Vision Care Benefits
When you enroll in any Con Edison Retiree Medical/Hospital plan, you will automatically receive vision care benefits at no additional cost. The vision plan has both in- and out-of-network coverage. The plan is administered by CPS Optical, and all questions and claims should be directed to them.
Search for an in-network provider
Summary of Retiree Vision Benefits
- Comprehensive eye examination, including testing for glaucoma, every 12 months
- Standard single vision plastic lenses every 24 months, or after 12 months if prescription changes
- Frames with a retail value up to $175 every 24 months
Additional lens coverages are available to you at no cost, once in a 24-month period or once in a 12-month period if prescription changes:
- Bifocals and Trifocals
- Prescription sunglasses
- Standard progressive lenses
- Conventional daily-wear or extended-wear contacts
- 30-day supply of daily disposable contacts
- 18-week supply of two-week disposable contacts
- Cosmetic tinting, ultraviolet and scratch resistant coatings, and oversized lenses
Optional services are also available to you at the following co-payment amounts, once in a 24month period and once in a 12-month period if prescription changes:
- Polycarbonate single vision lenses - $25 copay
- Polycarbonate multifocal vision lenses - $30 copay
- Standard anti-reflective coating - $35 copay
- Hi-index single vision 1.60 index lenses - $50 copay
- Hi-index multifocal 1.60 index lenses - $55 copay
- Polarized single vision lenses - $70 copay
- Polarized multifocal lenses - $75 copay
- Varilux comfort 2 progressive lenses - $90 copay
- Standard photosensitive single vision plastic lenses - $60 copay
- Standard photosensitive multifocal vision plastic lenses - $65 copay
- The schedule of vision care allowances for use of non-participating providers is $100 and includes:
- Comprehensive Eye Exam - $20 (including testing for glaucoma) every 12 months
- Lenses - $60 every 24 months, or after 12 months if prescription changes
- Frames - $20 every 24 months
Frames
Frames with a retail value up to $175 are available every 24 months at no cost to you when using an in-network provider. If you choose a frame with a retail value greater than $175, you will be responsible for paying the difference between the total retail price and $175. For example, if the frame you choose costs $185, you will have to pay $10. Please note that certain stores only offer a specific selection of frames under insurance plans, including the Con Edison plans.
Claim Form
Participating providers have claim forms. Your provider will ask you to sign a claim form after you receive services. If you use out-of-network providers, you will need to complete a claim forms for non-participating providers and submit it to CPS Optical with itemized receipts.
The reimbursement for using out-of-network providers is the following:
- Exam - $20
- Lenses - $60
- Frames - $20
Although Con Edison currently sponsors the Retiree Health Program, the information above does not alter the company’s right to change or terminate the program at any time due to changes in laws governing employee benefit plans, the requirements of the Internal Revenue Code, Employee Retirement Income Security Act, or for any other reason. The company is not obligated to contribute any fixed amount or percentage of program costs.
Notice of Privacy Practices
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires Con Edison and the health plans sponsored by the company to protect your personal health information (PHI). As a participant under one of the health plans offered by Con Edison, we are required to notify you of the privacy practices that will be followed by the company and the plans and your rights concerning your personal health information.
Under the law and privacy practices, we have the responsibility to protect the privacy of your personal health information by:
1. limiting who may see it
2. limiting how we may use or disclose it
3. explaining our legal duties and privacy practices
4. adhering to these privacy practices
5. informing you of your legal rights