Vision Benefit Vision care from VSP
This page provides basic information about the Vision Service Plan (VSP) available through the UNITE HERE Local 11 Health Benefit Fund. For eligibility rules and full plan details, see the Summary Plan Description.
- Getting started
- What’s covered
- Find a provider
Begin using your VSP benefit in two easy steps:
1. Get an eye exam.
To use the VSP benefit, you must first have a vision exam and get a prescription for eyeglasses or contact lenses.
Participants Enrolled in an HMO Plan
If you are enrolled in one of the HMO Plans (Kaiser or Health Net) you must obtain your vision exam through your HMO, not through VSP.
Participants Enrolled in MLK Care
If you are enrolled in the MLK Care Medical Plan: you can obtain your vision exam from a VSP provider at no charge. You may also choose to use a provider who is not in the VSP network, and VSP will reimburse you up to $45 for your eye exam.
2. Create an online account.
It’s simple—create an account and log in to view your benefits! Once you’re logged in, you can access information about your vision coverage, view and download your member ID card, find an in-network provider, and more.
Log in or create an account at VSP.com to get started.
Vision benefits are provided to all eligible employees and their dependents, regardless of what medical plan you are enrolled in. You must be enrolled for medical coverage under one of the Fund’s medical plans to have vision coverage. Details about the vision benefit are described in Summary Plan Description in the Find Forms & Documents section of this website.
Lenses, frames, and contacts
VSP will provide benefits for frames and lenses (or contacts) as described below. In addition, if you are in the MLK Care Medical Plan, vision exams are provided every 12 months.
| Benefit | Participant Cost (using an in-network VSP provider) | |
|---|---|---|
| Standard Plastic Lenses: | Every 24 months | |
| Single vision | $0 copay | |
| Bifocal | $0 copay | |
| Trifocal | $0 copay | |
| Options such as UV coating, tint, anti-reflective coating, and polycarbonate lenses are available for an additional charge. | ||
| Standard Progressive Lenses | $0 copay | Every 24 months |
| Premium Progressive Lenses | Premium: $95-$105 Custom: $150-$175 | Every 24 months |
| Lens Options: UV Coating | $10-$16 copay | |
| Lens Options: Tint (solid and gradient) | $0 copay | |
| Lens Options: Standard Polycarbonate | $31 copay ($35 if multifocal lens) | |
| Lens Options: Standard Anti-Reflective Coating | $41 copay | |
| Lens Options: Other Add-Ons | Most lens enhancements are covered with fixed co-pays, saving participants an average of 25%. All other lens enhancements receive a 20% discount. | |
| Frames: Basic | Participant pays 80% of cost above $120 allowance | Every 24 months |
| Frames: Featured Brands | Participant pays 80% of cost above $140 allowance | |
| Contact Lenses: Conventional or Disposable | Participant pays 100% of cost above $120 allowance for lenses available every 24 months. Up to $60 copay for contact lenses fitting exam. Coverage for contact lenses is in lieu of benefits available for glasses. | |
| Contact Lenses: Medically Necessary (as determined by VSP) | $0 copay | |
| Additional Pairs of Glasses | Participant pays 80% of retail cost |
Laser Vision Correction
| Benefit | Participant Cost |
|---|---|
| Lasik or PRK (photorefractive keratectomy) | Participant pays 85% of retail cost |
The VSP benefit provides out-of-network benefits. However, if you use an out-of-network provider (i.e., a provider that is not contracted with VSP), benefits will be limited and you will need to call VSP or the Benefit Administrative Office for information about benefits.
For detailed information about the VSP Benefit, please refer to the Evidence of Coverage (“EOC”), available for download on the Forms & Documents page or by calling the Benefit Administrative Office.
Note: If there is a conflict between any description of the VSP Benefit contained on this website and VSP’s EOC or the Fund’s contract with VSP, the EOC or the contract with VSP will control. Please call VSP at (800) 877-7195 for a detailed benefit summary or refer to EOC.
VSP has an extensive network of providers throughout the United States. For a list of VSP providers, call VSP at (800) 877-7195 or visit their website at vsp.com.
Once you have located a VSP provider, you can call their office directly to make an appointment. There are no ID cards necessary or claim forms to complete when using a VSP provider; simply inform the provider that you’re a VSP member.