{"id":379,"date":"2014-08-06T14:49:47","date_gmt":"2014-08-06T19:49:47","guid":{"rendered":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/?page_id=379"},"modified":"2026-01-15T14:25:50","modified_gmt":"2026-01-15T20:25:50","slug":"vision","status":"publish","type":"page","link":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/dental-vision\/vision\/","title":{"rendered":"Vision Insurance"},"content":{"rendered":"<div id=\"toc\" class=\"uwsa-toc callout hidden-print\"><\/div><style>@media (min-width: 768px) {#toc { max-width: 40%} <\/style><script>jQuery(document).ready(function() {\n \t\t\t\t\tgenerateTOC(\"Vision Insurance\", \"\", \"div.entry-content\" ,1 ,\"true\", \"toc\");\n \t\t\t\t\t });<\/script>\n<h2><strong>Overview<\/strong><\/h2>\n<p>This insurance provides benefits for eye exams and materials (contacts and glasses). For plan details, see the Vision Summary in the Forms &amp; Resources section below.<\/p>\n<p>In 2025, vision insurance was offered through DeltaVision (in partnership with EyeMed). In 2026, vision insurance carrier is MetLife.<\/p>\n<h2><strong>Eligibility<\/strong><\/h2>\n<p>You must meet the following requirements to be eligible for vision insurance:<\/p>\n<ul>\n<li>Eligible for State Group Health Insurance; and<\/li>\n<li>Are not receiving a Wisconsin Retirement System (WRS) annuity.<\/li>\n<\/ul>\n<p><span style=\"float: none;background-color: transparent;color: #333333;cursor: text;font-family: 'Open Sans','Helvetica Neue',Helvetica,Arial,sans-serif;font-size: 14px;font-style: normal;font-variant: normal;font-weight: 400;letter-spacing: normal;text-align: left;text-decoration: none;text-indent: 0px;text-transform: none\">For information on who you can cover on this plan, review the <span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/download\/Dependent-Eligibility-Chart-UWS-25.pdf\" target=\"_blank\">Dependent Eligibility Chart (UWS 25)<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n.<\/span><\/p>\n<h2><strong>Coverage<\/strong><\/h2>\n<table class=\"table-bordered\" style=\"width: 825px\">\n<thead>\n<tr style=\"height: 39px\">\n<th style=\"width: 329.188px;height: 39px;text-align: center;vertical-align: middle\"><strong>Schedule of Benefits<\/strong><\/th>\n<th style=\"height: 39px;width: 263.812px;text-align: center;vertical-align: middle\"><strong>In-Network<\/strong><\/th>\n<th style=\"height: 39px;width: 220px;text-align: center;vertical-align: middle\"><strong>Out-of-Network Reimbursement<\/strong><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"height: 39px\">\n<td style=\"height: 39px;width: 329.188px\"><strong>Annual Exam with Dilation<\/strong><\/td>\n<td style=\"height: 39px;width: 263.812px;text-align: center\">$15 copay per person<\/td>\n<td style=\"height: 39px;width: 220px;text-align: center\">Up to $45 per person<\/td>\n<\/tr>\n<tr style=\"height: 39px\">\n<td style=\"height: 39px;width: 329.188px\"><strong>Retinal Imaging<\/strong><\/td>\n<td style=\"height: 39px;width: 263.812px;text-align: center\">$39 copay per person<\/td>\n<td style=\"height: 39px;width: 220px;text-align: center\">Applied to exam allowance<\/td>\n<\/tr>\n<tr style=\"height: 8px\">\n<td style=\"height: 8px;width: 329.188px\"><strong>Frames Benefits<\/strong><\/td>\n<td style=\"height: 8px;width: 263.812px;text-align: center\">$150 allowance per person<\/td>\n<td style=\"height: 8px;width: 220px;text-align: center\">Up to $70 per person<\/td>\n<\/tr>\n<tr style=\"height: 134px\">\n<td style=\"height: 134px;width: 329.188px\"><strong>Benefit Frequency<\/strong><\/p>\n<p>Lenses<\/p>\n<p>Frames<\/td>\n<td style=\"height: 134px;width: 263.812px;text-align: center\">&nbsp;<\/p>\n<p>12 months<\/p>\n<p>24 months adults, 12 months children<\/td>\n<td style=\"height: 134px;width: 220px;text-align: center\">&nbsp;<\/p>\n<p>12 months<\/p>\n<p>24 months adults, 12 months children<\/td>\n<\/tr>\n<tr style=\"height: 134px\">\n<td style=\"height: 134px;width: 329.188px\"><strong>Lenses<\/strong><\/p>\n<p>Single vision<\/p>\n<p>Bifocal vision<\/p>\n<p>Trifocal<\/td>\n<td style=\"height: 134px;width: 263.812px;text-align: center\">&nbsp;<\/p>\n<p>$25 copay per person<\/p>\n<p>$25 copay per person<\/p>\n<p>$25 copay per person<\/td>\n<td style=\"height: 134px;width: 220px;text-align: center\">&nbsp;<\/p>\n<p>Up to $30 per person<\/p>\n<p>Up to $50 per person<\/p>\n<p>Up to $65 per person<\/td>\n<\/tr>\n<tr style=\"height: 79px\">\n<td style=\"height: 79px;width: 329.188px\"><strong>Progressive Lenses<\/strong><\/td>\n<td style=\"height: 79px;width: 263.812px;text-align: center\">Standard: $25 copay<\/p>\n<p>Premium, Ultra, Ultimate:<\/p>\n<p>You pay up to $70, $80, or $175 copay<\/td>\n<td style=\"height: 79px;width: 220px;text-align: center;vertical-align: middle\">Up to $50 per person<\/td>\n<\/tr>\n<tr style=\"height: 9px\">\n<td style=\"height: 9px;width: 329.188px\"><strong>Conventional and Disposable Contacts<\/strong><\/td>\n<td style=\"height: 9px;width: 263.812px;text-align: center\">$150 allowance per person<\/td>\n<td style=\"height: 9px;width: 220px;text-align: center\">Up to $105 per person<\/td>\n<\/tr>\n<tr style=\"height: 9.5px\">\n<td style=\"height: 9.5px;width: 329.188px\"><strong>Contact Lens Fit and Follow-up Visit<\/strong><\/td>\n<td style=\"height: 9.5px;width: 263.812px;text-align: center\">Standard: $30 copay per person<\/p>\n<p>Specialty: $30 copay per person then $50 allowance<\/td>\n<td style=\"height: 9.5px;width: 220px;text-align: center;vertical-align: middle\">Applied to contact lens allowance<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"ProviderNetwork\"><strong>Provider Network<\/strong><\/h2>\n<p>For lower out-of-pocket costs, see an in-network vision provider. In-network vision providers will submit claims to the vision insurance administrator on your behalf.<\/p>\n<p>There are out-of-network benefits for the vision insurance; however, your out-of-pocket cost will likely be higher. In addition, you will need to submit your claims to the vision insurance administrator. Out-of-network providers typically will not submit claims on your behalf.<\/p>\n<p>Not sure if your vision provider is in-network? To find out, reach out to the appropriate Plan Administrator by using the contact information provided in the Plan Administrator section below.<\/p>\n<h2><strong>Enrollment<\/strong><\/h2>\n<p>You have 30 days from your date of employment or newly benefits-eligible position to enroll in vision insurance. Coverage will begin on the first of the month on or following your eligibility date. If you do not enroll during the initial 30-day enrollment period, your next opportunity to do so will be during the enrollment period each fall for coverage effective the following January 1 or if you have a qualifying life event. See <a href=\"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/life-events\/\">Life Events<\/a> for more information.<\/p>\n<p><strong>Note: Once you are enrolled in vision insurance, you must remain enrolled for the entire calendar year.<\/strong><\/p>\n<h2><strong>ID Cards<\/strong><\/h2>\n<p>If you enroll in vision insurance, you will <strong>not<\/strong> receive an ID card from MetLife, the vision insurance carrier. If your vision provider is in the MetLife Superior network, your vision provider will be able to verify your vision insurance coverage when you provide them with your full legal name and date of birth. Otherwise, you can print a <a href=\"https:\/\/www.metlife.com\/content\/dam\/metlifecom\/us\/homepage\/wisconsin\/Superior_Vision_Welcome_ID_Cards_State_of_Wisconsin.pdf\" target=\"_blank\" rel=\"noopener\">generic vision insurance ID card<\/a> to take with you to your vision appointment.<\/p>\n<h2><strong>Benefit Premiums<\/strong><\/h2>\n<p>For Vision Insurance premiums review the <a href=\"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/premiums\/\" target=\"_blank\" rel=\"noopener\">Benefit Premiums web page<\/a>.<\/p>\n<h2><strong>Forms &amp; Resources<\/strong><\/h2>\n<ul>\n<li><a href=\"https:\/\/etf.wi.gov\/publications\/et-2339\/download?inline=\" target=\"_blank\" rel=\"noopener\">Supplemental Insurance (dental, vision, accident) Application\/Change Form (ET-2339)<\/a><\/li>\n<li><span class=\"doc-icon\"><a class=\"doc-type pdf\" href=\"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/download\/summary.pdf\" target=\"_blank\">Vision Insurance Summary<span class=\"sr-only\"> pdf<\/span><\/a><\/span>\r\n<\/li>\n<li><a href=\"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/terms-conditions\/\" target=\"_blank\" rel=\"noopener noreferrer\">Terms and Conditions<\/a><\/li>\n<\/ul>\n<h2>Plan Administrator<\/h2>\n<ul>\n<li>2025: <a href=\"https:\/\/www4.deltadentalwi.com\/state-of-wi-vision\" target=\"_blank\" rel=\"noopener noreferrer\">DeltaVision\/EyeMed<\/a> | (855) 544-6035 | <a href=\"https:\/\/eyedoclocator.eyemedvisioncare.com\/member\/en#\/member\/en?networkSetId=1166&amp;networkDDDisabled=true\" target=\"_blank\" rel=\"noopener\">Find a Vision Insurance Provider<\/a> (Insight network)<\/li>\n<li>2026: <a href=\"https:\/\/metlife.pathfactory.com\/state-of-wisconsin\" target=\"_blank\" rel=\"noopener\">MetLife<\/a> |(866) 498-9858 | <a href=\"https:\/\/metlife.pathfactory.com\/state-of-wisconsin\" target=\"_blank\" rel=\"noopener\">Find a Vision Insurance Provider<\/a>\u00a0(Superior network)<\/li>\n<\/ul>\n<hr \/>\n<p style=\"text-align: right\">\n","protected":false},"excerpt":{"rendered":"<p>Overview This insurance provides benefits for eye exams and materials (contacts and glasses). For plan details, see the Vision Summary in the Forms &amp; Resources section below. In 2025, vision insurance was offered through DeltaVision (in partnership with EyeMed). In 2026, vision insurance carrier is MetLife. Eligibility You must meet the following requirements to be [&#8230;]<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":7394,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/42.7563.php","meta":{"footnotes":""},"class_list":["post-379","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/379","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/comments?post=379"}],"version-history":[{"count":17,"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/379\/revisions"}],"predecessor-version":[{"id":29708,"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/379\/revisions\/29708"}],"up":[{"embeddable":true,"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/pages\/7394"}],"wp:attachment":[{"href":"https:\/\/dev.wisconsin.edu\/ohrwd\/benefits\/wp-json\/wp\/v2\/media?parent=379"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}