Skip to main content

An Employer’s Guide to Vision Benefits (Costs, Coverages, and FAQs) 

Vision Insurance Guide

Over 150 million Americans wear eyeglasses, and 37 million wear contact lenses.

Without insurance, an annual vision exam generally runs about $100. 

And without insurance, the average cost of a pair of eyeglass frames is $242. The average price for eyeglass lenses is $113. That means the total, on average, is around $355.

In the same vein, the annual cost for contact lenses is between $200 and $300. Or between $500 and $700 if you have astigmatism.

These costs for one individual can be really expensive. And just imagine if you’re a family of four. (Or like my boss’s family, a family of 12!)

Vision expenses can quickly add up!

It’s no wonder group vision benefits are so highly valued by employees. But only about 50% of adults in the U.S. have vision benefits. 

If you want to provide your employees with a robust benefits package, adding vision coverage is a must. 

But can you afford it? What will it cost? Do all of your employees need to enroll? What will the benefits cover?

As an employee benefits broker, I routinely help my clients explore the possibility of adding group vision insurance to their medical benefits. And to help you consider this option for your business, I’ve written this brief guide that answers the most common questions I am asked.

In this article, I answer the top 11 questions employers ask:

  1. What are the benefits of adding group vision insurance?
  2. How many employees do I have to employ to qualify for group vision benefits?
  3. How much will it cost to add vision insurance for my employees?
  4. How can I get the best price on vision benefits?
  5. Does my company have to pay for my employees’ group benefits?
  6. We can’t afford to add vision benefits. Is there a creative way to provide vision benefits to my employees?
  7. What is covered on a vision benefits plan?
  8. What is NOT covered on a vision benefits plan?
  9. Can you add additional coverages to your vision plan?
  10. Do my employees have to go to vision providers in a particular network?
  11. Which insurance companies provide vision benefits in the Pittsburgh area?

 

What are the benefits of adding group vision insurance?

The most significant benefit of adding group vision insurance is employee satisfaction and talent recruitment. 

Consider these statistics.

  • 78% of employees reported they’re more likely to stay with an employer because of their benefits program.
  • 69% of employees say having a wider array of benefits would increase loyalty to their employer
  • 45% of individuals most heavily evaluate whether they will accept a job based on the  health benefits they are offered.

 

If you want to retain great employees or attract new talent to your organization, a robust benefits package is essential. And vision insurance should be part of that package.

How many employees do I have to employ to qualify for group vision benefits?

Almost all sizes of employers can qualify for group vision benefits. What will vary is the amount of employee participation you need to qualify for benefits. ‘

If you are a large employer with over 100 employees, you would need about 50% of your employees to enroll in your vision benefits. 

If you are a small group, you will likely need between 75% and 100% participation in the program. If you have just two employees, you’ll both need to enroll in the plan.

How much will it cost to add vision insurance for my employees?

Vision benefits are very affordable. The monthly cost per employee is anywhere from $2.50 to $8.00. If enrolling on a family plan, you can expect those costs to double.

How can I get the best price on vision benefits?

One way to get great rates on vision benefits is by adding these benefits to your health plan. Most group health companies will give a “multi-line” discount when you add benefits to your plan. If you add group dental or group life insurance to your plan, you may save even more.

Another way to get competitive pricing is by shopping multiple insurance companies. Different insurance companies will price their policies differently depending on what level of benefits you’re considering. 

Does our company have to pay for their vision benefits?

The three options for paying for vision benefits are:

  • Fully funded by the employer
  • Partially funded by the employer and partially funded by the employee
  • Fully funded by the employee

We can’t afford to pay for more benefits. Is there still a way to provide vision benefits to my employees?

You can opt to add vision benefits as a voluntary benefit to your employees’ health package. As a voluntary product, your employees can choose to enroll and pay for vision benefits. They also have the choice to opt ouhttp://voluntaryt of vision benefits. 

As the employer, your costs will be very minimal if you offer vision benefits this way. You will only need to pay for the administration of the benefit – the cost to make sure the premium is deducted from each enrolled employee’s paycheck.

Often this does not add any additional cost to you, the employer.

And, employees can benefit from this option as well. They can have their contributions deducted from the paycheck pre tax under your Section 125 plan.

What is usually covered on a vision benefits plan?

Vision benefits typically cover exams, lenses (both eyeglass lenses and contact lenses), and eyeglass frames. Depending on the plan, policyholders can use the benefits once every 12 months or 24 months. 

Most often, policyholders also have to choose between eyeglass lenses or contact lenses. Most plans don’t cover both in a policy year.

What is usually NOT covered on a vision benefits plan?

Vision insurance does not fully cover the following:

  • Coatings, polarization, featherweight lenses

There may be some coverage for these options, but policyholders usually have to pay at least a portion of the cost.

  • Designer eyeglasses

Your insurance will not cover the entire cost of designer eyeglasses. Often your vision provider will have a set of frames that your insurance will cover.

  • Bifocals 

Policyholders can purchase bifocals on the plan, but the total cost will not be covered.

  • Eye procedures

If you have an eye injury or require some kind of eye surgery, your plan will not cover those expenses. Your medical insurance should cover these expenses.

  • Cataract surgery

Cataract surgery is considered a medical procedure. Your medical insurance will have to cover this expense.

  • Lasik surgery

If you want to have corrective Lasik surgery, your vision plan will not cover this expense. Lasik surgery must be covered 100% by the patient.

Can you add additional coverage to the plan?

One upgrade that you can make to your vision package is a provision for the policyholder to purchase both contact lenses and eyeglass lenses in the same year. This upgrade will cost more. 

Do my employees have to go to vision providers in a particular network?

Most group vision insurance companies have an extensive network of providers that they approve for their group participants. Your employees may be able to get care outside of that network, but they may have to pay a greater portion of the cost.

Which insurance companies provide vision benefits in the Pittsburgh area?

The number of insurance companies that provide vision benefits in the Pittsburgh area is too great to list. However, here is a list of the top-ranking companies that serve our area. These companies provide excellent products and services.

  • Vision Benefits of America
  • Principal
  • Lincoln Vision Care
  • VSP
  • Eyemed
  • Davis Vision
  • Aetna
  • Highmark
  • UPMC

 

How can I explore adding vision benefits to my employees’ medical package? What next?

If you don’t currently offer vision benefits to your employees, it’s a great time to get started. Even if you are months away from your group health renewal, it’s good to let your benefits broker about changes you want to consider in the upcoming year. 

A great benefits broker will:

  • Perform a complete assessment of your current benefits package to identify its strengths and weaknesses. 
  • Have in-depth knowledge about the medical benefits market in your area.
  • Know which insurance providers will best satisfy your medical benefit goals within your budget.
  • Provide you with creative funding solutions to attain your benefits goals.

 

Your benefits broker should be an active partner in your employee benefits program.

If you don’t have this type of broker, it may be time to move on and find an expert to help you create a long-term strategy for your employee benefits program.

Working with Baily Insurance

At Baily Insurance, we are committed partners with our clients. Throughout the year, we team up with our clients to ensure that their benefits program effectively meets their needs. We also take an active role in helping our clients control their benefits costs.

If you operate a business in Pennsylvania, West Virginia, Maryland, or Ohio, our team would value the opportunity to sit down with you and take a deep dive into your current benefits program. 

Our clients have benefitted from our six-step strategy to create a robust benefits program and control their benefits costs. 

Rather than being surprised by unpredictable rate increases year after year, our approach allows our clients to budget for their benefits costs and have a good idea of what increases they may encounter.

If you’re ready to create a long-term plan for your business, let’s get some time on my schedule. You can give me a call at the office (724.627.6121) or reach out to me at aochs@bailyagency.com.

I am looking forward to connecting!

Aaron

Contact Me

  • Please do not include sensitive, private information in this area.
  • This field is for validation purposes and should be left unchanged.