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benefits management Vision Care Program Providers in Florida The Con Edison Retiree Health Plan provides vision care benefits for you and your eligible dependents. The company has arranged with participating providers in Florida – listed on the following pages – to supply vision care services at no cost to you. Services generally are provided at no cost only if you receive all services an eye examination, lenses and frames – from the same provider. In some areas, eye examinations are not available from participating providers, but may be available from independent doctors within or adjacent to the facilities of participating providers. In the listing on the following pages, an asterisk indicates a participating provider from whom you can obtain glasses but not an examination. If you use one of these providers, the plan will reimburse you for your examination according to the schedule of benefits on page 43 of your Retiree Health Program booklet. Here is an outline of services available through the participating providers: A comprehensive eye examination, including testing for glaucoma.
Contact lenses You will be responsible for paying 70% of the difference between the retail price and the $70 credit. For example, if the regular retail price is $250, you will have to pay $126 toward the cost of your contact lenses. $250 – $70 = $180; 70% of $180 = $126. Optional services Additional services are available to you through participating providers at the costs indicated:
Claim form procedure When you go to a participating provider, all you have to do is show your Con Edison Retiree Health Plan identification card, and complete and sign a Retiree Health Plan claim form. The provider will send the form to UnitedHealthcare, and UnitedHealthcare will reimburse the provider directly. If you do not go to a participating provider, or you receive an eye examination from an independent doctor, you will have to pay the provider and submit a completed Retiree Health Plan claim form to UnitedHealthcare. UnitedHealthcare will reimburse you according to the plan's schedule of benefits. Questions? If you have any questions, please write Con Edison Employee Benefits Department, Attention: Retiree Health Plan Vision Care, Room 1100, 4 Irving Place, M020, New York, NY 10003 or call 1-800-582-5056.
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