VISION INSURANCE

Enrollment into vision coverage is linked to enrollment in medical coverage.

Employees and their eligible dependents enrolled in LAwell medical coverage will automatically be enrolled in vision coverage.
Employees electing Cash-in-Lieu will automatically be enrolled in the employee-only level of vision coverage. If they are covered as a dependent of another City employee, they will only receive one coverage benefit as a dependent.

Member Services: 877-635-6403
Blue View Vision provides care through a network of vision care specialists
who have agreed to offer covered services at discounted rates.

Blue View Vision Links

LAwellVision.org
Sydney Health Mobile App

Vision Plan Details

Annual Benefit Details

The benefits through Blue View Vision, including exams, frames, and either lenses or contacts, are available to you and your covered dependents once every twelve (12) months.

Your Blue View Vision Plan Benefits	In-Network	Out-of-Network	Frequency
Routine Eye Exam
A comprehensive eye examination	$10 copay	$Up to45 reimbursement	Once every 12 months
A comprehensive eye examination at a PLUS Provider	$0 copay	Not covered	Once every 12 months
Eyeglass Frames
One pair of eyeglass frames	$150 allowance, then 20% off any remaining balance	Up to $104 reimbursement	Once every 12 months
One pair of eyeglass frames at a PLUS Provider	$200 allowance, then 20% off any remaining balance	Not Covered	Once every 12 months
Eyeglass Lenses (instead of contact lenses)
One pair of standard plastic prescription lenses:
Single Vision lenses Bifocal lenses Trifocal lenses Lenticular lenses	$10 copay $10 copay $10 copay $10 copay	Up to $35 reimbursement Up to $70 reimbursement Up to $65 reimbursement Up to $65 reimbursement	Once every 12 months
Eyeglass Lens Enhancements When obtaining covered eyewear from a Blue View Vision provider, you may choose to add any of the following lens enhancements at no extra cost.
Transition Lenses (for a child under age 19) Standard polycarbonate (for a child under age 19) Factory scratch coating Retinal imaging (obtained during covered eye exam)	$0 copay $0 copay $0 copay $10 copay	Not Covered Up to $28 reimbursement Not Covered Up to $21 reimbursement	Same as covered eyeglass lenses
Contact Lenses (instead of eyeglass lenses) Contact lenses allowance will only be applied towards the first purchase of contact made during a benefit period. Any unused amount remaining cannot be used for subsequent purchases in the same benefit period , nor can any used amount be carried over to the following benefit period.
Elective conventional (non- disposable)	$150 allowance, the 15% off any remaining balance	Up to $120 reimbursement	Once every 12 months
OR
Elective disposable	$150 allowance (no additional discount)	Up to $120 reimbursement
OR
Non- elective (medically necessary)	Covered in full	Up to $120 reimbursement

Eyeglasses & Contacts Benefit

Your benefits through Blue View Vision include either eyeglass lenses or contact lenses every 12 months. You may select one of the two options below:

• Option 1: $150 contact lens allowance + $150 frame allowance (Eyeglass lenses are not covered.)

• Option 2: Eyeglass lens copay benefit options + $150 frame allowance (Contact lenses are not covered.)

Additional Benefits

Retinal Imaging benefit

Retinal imaging uses a laser to scan the eyes and then produces digital images of the retinas. The images can be useful in finding abnormalities and comparing the condition of retinas from year to year. You may receive one retinal screening every 12 months for an additional $10 copay.

Diabetic Eye Care benefit

Your vision plan will include a benefit that provides follow-up care and supplementary diagnostic testing for members with type 1 or type 2 diabetes. With this benefit, eligible members can obtain an additional vision evaluation every six months to detect or monitor signs of diabetic complications. Diagnostic testing once every six months, including fundus photography (retinal imaging), extended ophthalmoscopy, gonioscopy, and laser scanning, is available with no in-network copay, subject to provider determination. An out-of-network reimbursement is also available.

Access Vision Services

Find a Provider

To access benefits, an ID care is not needed, just provide your name and date of birth to an in-network Blue View Vision provider to locate you in their system.

Although ID cards are not needed, they can be printed by visiting LAwellvision.org.

To find a network provider near you:

Visit LAwellvision.org and click “Find an Eye Doctor”

Download the Sydney Health mobile app (available in the Apple App Store and Google Play Store) and choose the Insight network from the list of network options.

Call the Blue View Vision Customer Care Center at 877-635-6403

Create an Online Account

To register an online account with Blue View Vision, visit the City of Los Angeles Blue View Vision microsite at LAwellVision.org

Upon your first visit, you will need to enter your:

First and last name
Date of birth
Last four digits of your SSN

In-Network Providers

The Blue View Vision plan provides care through a network of vision care specialists who have agreed to offer covered services at discounted rates. The Blue View Vision network has over 42,000 providers, at over 32,000 locations including independent providers plus national retail chains such as LensCrafters®, Target Optical®, and most Pearle Vision® locations.

Note that individual optometrist participation in any network is subject to change at any time, as optometrist and facility participation in a network is contractual.

Out-of-Network Providers

You can visit a vision care provider who does not participate in the Blue View Vision network and still receive benefits for covered services. You will be reimbursed up to a maximum dollar amount if you provide Blue View Vision with an itemized receipt and a completed claim form. Claim forms are available at LAwellvision.org or by calling the Blue View Vision Customer Care Center at 877-635-6403.

How Blue View Vision Benefits Work with Medical Plan Vision Benefits

Your medical vision services (Ophthalmology) are unchanged and still managed by your medical plan provider. This change to your stand-alone vision provider has no impact on your medical benefits.

Anthem and Kaiser members who prefer to receive an annual vision exam through their medical plan providers may do so but are not entitled to an eyewear allowance through their medical plan. Eyewear (frames, lenses, and contacts) received from a medical plan provider may be submitted to Blue View Vision for reimbursement as an out-of-network provider. Members may also visit a Blue View Vision in-network provider using their medical plan provider prescription and purchase eyewear using their Blue View Vision materials benefit.

The table below outlines how your Blue View Vision benefit can be used with your medical plan. Note: Allowances may vary per specific benefit, based on the type of benefit item purchased, and do not apply to all benefits.

Description	Blue View Vision	Kaiser	Anthem
Routine Eye Exam	Covered with copay	Covered with copay	Not covered
Eyewear – Frames, Lenses, or Contacts	Up to $150 allowance every year (does not roll over if not used)	Not covered (Partial reimbursement available from Blue View Vision if member files an out-of-network claim.)
Medical Eye Exams (e.g., screening for medical vision conditions like glaucoma and cataracts)	Check with Blue View Vision provider before seeking medical/ ophthalmology-related services	Covered with copay	Covered with copay Primary care physician (PCP) referral and/or medical group authorization may be required under HMO plans. Please contact your PCP for information regarding their referral process before seeking care from a specialist.
Treatment of Vision Conditions (e.g., glaucoma and cataracts)	Not covered	Covered with copay	Covered with copay Primary care physician (PCP) referral and/or medical group authorization may be required under HMO plans. Please contact your PCP for information regarding their referral process before seeking care from a specialist.