{"id":69,"date":"2026-06-22T16:54:15","date_gmt":"2026-06-22T16:54:15","guid":{"rendered":"https:\/\/octdevsite.wpenginepowered.com\/?page_id=69"},"modified":"2026-07-07T19:13:46","modified_gmt":"2026-07-07T19:13:46","slug":"oct-vision-benefits","status":"publish","type":"page","link":"https:\/\/www.teamstersinsurance.com\/?page_id=69","title":{"rendered":"OCT Vision Benefits"},"content":{"rendered":"\n<h3 class=\"wp-block-heading\">National Vision Administrators<\/h3>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<div class=\"sob-wrap\">\n\n  <h1 class=\"sob-title\">Schedule of Benefits<\/h1>\n\n  <table class=\"sob-table\">\n    <thead>\n      <tr>\n        <th>Benefit Frequency<\/th>\n        <th>Participating Provider<\/th>\n        <th>Non-participating Provider<\/th>\n      <\/tr>\n    <\/thead>\n    <tbody>\n\n      <tr>\n        <td>\n          <p class=\"sob-label\">EXAMINATION<\/p>\n          <p class=\"sob-sublabel\">Once Every 12 months<\/p>\n        <\/td>\n        <td>\n          <ul><li>Covered 100%<\/li><\/ul>\n        <\/td>\n        <td>\n          <p class=\"sob-label\">Reimbursed Amount:<\/p>\n          <ul><li>Up to $30<\/li><\/ul>\n        <\/td>\n      <\/tr>\n\n      <tr>\n        <td>\n          <p class=\"sob-label\">LENSES<\/p>\n          <p class=\"sob-sublabel\">Once Every 12 months<\/p>\n          <ul>\n            <li>Single Vision<\/li>\n            <li>Bifocal<\/li>\n            <li>Trifocal<\/li>\n            <li>Lenticular<\/li>\n            <li>Progressive \u2014 Tier 1<\/li>\n          <\/ul>\n        <\/td>\n        <td>\n          <p class=\"sob-label\">Standard Glass or Plastic<\/p>\n          <ul>\n            <li>Covered 100%<\/li>\n            <li>Covered 100%<\/li>\n            <li>Covered 100%<\/li>\n            <li>Covered 100%<\/li>\n            <li>\n              <span class=\"sob-tooltip-link\" data-title=\"Progressive - Tier 1: Covered 100%\" data-body=\"In network Tri-focal and Tier 1 Progressive covered in full.\">Covered 100% <span class=\"sob-tooltip-icon\">?<\/span><\/span>\n            <\/li>\n          <\/ul>\n        <\/td>\n        <td>\n          <ul>\n            <li>Up to $30<\/li>\n            <li>Up to $40<\/li>\n            <li>Up to $50<\/li>\n            <li>Up to $50<\/li>\n            <li>\n              <span class=\"sob-tooltip-link\" data-title=\"Progressive - Tier 1: Reimbursement Not Available\" data-body=\"Out of network Tier 1 Progressive included in Tri-focal reimbursement.\">N\/A <span class=\"sob-tooltip-icon\">?<\/span><\/span>\n            <\/li>\n          <\/ul>\n        <\/td>\n      <\/tr>\n\n      <tr>\n        <td>\n          <p class=\"sob-label\">FRAME<\/p>\n          <p class=\"sob-sublabel\">Once Every 12 months<\/p>\n        <\/td>\n        <td>\n          <p class=\"sob-label\">Retail Allowance<\/p>\n          <ul>\n            <li>Up to $125<\/li>\n            <li>\n              <span class=\"sob-tooltip-link sob-italic\" data-title=\"Frame Discount: 20% off balance\" data-body=\"Does not apply to certain proprietary brands.\">20% discount off balance <span class=\"sob-tooltip-icon\">?<\/span><\/span>\n            <\/li>\n          <\/ul>\n        <\/td>\n        <td>\n          <ul><li>Up to $35<\/li><\/ul>\n        <\/td>\n      <\/tr>\n\n      <tr>\n        <td>\n          <p class=\"sob-label\">CONTACT LENSES<\/p>\n          <p class=\"sob-sublabel\">Once Every 12 months<\/p>\n          <ul>\n            <li>Elective Contact Lenses<\/li>\n            <li>\n              <span class=\"sob-tooltip-link\" data-title=\"Contact Lenses: Fit\/Follow-Up\" data-body=\"Only covered if you choose Contact Lenses.\">Fit\/Follow-up <span class=\"sob-tooltip-icon\">?<\/span><\/span>\n              <ul>\n                <li>Standard Daily Wear<\/li>\n                <li>Standard Extended Wear<\/li>\n                <li>Specialty Wear<\/li>\n              <\/ul>\n            <\/li>\n            <li>\n              <span class=\"sob-tooltip-link\" data-title=\"Contact Lenses: Medically Necessary\" data-body=\"Pre-approval from NVA required.\">Medically Necessary <span class=\"sob-tooltip-icon\">?<\/span><\/span>\n            <\/li>\n          <\/ul>\n        <\/td>\n        <td>\n          <p class=\"sob-label\">In lieu of Lenses &amp; Frame<\/p>\n          <ul>\n            <li><strong>Up to $125 Retail<\/strong><\/li>\n            <li>\n              <span class=\"sob-tooltip-link sob-italic\" data-title=\"Contact Lenses: Up to $125 Retail Discount\" data-body=\"Does not apply to Contact Fill (NVA Mail Order) or certain locations at: Target, Sears, Pearle, &amp; K-Mart and may be prohibited by some manufacturers.\">15% discount (Conventional) or;<br>10% discount (Disposable) off balance <span class=\"sob-tooltip-icon\">?<\/span><\/span>\n            <\/li>\n            <li><strong>Covered 100%<\/strong> After $20 copay<\/li>\n            <li><strong>Covered 100%<\/strong> After $30 copay<\/li>\n            <li><strong>Covered 100%<\/strong> After $50 copay<\/li>\n            <li>Up to $125<\/li>\n          <\/ul>\n        <\/td>\n        <td>\n          <p class=\"sob-label\">In lieu of Lenses &amp; Frame<\/p>\n          <ul>\n            <li>Up to $60<\/li>\n            <li>Up to $20<\/li>\n            <li>Up to $30<\/li>\n            <li>Up to $50<\/li>\n            <li>Up to $60<\/li>\n          <\/ul>\n        <\/td>\n      <\/tr>\n\n    <\/tbody>\n  <\/table>\n\n<\/div>\n\n<\/div>\n\n<script>\n(function(){\n  var modal = document.getElementById('sob-modal');\n  var mTitle = document.getElementById('sob-modal-title');\n  var mBody = document.getElementById('sob-modal-body');\n  var mClose = document.getElementById('sob-modal-close');\n\n  document.querySelectorAll('.sob-tooltip-link').forEach(function(el){\n    el.setAttribute('role', 'button');\n    el.setAttribute('tabindex', '0');\n    el.addEventListener('click', function(){\n      mTitle.textContent = el.dataset.title;\n      mBody.textContent = el.dataset.body;\n      modal.classList.add('open');\n    });\n    el.addEventListener('keydown', function(e){\n      if (e.key === 'Enter' || e.key === ' ') { e.preventDefault(); el.click(); }\n    });\n  });\n\n  mClose.addEventListener('click', function(){ modal.classList.remove('open'); });\n  modal.addEventListener('click', function(e){ if (e.target === modal) modal.classList.remove('open'); });\n  document.addEventListener('keydown', function(e){ if (e.key === 'Escape') modal.classList.remove('open'); });\n})();\n<\/script>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Exclusions and Limitations<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">No benefits are available for the following services:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Professional services and\/or materials in connection with: Plano (non-prescription) lenses; Aniseikonic Lenses; Subnormal visual aids; Orthoptics, vision training, developmental vision procedures, and any associated supplemental testing.<\/li>\n\n\n\n<li>Broken, lost or stolen lenses, contact lenses, or frames. NVA network providers may offer additional warranties to cover materials.<\/li>\n\n\n\n<li>Services or materials, which are payable under any workers\u2019 compensation act, similar law or any public program, other than Medicaid.<\/li>\n\n\n\n<li>Services or materials rendered by a provider other than ophthalmologists, optometrists, or opticians acting within the scope of their licensure.<\/li>\n\n\n\n<li>Any additional service required outside basic vision analysis for contact lenses, including but not limited to fitting fees, unless otherwise specified in the Proposed Schedule of Benefits.<\/li>\n\n\n\n<li>Services rendered after the date a person ceases to be covered under this policy, except when vision materials ordered before coverage ended are delivered and the services rendered to the person within 31 days from the date of such order.<\/li>\n\n\n\n<li>Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under plan.<\/li>\n\n\n\n<li>Medical and\/or surgical treatment of the eye, eyes or supporting structures.<\/li>\n\n\n\n<li>Two pairs of glasses in lieu of bifocals.<\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Finding an In-Network provider<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Visit <a href=\"https:\/\/www.e-nva.com\" target=\"_blank\" rel=\"noreferrer noopener\">www.e-nva.com<\/a> and select the \u201cFind a Provider\u201d link. Enter your group number <strong>1369000001<\/strong> and your search parameters. You will also have access to the frame inventory of network providers near you. You may also nominate a provider to our network by completing the online form within your member portal. The NVA Mobile App offers this same convenience.<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Non-Participating Providers<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">You will be responsible for 100% of the cost at the time of service at a non-participating provider. You can request a claim form from NVA via the website <a href=\"https:\/\/www.e-nva.com\" target=\"_blank\" rel=\"noreferrer noopener\">www.e-nva.com<\/a> or you may submit receipts along with a letter containing the member\u2019s full name, patient\u2019s full name, address, ID# and sponsoring organization to NVA, P.O. Box 2187, Clifton, NJ 07015.<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Contacting NVA<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">For your convenience, NVA\u2019s US-based Customer Service team is available 24\/7\/365 and can be reached at: 1-800-672-7723.<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Benefits, Network &amp; Claim Submission<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Eligible members and dependents are entitled to receive a vision examination and one (1) pair of lenses and a frame OR contact lenses and contact lens evaluation\/fitting once every 12 months from last date of service. Refer to the Schedule of Benefits below for additional information.<\/p>\n\n\n\n<div class=\"wp-block-genesis-blocks-gb-spacer gb-block-spacer gb-divider-solid gb-divider-size-1\" style=\"color:#ddd\"><hr style=\"height:30px\"\/><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Value-Added Services<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fixed Pricing on Lens options (in-network only)<\/strong> &#8211; NVA offers members discounted fixed pricing on the most highly requested lens options through in-network providers. Members pay the lower of the fixed price or 20% off the provider\u2019s usual and customary price. Members receive a 20% courtesy discount on lens options not listed under fixed pricing.<\/li>\n\n\n\n<li><strong>EYEESSENTIAL\u00ae<\/strong> Plan Discounts for purchases after benefits are exhausted &#8211; up to 35%.<\/li>\n\n\n\n<li><strong>Contact Fill<\/strong> \u2013 Substantial savings through NVA\u2019s contact lens mail\u2010order replacement program.<\/li>\n\n\n\n<li><strong>Lasik<\/strong> &#8211; 15% off standard prices -or- 5% off promotional prices.<\/li>\n\n\n\n<li><strong>Hearing Discount<\/strong> \u2013 Between 30% and 60% off retail at participating provider locations.<\/li>\n\n\n\n<li><strong>Glasses.com<\/strong> \u2013 NVA members can purchase brand name prescription eyeglasses and sunglasses on Glasses.com at a 30% discounted price.<\/li>\n\n\n\n<li><strong>NVA Smart Buyer\u00ae Program<\/strong> &#8211; Tools &amp; resources on NVA\u2019s website that can save you money and increase your buying power when using your vision benefit.<\/li>\n\n\n\n<li><strong>NVA Mobile App<\/strong> &#8211; Locate a provider, view benefits, access your ID card, discover Smart Buyer\u00ae<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Upon enrollment, you will receive two identification cards with participating providers in your zip code area listed on the back. At the time of your appointment, simply present your NVA identification card to the provider or indicate that your benefit is administered by NVA. Your ID card is also available on the NVA Mobile App. The provider will contact NVA to verify eligibility. A vision claim form is not required at an NVA participating provider.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>National Vision Administrators Schedule of Benefits Benefit Frequency Participating Provider Non-participating Provider EXAMINATION Once Every 12 months Covered 100% Reimbursed Amount: Up to $30 LENSES Once Every 12 months Single Vision Bifocal Trifocal Lenticular Progressive \u2014 Tier 1 Standard Glass or Plastic Covered 100% Covered 100% Covered 100% Covered 100% Covered 100% ? Up to [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-69","page","type-page","status-publish","hentry"],"featured_image_src":null,"featured_image_src_square":null,"_links":{"self":[{"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=\/wp\/v2\/pages\/69","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=69"}],"version-history":[{"count":5,"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=\/wp\/v2\/pages\/69\/revisions"}],"predecessor-version":[{"id":122,"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=\/wp\/v2\/pages\/69\/revisions\/122"}],"wp:attachment":[{"href":"https:\/\/www.teamstersinsurance.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=69"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}