Open Enrollment Information
Health, Benefits, & Employee Services (HBE)
Phone: (505) 844-4237
Davis Vision provides the following three member options to obtain assistance:
The Davis Vision control code "7310" is required for new employees/members that have not been added to the Sandia and/or Davis Vision eligibility database.
DFE is a universally recognized critical diagnostic procedure in the detection and management of glaucoma, hypertension and many other ocular and/or systemic diseases. To perform this evaluation, the provider administers a diagnostic pharmaceutical agent (eye drops) that enlarges the patient's pupils, enabling the provider to examine the inside and rear of the eye.
Yes, the DFE diagnostic procedure is covered under the comprehensive exam benefit, when professionally indicated by the physician.
The Davis Vision Frame Collection is an exclusive "collection" of choice frames available at many in-network physician office locations. Purchasing from this frames collection affords members the opportunity to select high-quality frames while minimizing out-of-pocket expenses. To obtain more information on the Davis Vision Frame collection, go to the Davis Vision website.
The Davis Vision contact lens formulary only applies to all single-vision spherical lens purchases. The formulary is designed to offer members selecting contact lenses full allowance coverage (up to $100 plus 15% discount off overage), which includes evaluation, materials, fitting and follow-up care. To obtain more information on the Davis Vision Contact Lens Formulary, go to the Davis Vision website.
Davis Vision provides free membership and access to a mail order replacement contact lens service, Lens 123, providing a fast and convenient way to purchase replacement contact lenses at a significant savings. For more information, call 800-LENS-123 (800-536-7123) or visit the Lens 123 website at www.LENS123.com.
All Davis Vision frame collection eyeglasses include an unconditional breakage warranty for one full year. Contact members services 888-575-0191 to obtain additional information on the Davis Vision warranty policy.
The following list of lenses/coatings are included at no charge, if the member purchases the spectacle lenses from the Davis Vision Frame collection:
The following list encompasses the discounted fixed fees the member receives when purchasing services from in-network providers:
† Progressive addition multifocals can be worn by most people. Conventional bifocals will be supplied at no additional cost for anyone who is unable to adapt to progressive addition lenses; however, the copayment is not refundable.
Members can have a Personalized Provider List mailed to their homes at any time by contacting Davis Vision at 888-575-0191. Members can also download directories by logging on to the Davis Vision website.
The Sandia Vision Care Plan includes an out-of-network option; members can use any licensed provider, although you will receive the greatest value and maximize your benefit dollars if you select a provider who participates in the Davis Vision network. Members must pay the provider directly for all charges and then submit for reimbursement by completing a Davis Vision claim form and mailing the form and receipt to:
Davis Vision
Vision Care Processing Unit
P. O. Box 1525
Latham, NY 12110
To obtain a claim form, contact Davis Vision at 888-575-0191 or visit the Davis Vision website.
Members may nominate a provider for participation by contacting Davis Vision Member Services at 888-575-0191.
Members should report problems through Davis Vision Member Services at 888-575-0191. Davis Vision provides a 100% satisfaction guarantee. Therefore, if there is a challenge with a given office that cannot be resolved by the provider and patient, a replacement service will be provided at no additional cost.
Davis Vision selects providers on their basis of the professional credentials and reputations, and geographic network need. Davis Vision's extensive credentialing process is in accordance with NCQA standards, which assures that only the highest-quality providers are included in the network panel.
Davis Visions provider network is comprised of optometrists, ophthalmologists and opticians (in both private and retail locations), who are invited to join the network based upon their professional qualifications and reputations. Davis Vision maintains strict participation requirements to ensure that only the best providers are included in the provider network panel.
Laser vision correction surgery is not a covered benefit under the Sandia Vision Care Plan. However, Davis Vision does offer a Laser Vision Correction discount program through a network of ophthalmic surgeons nationwide who specialize in laser correction procedures. Members will be entitled to savings of up to 25% off the provider's usual and customary fees, or a 5% discount of any advertised special through a network of pre-eminent physicians affiliated with Eye Centers of Excellence. To locate a contracted network physician, go to Davis Vision website.
The Sandia Vision Care Plan, administered by Davis Vision, is designed to encourage regular comprehensive eye examinations, to help pay for eyeglass frames and corrective lenses, and to offset the cost of additional eyewear purchased through in-network (participating) providers.
| Benefit | Covered Participant Pays |
|---|---|
| Refractive Vision Exam * Contact lens exams may require additional fees Frequency: Every 12 months |
$20 |
| Frames Frequency: Every 24 months |
Any amount over $90 Note: Purchase from the exclusive Davis Vision frame Collection and you could reduce your out-of-pocket costs significantly |
| Prescription Lenses Single Vision, Bifocals, Trifocals, or Lenticular lenses Frequency: Every 12 months (in lieu of contact lenses) |
$25 Note: Fashion and gradient tinting, oversized lenses, and glass-grey #3 prescription sunglasses are included at no additional charge, if purchased from the exclusive Davis Vision Frame Collection |
| Contact Lenses (allowance must be used all at one time) Frequency: Every 12 months (in lieu of prescription lenses) |
Any amount over $100 Note: Ask your provider if Davis Vision contact lens formulary contacts will work for you. It could minimize your out-of-pocket costs for contact lens purchases |
Important: The exclusive Davis Vision Frame Collection is only available by request from in-network independent ophthalmologists and optometrists (not retail providers like Wal-Mart)
| Type of Expense | Scheduled Benefit Option (Out-of-Network) |
|---|---|
| Comprehensive Eye Examination * | Reimbursed up to $30 |
| Spectacle Lenses Single Vision Bifocals Trifocals Lenticular |
Reimbursed up to $30 Reimbursed up to $50 Reimbursed up to $60 Reimbursed up to $80 |
| Frames | Reimbursed up to $40 |
| Contact lenses in lieu of spectacle lenses) |
Reimbursed up to $80 |
| Type of Expense | Frequency |
|---|---|
| Comprehensive Eye Examination * | Once every 12 months (from last claim paid) |
| Spectacle Lenses Single Vision Bifocals Trifocals Lenticular |
Once every 12 months Once every 12 months Once every 12 months Once every 12 months |
| Frames | Once every 24 months |
| Contact lenses ** (in lieu of spectacle lenses) |
Once every 12 months |
* Excludes Kaiser Health Plan members - Kaiser members are required to use their Kaiser Health Plan to obtain refractive exams.
** Lenses—one pair of eyeglass lenses, or one pair of contact lenses, or one supply of disposable contact lenses (single purchase) in any 12 months
Davis Vision has contracted a network of providers that accept their discount plan for additional material purchases. All in-network providers have agreed to the discount plan.
Kaiser Health Plan members receive an optometry benefit already paid for by Sandia through the Kaiser medical plan monthly premium. The other medical plans do not offer this coverage.
The following items are not covered by the Sandia Vision Care Plan: