Vision & Optical Insurance

Our agency is very active in the group and individual vision insurance marketplace. Whether you are investigating vision insurance for an individual, a group plan for a small start up, or a partially self-funded multi-state corporate group plan, our agency is prepared to assist you. We can help you evaluate your needs, survey the marketplace, prepare side by side plan and price comparisons for your review, and then help you implement the plan(s) that you determine best meet your objectives.

There are various ways to secure quotations for vision insurance through our agency. We do not expect nor even anticipate our clients or prospective clients to shop their insurance by themselves over the internet or through companies that purport to sell direct. On the other hand, we want to make your fact gathering as easy as possible. Thus we have the various tools on our website to assist you.

There are 1500 insurance companies in the United States, and only a handfull offer some type of vision insurance. Unlike medical providers, there has not been much consolidation in this arena. The largest vision insuring or vision claims processing companies in the U.S. are Vision Services Plans (VSP) Medical Eye Services (MES) Guardian Life, Principal Life Insurance Company, Nippon Life Insurance Company Aetna/Prudential, Blue Cross and then others have a small piece of the market . Also, many more companies choose to self insure their vision plans than medical. The California marketplace is dominated by the big carriers, VSP and MES.

Which Category are you in?

There are basically five Vision insurance categories that you might fit into.

• Permanent Individividual and Family Vision insurance Plans
• A Group Vision Plan for a Business with fewer than 10 W-2employees
• A Group Vision Plan for a Business with fewer than 25 W-2 employees
• A Group Vision Plan for a Business with over 25 W-2 employees
• Self Funded Group Insurance Arrangements for groups of 25 and above.

Permanent Individual or Family Vision Plans are available to persons that can qualify for coverage after completing the appropriate applications. In general the individual PPO or indemnity vision plans are inferior to their group insurance cousins. They tend to be relatively expensive, have long waiting periods for certain procedures to be covered. In addition, because they tend not to be tax deductible, one must weigh the benefits of the plans before blindly purchasing it for insuring sake.

Please call us to provide you with a custom vision insurance plan to meet your needs.

Companies with fewer than 10 employees secure group vision insurance plans through a host of Insurance Companies and Health Maintainence Companies HMOs who have a vision component, who compete for the business. There are very few exceptions from the Standard Indemnity / PPO plan providers, but the HMO plans do not normally have any type of waiting period restrictions. Like Medical Insurance, there has never been an easier time for small employers to purchase vision insurance than the present.

The rates carriers charge for employees in your company are usually determined by

• Age
• Previous Group Coverage
• Industry
• Actual Participation
• Enrollment Status (Single, Family etc.)

There are two subgroups in this under 50 category. Companies that employe 20 or more most comply with Federal COBRA laws that allow employees to continue coverage when they leave the company. Companies that employ less that 20 are required to comply with the CAL COBRA laws in the state of California. To begin the process of reviewing and securing coverage (link to the section that gives the options above)

Companies with fewer than 25 employees secure group vision insurance plans through various Insurance Companies and Health Maintainence Companies HMO s who compete for your business. Like Medical Insurance, there has never been an easier time for small employers to purchase vision insurance than the present.

The rates carriers charge for employees in your company are usually determined by

• Age
• Previous Group Coverage
• Industry
• Actual Participation
• Enrollment Status (Single, Family etc.)

There are two subgroups in this under 25 category. Companies that employ 20 or more most comply with Federal COBRA laws that allow employees to continue coverage when they leave the company. Companies that employ less that 20 are required to comply with the CAL COBRA laws in the state of California. To begin the process of reviewing and securing coverage (link to the section that gives the options above)

Companies with more than 25 employees secure group vision insurance plans through a number of Insurance Companies and Health Maintainence Companies who compete for your business. Like Medical Insurance, there has never been an easier time for small employers to purchase vision insurance than the present.

The rates carriers charge for employees in your company are usually determined by

• Age
• Previous Group Coverage
• Industry
• Actual Participation
• Enrollment Status (Single, Family etc.)

Companies that employ 20 employees or more must comply with Federal COBRA laws that allow employees to continue coverage when they leave the company.

There are various situations where partially self insuring all or parts of your vision insurance plan makes good business sense. For all practical purposes, Insuring Vision reimbursement plans for groups of people is not risky .Unlike medical plans where there can be unlimited benefits, or extemely high individual claims, vision plans tend to limit the benefit an insured can receive each year to $1,000 or $2,000. And, there are reliable utilization statistics that poinpoint the level of claims you might experience.

With this in mind, you would expect alot more self insurance for this risk.

So what does an insurance company really do relative to vision insurance?

Remember, vision insurance is not as much about taking on risk as it is about taking on administrative claim paying duties, protecting you against fraud and abuse, negotiating the deepest and best discounts with the vision providers, and keeping an arms length between your company and your employees vision hygene experience. The insurance companies are great at the above tasks, and quite often these benefits outway the potential benefits of self-insuring your own vision plan. Experience can count!

The most obvious opportunity to self insure is when the total financial risk in self insuring is less than the fully insured plan costs being offered to you, or you have sufficient accurate data on your employee population that indicates that self insurance is the only way to go. There are numerous potential advantages to self-insuring and there can be financial consequences for not doing your homework and embarking on this course of action. But as a general rule, Self Insurance Works! However maximizing the benefits of self insuring your vision plan involves wise selection of the administration organization and methods that you select to oversee your plans.