.42	$2.74
Family	$13.06	$4.42	$8.64
*University of Delaware retirees are responsible for the Total Monthly Premium. There is no University contribution toward the cost of vision coverage for retirees or their eligible family members.

Previous Year Plan Rates

Vision Coverage
Valid 9/1/15-6/30/16
	Total Monthly Rate	University Share	Employee Share
Vision Plan Administered by National Vision Administrators (NVA) for Active Employees and UD Retirees*
Employee	$4.42	$4.42	$0
Employee & Spouse	$9.50	$4.42	$5.08
Employee & Child(ren)	$7.16	$4.42	$2.74
Family	$13.06	$4.42	$8.64
*University of Delaware retirees are responsible for the Total Monthly Premium. There is no University contribution toward the cost of vision coverage for retirees or their eligible family members.

COBRA Monthly Rates

Vision Coverage
New Rates Effective 7/1/16
	Total Monthly Rate	COBRA @ 102%
Vision Plan Administered by National Vision Administrators (NVA)
Employee	$4.42	$4.51
Employee & Spouse	$9.50	$9.69
Employee & Child(ren)	$7.16	$7.30
Family	$13.06	$13.32

Double State Share Benefit Rates

Vision Coverage
New Rates Effective 7/1/16
	Total Monthly Rate	University Share	Employee Share
Vision Plan Administered by National Vision Administrators (NVA)
Employee	$2.21	$2.21	$0
Employee & Spouse	$4.75	$2.21	$2.54
Employee & Child(ren)	$3.58	$2.21	$1.37
Family	$6.53	$2.21	$4.32

Human Resources

Benefits

413 Academy St. Newark, DE 19716 Phone 302-831-2171