Comparing cost vs. premiums for your employees’ vision care insurance benefits

Blog_Eye360
BENEFITS 101

When comparing vision benefits, many decision makers go straight to the plan premiums instead of thinking about how much employees will actually pay when using their coverage. But it’s important to look at the bigger picture and remember – premiums are the upfront price, not the actual cost of the benefits. 


EyeMed really stands out when it comes to comparing cost versus premiums. It’s one of the reasons why we’re America’s fastest growing vision company.1 


The difference between premiums and actual cost

The amount your employees owe at the checkout for their eye care services is separate from the price of a plan’s premium. And a better premium doesn’t always equate to a better deal. 

Here is a real-life example: 2 employees visit an eye care provider for a vision care exam, frames and standard progressive lenses with an anti-reflective coating. 

As illustrated in the sample chart below, the employee with Plan A pays $43 less in premium, but the employee with Plan B pays $120 less in total out-of-pocket costs at an in-network provider.2
 

Eye360 Blog support Graphic


As you can see, when it comes to vision insurance benefits – not all plans are created equal. Plan B simply has better benefits. Like a higher frame allowance, a lower lens copay and $0 copay for progressives. That means a much lower out-of-pocket cost for the member.


When comparing cost against premium, consider the following:

Compare coverage levels 
First make sure copays and allowances cover the same things. For example, a plan’s allowances may not cover both frames and lenses. While another plan’s allowance covers both a contact lens exam and the actual contacts. 


Don’t limit choices 
Some low premium carriers may limit how allowances can be used and what products they can be used for. So be sure to watch out for frame towers and lens formularies.


Know what drives out-of-pocket costs 
It’s helpful to understand how employees use their benefits and what they purchase. Such as contacts, progressive lenses and lens options like anti-reflective coating and Transitions® lenses. If your employees are interested in these items, consider a plan with deeper benefits and compare it to the overall cost of a lower premium plan.


Pay attention to special offers and discounts 
Become familiar with all the special offers and discounts available to your employees. A benefits summary doesn't always reflect total savings. It’s important to consider all the additional special offers and discounts members can take advantage of.*


Know what matters to your employees 
Every company is different. What looks good on paper may not work for every company. We know that 70% of EyeMed members use their vision insurance benefits to buy glasses and 30% purchase contacts.3 But low copays on progressive lenses may not matter if your company is primarily younger employees who may be more interested in contact lenses. That's why you need to know the products and features your employees use most often and focus on the out-of-pocket costs for those items. 


Maintain full transparency 
Once your employees are signed up, be transparent about costs and copays. That's where EyeMed’s Know Before You Go cost comparison tool can help. This tool helps members make smarter decisions before they visit an eye care provider. It’s just one of the reasons why 99% of our customers agree our benefits are easy to understand.4


As you can see, EyeMed’s benefits go beyond the price of premiums by offering employers the value they need in an overall vision plan. If you’re ready to learn more, reach out to your EyeMed representative today – or visit eyemed.com


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1 – Internal analysis of EyeMed membership data compared to data from leading vision benefit companies, as reported in publicly available information, 2021.

2 – This illustrative table shows out-of-pocket costs as examples. See policy for benefits, limitations and exclusions.

3 – EyeMed commercial book of business, 2021. 

4  – (T3B) EyeMed client satisfaction survey conducted by Walker, 2021. This includes SMB, National and Strategic segments.

*Discounts are not insurance. Fully insured plans are underwritten by: Fidelity Security Life Insurance Company®, Kansas City, MO 64111.