C o n n e c t i c u t C a r p e n t e r s H e a l t h F u n d P l a n

Vision

There are a lot of ways to correct your eyesight — from simple reading glasses to post-operative corrective lenses. And they can all be expensive — especially if you need to add special coatings or tints. The Health Fund offers you a vision care program through Davis Vision, Inc. (DVI).

If you go to a participating DVI provider, you’ll pay copays for your exam and the products you select. If you go to a non-DVI provider, you’ll be reimbursed up to $95.

You must get a voucher before your visit and use it within 60 days. To get your voucher:

call DVI at 1.800.999.5431
give the Social Security Number of the covered person to the DVI representative

Give the voucher to the provider and use it for all services for that visit.

If you don’t use a DVI provider, you must still get a voucher from DVI and return it to DVI with an itemized receipt. The same services and materials that are covered at DVI providers are covered at non-DVI providers.

Each covered person may have only one voucher per calendar year, and may get either glasses or contact lenses.

Carpenters may get one pair of safety glasses instead of regular glasses or contact lenses in a calendar year. Any covered person can get a pair of sunglasses instead of regular glasses in a calendar year.

DVI does not coordinate benefits with other vision plans.

Please refer to the separate DVI brochure for specific information on copays, services, materials and breakage warranties.

Laser vision correction is not covered. However, you can get a discount if you go to a DVI specified provider.

Vision Care

Full Spectrum

Full Health

Disabled Member

Retiree Full

When you select your glasses, you’ll pay nothing for the frame if you pick a non-Premier frame from the Tower Collection. In addition, the following lenses and coatings are included at no charge:

· Plastic or glass single vision, bifocal or trifocal lenses, in any prescription range

· Glass grey #3 prescription lenses

· Oversize lenses

· Post-cataract lenses

· Polycarbonate lenses (for dependent children and monocular patients)

· Fashion, sun or gradient tinted plastic lenses.

· Blended invisible bifocals

· Photogrey Extra ® (sun-sensitive) glass lenses

What Isn’t Covered?

Except for some situations already mentioned, some goods and services are not covered:

· More than one exam per year

· Medical treatment of eye disease or injury; vision therapy

· Contact lenses and eyeglasses in the same calendar year

· Special lens designs or coatings, other than those previously described

· Replacement of lost eyewear

· Plano (non-prescription) lenses

· Services not performed by licensed personnel