Vision

The Fund provides benefits for one eye exam and lens(es) per calendar year. The Plan’s fee schedule is as follows:

• Eye exam ($20)
• Lenses ($50)

The Fund presently has an arrangement with three vision care networks; General Vision Services (“GVS”), Comprehensive Professional Systems (CPS) and Vision Screening that have agreed to accept the Fund’s fee schedule for the selected eye care as payment in full. There is no out-of-pocket expense provided the lenses and frames you select are within the variety of lenses and frames offered under the Fund. Please call the Fund Office or click on the vision care network links above for lists of participating GVS, CPS and Vision Screening locations and phone numbers to call to schedule an appointment.

To submit vision claims, you must complete and return the appropriate form to the Fund Office:

• Commercial In-House Claim Form (PDF)
• School In-House Claim Form (PDF)

 

Lasik Surgery

Davis Vision is a participating vendor for Lasik surgery only. The Fund allows $1,000 per eye for Lasik surgery. You may contact Davis Vision directly at 855-502-2020 or log onto http://www.davisvision.com/ Once logged onto the Davis Vision website the client code for Local 94 Health and Benefit Fund is 7084. Learn more.

You may also obtain Laser Vision correction services from any non-participating provider you choose.

If you choose a non-participating provider, you will be responsible for paying any cost beyond the Health and Benefit Fund’s maximum allowance of $1,000 per eye for Laser Vision correction surgery.

In order to receive payment for a non-network provider you must complete the Anthem Blue Cross claim form and submit the claim directly to Anthem Blue Cross.

If you have to file a medical claim with Anthem for reimbursement, download and fill out the Anthem Claim Form (PDF). Once you fill out the form, mail it and any applicable documents to:

Anthem Blue Cross Blue Shield
P.O. Box 1407
Church Street Station
New York, NY 10008-1407