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Places for People, Inc.
2016 Annual Enrollment
2016 Page 7
VoluntaryVision Plan Summary
The Vision Plan will continue with Vision Benefits of America (VBA) effective January 1, 2016. Select a VBA Partici-
pating Provider in your area. When scheduling an appointment, please notify the VBA Participating Provider that your
vision is administered by VBA. The provider selected will contact VBA to verify eligibility via an on-line system and will
process services received electronically.
You will not receive an ID card as one is not required to obtain services.
Below is a highlight of the vision benefits.
Benefit/Service
In Network
Out of
Network
Examination Co-pay
$10 Co-pay
$40 reimbursement
Frequency of Service:
Exam
Lenses
Frames
Every 12 months
Every 12 months
Every 24 months
Lenses
Single
Bifocal
Trifocal
$25 Co-pay then
100%
100%
100%
Reimbursement
$40
$60
$80
Frames
Covered 100% up to
$150 retail
$50
Contacts
Necessary
Elective
Covered at 100%
$160
Reimbursement
$320
$160
Out of Network Services—You can choose to receive care outside of the Vision Benefits of America Vision network. You
simply get an allowance toward services and you pay the rest. (In Network benefits and discounts will not apply.) Just
pay in full at the time of service and then file a claim for reimbursement.
2016 Employee Vision Contributions
Vision Employee Cost
Monthly
Employee
$4.73
Employee & Spouse
$8.98
Employee & Child(ren)
$9.22
Employee & Family
$12.30
To find a VBA vision provider in your area, visit the website at
www.visionbenefits.com.
Click on “Search for Providers” on the left side of the page
Enter your zip code and hit the Search button
The search will generate a report of the Search Results, listing the providers closest to your zip code first
Clicking on the address next to the provider will display a map to the office
OR, you can call 1 (800) 432-4966 to speak with a Customer Service representative
Please Note!!
Before making an appointment for you or your dependent, please verify eligibility by
visiting ‘My Plan Benefits’ on the website - OR - by contacting customer service at (800) 432-4966.