With 8 in 10 adults needing some type of vision correction, employees are much more likely to go for an annual vision exam than to schedule an annual physical with their primary care physician. Over the years, study after study has shown numerous diseases can be detected through an eye exam. For example, a VSP study of 120,000 of its members found that, over a four-year period, eye doctors were the first to detect signs of diabetes 34% of the time. For hypertension it was 39%, and for cholesterol it was 62% of the time, according to Dan Schauer, SVP and general manager at VSP Vision Care.
But what happens to all the health data collected by vision providers is quickly becoming the next frontier in comprehensive health care.
VSP will not only trade data with health plan partners, but also has reminder programs that encourage people who have shown signs of diabetes, for example, to get their annual eye exam, Schauer says.
Advisers who excel in the vision field do the best job of making the connection between vision and medical plans, he adds. They really turn it into a complete health plan solution. So theyll have not just benefit experts talking about the blocking and tackling of a vision benefit, but theyll also have health care conditions that can tie it all in, Schauer says. Some of the top benefit advisers do an excellent job of that. So they not only address the compliance and administrative issues, but they also look at cost drivers that can help lower overall costs.
This is true for Shannon Enders, a founding partner at Lakeshore Employee Benefits in Norton Shores, Mich., whos found when he brings the idea of connecting vision and health data to clients attention, they quickly become very interested.
Naturally, Enders self-funded medical clients have always been more interested in an overall return on investment vision plans return $1.45 for every dollar spent, VSP finds but lately, that rule of thumb has applied to an increasing number of clients, as the self-funded market goes downstream to groups as small as five to 25.
Thats a whole new pool of group-size organizations that all of a sudden are really interested in things like what kind of ROI do I get by putting vision in or by putting dental in those types of things that are tied to overall health, says Enders.
However, Mark Abate, partner at Strategic Benefit Advisors in Southborough, Mass., cautions that the connection between vision data and health data is underdeveloped. There is not a lot of coordination between third party vision programs and the national health plans, he says. Most of the national health plans offer a vision benefit thats included as part of their health care benefit, so the capability exists. The pipes are all laid between the independent vision plans and the health plans.
EyeMed Vision Care President Lukas Ruecker says the key is two-way integration with the medical provider. You need both sides of the equation to work, he says.
For EyeMed, it helps that a large percentage of the companys business is with the largest medical insurance carriers in the country, which makes it easier to integrate the data on the medical side. Data is sent from the vision provider to the medical plan, but relevant medical information is also sent from the medical plan to the vision provider at the point of service, Ruecker explains.
Its a two-way integration where the vision plan not only feeds information into the wellness package, but actually gets information from the wellness package to create an even better vision exam at the point of service, he says. If you are an adviser today, you need to make sure that both sides of the equation are equally responsive to it. The information is not useful if the other side is not accepting it.
At NextLogical Benefit Strategies in Westminster, Md., Lucille Listorti, VP of client services, says the firm regularly collects client medical data through VSP. Theyre identifying people who are diabetic, have glaucoma, hypertension, high cholesterol. And theyre feeding that information over to us so that we can evaluate medical management, she says.
NextLogical also offers clients a comprehensive wellness program, and while vision exams are not a requirement, employees do earn points for completing one annually, adds Danielle Herndon, a registered nurse and VP of medical management at the brokerage.
Proper vision care can also contribute to overall wellness by boosting employee productivity. Employees who cant see well cant work as well, says Jonathan Ormsby, strategic account manager at Transitions Optical. The companys research has found employees want more protection from light, and options like photochromic lenses and anti-reflective treatments are growing in popularity. Nine out of 10 employees say that problems with their vision have negatively impacted their workplace productivity, he says.
Thats been the personal experience of Chip Knoop, senior consultant with CBIZ Benefits & Insurance Services, who spends five to eight hours a work day staring at his laptop. My eyes get tired, he says. It was not until my most recent eye exam that I mentioned this to my optometrist and he said, What you need is some reading glasses that are specially made for being in front of a computer. It should ease your eyes and everything else. Quite frankly, it has. From my standpoint, Ive become more productive.
Whos paying for it?
Overall, Lakeshores Enders doesnt think of vision coverage as an insurance product, but rather a better way to spend the dollars youre already spending. He says, Life insurance, disability, those are risk products that protect you against catastrophic loss. Nobodys going to lose their home if they have to pay for vision out of pocket.
Employers rarely pay 100% of the premium on vision coverage anymore, which makes sense, Enders says, since many employees will already have vision coverage elsewhere. Instead, employers will more often pay for some premium, or single coverage only and allow employees to buy up for dependents. Most recently, hes had an increasing number of clients offer vision as a voluntary benefit alone, with the employer paying nothing.
The change has not affected the popularity of vision benefits. Our participation has been fantastic, says Enders. With traditional voluntary enrollment, employee pay-all, we might see 10%, 20%, maybe a little higher, enrollment. Were enrolling 50%, 60%, 70% of the people in vision where the employer is not paying 100% of the premium.
Its about putting yourself in the employees shoes, Enders says, to ensure the greatest level of satisfaction with the plan. For example, going with the cheapest premium may sound appealing, but Enders says the extra out-of-pocket costs that accompany it are not worth it. Id rather put in a vision plan that cost $10 a month than $8 and have the member satisfaction be through the roof, he says.
When negotiating a plan design, Enders aims for low copays and built-up frame and lens allowances.
Lets say that puts the single rate at $14 instead of $9, he says. When they use it, theyre delighted because theyre not nickel and dimed every time they turn around.
Listorti, of NextLogical, aims to include things such as progressive and polycarbonate lenses, along with anti-reflective coating, which are the three most common non-covered benefits. If not included in the vision plan, she will try to negotiate a 30% to 50% discount on the price. The first rates that are proposed are not the final rates, Listorti says.
New products and plan flexibility
Expanded services and options offered on a fixed-cost basis are growing trends with vision carriers, says CBIZs Knoop. For example, parents may be interested in upgrading their kids lenses to transitioning ones that will easily go from the classroom to the playground, he says.
EyeMed offers an app that not only allows plan members to find a location-based doctor, but also helps them to pick the exam they want, which frame brands are offered at that location and will schedule appointments for them, says Ruecker.
All of these things are ways to make it easier for the member to get the product they want, the experience they want, when they want it, he says. The clients we talk to most often, they have an interest in innovation.
A trend that has really taken off, says VSPs Schauer, is expanded choice. The company is in the process of rolling out a product that moves the time of product selection away from open enrollment to when the plan participant is in the doctors office. Its a point-of-service selection for your eye care benefit, he says. A family, the mom might be really into fashion glasses so shed want the $200 frame allowance. The dad might want contact lenses, so hed prefer the contact allowance. Maybe their kids just want sunglasses. So thats where I think its really headed, is around the choice side of it. Thats a big trend.
At Lakeview, Enders produces custom employee benefit booklets for clients during open enrollment, and whether its a group of 25 or 200, he and his team will be there personally to do employee meetings and answer any and all questions about the plan. Anything new that were offering, well spend a fair amount of time talking about it, he says, adding that payroll stuffers and posters next to time clocks are fine add-ons to promote awareness, but thats not the solution.
The best outcome is when a companys CEO introduces his team, Enders says, and specifically mentions the new product. It gives us credibility, he says, adding that he always sticks around for at least 30 minutes after a meeting in case additional questions come up.
We have found it really drives understanding far better than placing the documents on a company intranet and saying, Go there and read about your benefits, Enders says.
Efficient communication of a vision plan also means distinguishing its benefits from, say, a discount coupon found in the Sunday paper. Employers are increasingly interested in doing so, says Strategic Benefit Advisors Abate. The major eyewear retailers publish coupons regularly and there was a time there where it was difficult to discern the benefit that the vision plan provides versus just clipping the coupon and presenting the coupon at the time of purchase, he says. Employers have been looking at the vision benefit as more of a strategic element in their program and providing generous coverage
The employers have been looking to get more value out of the vision benefit plans.
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