Vision Benefits
Even if you think you have perfect vision, a routine eye exam can be one of the best things you can do to protect the overall health and wellness of you and your loved ones. Your eyes are often a very effective window to your overall health. During a comprehensive eye exam, your eye doctor can observe and evaluate the health and condition of the blood vessels in your retina, which are good predictors of the health of blood vessels throughout your body. Conditions such as diabetes, hypertension, and hypercholesterolemia are visible by changes in the appearance of the retinal blood supply and blood vessels.
Routine eye exams are especially important for any with diabetes or who may be at risk for the disease due to family history, obesity, or other reasons. In its early stages, diabetic eye disease has no visible symptoms. Only a comprehensive eye exam can detect signs of the disease to prevent vision loss. Early detection of high eye pressure and other risk factors for glaucoma is possible only with routine eye exams.
Vision benefits are provided through National Vision Administrators (NVA). Members may use any provider; however, if you use an NVA participating provider, you will be charged a discounted price and the provider will submit the claim for you. If you do not use an NVA participating provider, you must pay the provider the full amount and then submit the paid invoice to NVA for reimbursement, subject to the applicable limits. Be sure to tell the NVA participating providers that you are covered through NVA at the time you make your appointment and take your card with you to the appointment.
Effective 01/01/2000, Revised 04/01/2025
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Maximum Out of Pocket Limit
The Fund pays 100% for the remainder of the year once you reach your MOOP limit. MOOP Limit includes examination copayments and purchase of standard frames and lenses, but does not include additional costs for upgraded frames, lenses, and contacts.
MOOP Limit: $25 per person, $50 family maximum
Benefit Frequency
Examination – Once Every Two Calendar Years
Lenses – Once Every Two Calendar Years
- Single Vision
- Bifocal
- Trifocal
- Lenticular
Frame – Once Every Two Calendar Years
Participating Providers
Examination
Covered 100% After $5 copayLenses
Standard Glass or Plastic- Covered 100%
Frame
Wholesale Allowance – up to $40 Provider will charge the difference between the wholesale cost and the plan allowance plus 20%Non-Participating Providers
Examination
Reimbursed Amount up to $30Lenses
- Single Vision – Up to $25
- Bifocal – Up to $35
- Trifocal – Up to $45
- Lenticular – Up to $75
Frame
Up to $25
Lens options purchased from a participating NVA provider will be provided to the member at the amounts listed in the fixed option pricing list below:
- $75 Polarized
- $30 Blended Bifocal (Segment)
- $40 Blue Light Blocker (Standard)
- $60 Blue Light Blocker (Premium)
- $150 Blue Light Blocker (Ultra)
- $12 Fashion Gradient
- $20 Glass Photogrey (single vision)
- $30 Glass Photogrey (Multi-focal)
- $55 High Index
- $12 Ultraviolet Coating
- $25 Polycarbonate (single vision)
- $30 Polycarbonate (Multi-focal)
- $10 Scratch-Resistant Coating (Standard)
- $65 Transition Single Vision (Standard)
- $70 Transitions Multi-Focal (Standard)
- $10 Solid Tint
- $40 AR Coating – Tier 1
- $50 AR Coating – Tier 2
- $65 AR Coating – Tier 3
- $80 AR Coating – Tier 4
- 20% discount AR Coating – Tier 5
- $50 Progressive – Tier 1
- $80 Progressive – Tier 2
- $100 Progressive – Tier 3
- $120 Progressive – Tier 4
- $140 Progressive – Tier 5
- $165 Progressive – Tier 6
- $190 Progressive – Tier 7
- 20% discount Progressive – Tier 8
- $39 Retinal Screening
For lens options & services purchased from a participating NVA provider, NVA members will only pay the fixed maximum amount or the provider’s wholesale cost plus 25%, whichever is less. Options not listed will be priced by NVA providers wholesale cost plus 25%. Fixed prices are available in-network only. In certain states, members may be required to pay the full retail amount and not the negotiated discount amount at certain participating providers. Some optometrist affiliated with Optical Retail locations (i.e., Visionworks, etc.) are independent providers and may not participate in the NVA program.
Participating providers are not contractually obligated to offer sale prices in addition to outlined coverage. Regardless of medical or optical necessity, vision benefits are not available more frequently than specified in your policy. In addition to your funded benefit, Members are eligible to access the EyeEssential® Plan discount (in network only) on additional purchases during the plan period. Please contact NVA for details.
Contact Lenses
(Participating and Non-Participating Providers)
Once Every Two Calendar Years
In lieu of Lenses and Frames
- Elective Contact Lenses – Up to $105 Retail (+ Routine Eye Exam)
- Medically Necessary (Pre-Approval from NVA required) – up to $150
The contact lens benefit includes all types of contact lenses such as hard, soft, gas permeable and disposable lenses. Medically necessary contact lenses includes fitting and follow up and may be covered with prior authorization when prescribed for: post cataract surgery, correction of extreme visual acuity problems that cannot be corrected to 20/70 with spectacle lenses, Anisometropia or Keratoconus.
Service by a Non-Participating Provider
If a Non-Participating Provider is used, Members are responsible for paying 100% of the cost at the time of service. You must then request reimbursement from NVA. To receive reimbursement:
- Complete a “Claim for Vision Care Expense” form. Forms can be downloaded here or at e-nva.com.
- Scan and submit form by email to: visionclaims@e-nva.com
- Or Fax form to 973-574-2430
- Or mail completed claim form and itemized receipt (copy or original) to:
National Vision Administrators
PO Box 2187
Clifton, NJ 07015
- If you cannot print the claim form, you may submit receipts along with a letter containing Member’s full name, patient’s full name, address, ID number, and OLDC-OCA Insurance Fund.
Remember, obtaining vision care services from a Non-Participating Provider will result in greater out-of-pocket expenses for you.
You can take NVA with you anywhere you go with the NVA mobile app. The NVA app is ready to download on Google Play for Android users and the App store for iPhone users. Simply download the app on your mobile device to get started. Find the app by typing NVA vision in the search box at the online stores. Only NVA active cardholders can access the NVA vision benefits member app at this time. Dependents cannot access the app.
With the NVA vision benefits member app, users can:
- Find an in-network vision care provider nearby, call the provider to setup an appointment, and get driving directions.
- Check benefit information on eye exams, eyeglass lenses and frames, and contact lenses.
- See the last time the benefit was used and the next time it can be used.
- View ID card
- Access the NVA Smart Buyer® to learn how prescription dictates the choice in lenses and frames, the pros and cons of lenses and lens options along with estimated retail pricing, factors to consider when selecting frames, and more.
- Create an account, reset password and/or username, reset security question and change e-mail address associated with the account (you can use the same username and password if you created one on the NVA website).
NVA has partnered with The National LASIK Network to offer certain discounts. Members are entitled to significant discounts and a free initial consultation with all Network Providers. Please contact NVA for additional details at 877-295-8599 or visit www.e-nvalasik.com.
No payment is made for medical or surgical treatments / Rx drugs or OTC medications / non-prescription lenses / two pair of glasses in lieu of bifocals / subnormal visual aids / vision examination or materials required for employment / replacement of lost, stolen, broken or damaged lenses/ contact lenses or frames except at normal intervals when service would otherwise be available / services or materials provided by federal, state, local government or Worker’s Compensation / examination, procedures training or materials not listed as a covered service / industrial safety lenses and safety frames with or without side shields / parts or repair of frame / sunglasses.
Contact NVA for additional details
Customer Service: 1-800-672-7723
Website: www.e-nva.com
Find A Provider – Sponsor #: 1373100
For additional information, Members can review their Insurance Summary Plan Description.