Brokers FAQs

Avesis currently requires a minimum group size of five employees for employer-paid programs, and has a minimum requirement of 10 eligible employees for voluntary plan offerings.

Avesis offers a wide range of vision care plans that will meet most client group needs. We also offer tremendous flexibility to tailor a plan to the precise specification of virtually any group in terms of desired benefit frequency, copayments, and plan coverages.

Avesis offers a Materials Only eyewear plan to groups that have an embedded eye examination fully covered by their health plan. Our Materials Only plan complements the eye exam coverage, thus ensuring comprehensive care and service for the members.

Avesis typically offers a two- or three-year rate guarantee and is also often receptive to establishing a rate cap on the subsequent two years, depending on the group’s qualifications and requirements.

Yes! Shortly after a group’s implementation, members will receive an ID card mailed to their homes. However, in order to provide an optimally hassle-free experience, members are not required to furnish an ID card to use their vision care benefits. Once a member schedules an appointment, the provider’s office will review his or her covered benefits and verify eligibility using one of the many tools at their disposal. Members who choose to carry an ID card can print a paper version at any time from the member portal of our website.

It is not necessary for members to carry an ID card (see above).

The following information will be needed to set up the group and issue enrollment materials:

• Group Information
• Plan sold (including copayments, frequency of benefits, and rates)
• Enrollment dates
• Additional enrollment material as requested

As part of the implementation process, each new group will receive an Administration Manual. This guide will include the actual policy and Certificate of Insurance, in addition to detailed instructions and other useful information on how to most efficiently administer the vision benefit.

Members will receive enrollment materials consisting of a Summary of Plan Benefits booklet, Enrollment Form(s), and a HIPAA Policy statement. Other educational materials about the vital importance of good vision care may also be included during open enrollment.

Avesis has an extensive, highly qualified and credentialed provider network that offers members convenience and choice, with more than 45,000 points of access nationwide. The network is composed of independent (68 percent) and retail (32 percent) ophthalmologists, optometrists, and opticians.

The Avesis plan does not cover medical or surgical treatment for eye disease or eye injury. The member, or the group’s Benefit Administrator, should contact his or her health plan for assistance in locating an appropriate surgeon. In case of medical emergency, members should call 911, or go to the nearest hospital emergency room.

You’ll find contact information for the Regional Vice President of Sales for your service area on the Representative Locator Map.