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OCT Vision Benefits
National Vision Administrators
National Vision Administrators (NVA) is the administrator for your vision benefits. Your vision program allows you the freedom to visit any provider; however, you will pay less out of pocket for covered services by staying in-network. NVA offers access to a large network of eye care providers from which to choose. If you choose to go out of network, the Fund will pay a portion of the cost of an eye examination, glasses, lenses or contacts for you and your eligible dependents.
Schedule of Benefits
Benefit Frequency |
Partcipating Provider |
Non-participating Provider |
EXAMINATION
Once Every 12 months |
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Reimbursed Amount:
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LENSES
Once Every 12 months
- Single Vision
- Bifocal
- Trifocal
- Lenticular
- Progressive – Tier 1
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Standard Glass or Plastic
- Covered 100%
- Covered 100%
- Covered 100%
- Covered 100%
- Covered 100%
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- Up to $30
- Up to $40
- Up to $50
- Up to $50
- N/A
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FRAME
Once Every 12 months
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Retail Allowance
20% discount off balance
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CONTACT LENSES
Once Every 12 months
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In lieu of Lenses & Frame
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In lieu of Lenses & Frame
- Up to $60
- Up to $20
- Up to $30
- Up to $50
- Up to $60
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Exclusions and Limitations
No benefits are available for the following services:
- Professional services and/or materials in connection with: Plano (non-prescription) lenses; Aniseikonic Lenses; Subnormal visual aids; Orthoptics, vision training, developmental vision procedures, and any associated supplemental testing.
- Broken, lost or stolen lenses, contact lenses, or frames. NVA network providers may offer additional warranties to cover materials.
- Services or materials, which are payable under any workers’ compensation act, similar law or any public program, other than Medicaid.
- Services or materials rendered by a provider other than ophthalmologists, optometrists, or opticians acting within the scope of their licensure.
- Any additional service required outside basic vision analysis for contact lenses, including but not limited to fitting fees, unless otherwise specified in the Proposed Schedule of Benefits.
- Services rendered after the date a person ceases to be covered under this policy, except when vision materials ordered before coverage ended are delivered and the services rendered to the person within 31 days from the date of such order.
- Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under plan.
- Medical and/or surgical treatment of the eye, eyes or supporting structures.
- Two pairs of glasses in lieu of bifocals.
Finding an In-Network provider
Visit www.e-nva.com and select the “Find a Provider” link. Enter your group number 1369000001 and your search parameters. You will also have access to the frame inventory of network providers near you. You may also nominate a provider to our network by completing the online form within your member portal. The NVA Mobile App offers this same convenience.
Non-Participating Providers
You will be responsible for 100% of the cost at the time of service at a non-participating provider. You can request a claim form from NVA via the website www.e-nva.com or you may submit receipts along with a letter containing the member’s full name, patient’s full name, address, ID# and sponsoring organization to NVA, P.O. Box 2187, Clifton, NJ 07015.
Contacting NVA
For your convenience, NVA’s US-based Customer Service team is available 24/7/365 and can be reached at: 1-800-672-7723.
Benefits, Network & Claim Submission
Eligible members and dependents are entitled to receive a vision examination and one (1) pair of lenses and a frame OR contact lenses and contact lens evaluation/fitting once every 12 months from last date of service. Refer to the Schedule of Benefits below for additional information.
Value-Added Services
- Fixed Pricing on Lens options (in-network only) - NVA offers members discounted fixed pricing on the most highly requested lens options through in-network providers. Members pay the lower of the fixed price or 20% off the provider’s usual and customary price. Members receive a 20% courtesy discount on lens options not listed under fixed pricing.
- EYEESSENTIAL® Plan Discounts for purchases after benefits are exhausted - up to 35%.
- Contact Fill – Substantial savings through NVA’s contact lens mail‐order replacement program.
- Lasik - 15% off standard prices -or- 5% off promotional prices.
- Hearing Discount – Between 30% and 60% off retail at participating provider locations.
- Glasses.com – NVA members can purchase brand name prescription eyeglasses and sunglasses on Glasses.com at a 30% discounted price.
- NVA Smart Buyer® Program - Tools & resources on NVA’s website that can save you money and increase your buying power when using your vision benefit.
- NVA Mobile App - Locate a provider, view benefits, access your ID card, discover Smart Buyer®
Upon enrollment, you will receive two identification cards with participating providers in your zip code area listed on the back. At the time of your appointment, simply present your NVA identification card to the provider or indicate that your benefit is administered by NVA. Your ID card is also available on the NVA Mobile App. The provider will contact NVA to verify eligibility. A vision claim form is not required at an NVA participating provider.
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