Vision Plan
- CIGNA Vision Plan Claim Form
- CIGNA website
- Vision Provider Directory
- CIGNA Vision Benefit Summary
- CIGNA Vision Benefits
- CIGNA Vision: How to use your Vision benefits
- Frequently Asked Questions
- Vision Summary Plan Description (PDF)
The University believes that overall “health” is achieved as individuals take control of their overall preventive health needs. Part of your overall health is ensuring that you have your annual eye exam.
The CIGNA Vision Plan provides coverage for quality vision care for you and your family’s eye care needs, and has benefits to assist with the costs relating to annual exams, frames, lenses and contact lenses.
Dependent children may be covered up to age 26. Also, if you cover one (1) dependent child under the vision plan, you must cover all eligible dependent children.
Employees will be able to choose a provider from CIGNA's network for maximum savings and virtually no paperwork. However, employees may also seek eye care from an out-of-network provider. With out-of-network providers, employees will be responsible for paying the provider in full at the time services are rendered and then file a claim form to receive reimbursement.
Schedule of PPO Vision Benefits per Calendar Year
| Benefit | In-Network Plan Coverage | Out-of-Network Plan Reimbursement |
|---|---|---|
Examination(one per frequency) Including but not limited to:
|
Covered in full after $20 copay |
$80 allowance |
Base Lenses*(one pair per frequency): |
||
|
Single Vision Allowance |
Covered in full |
$50 allowance |
|
Bifocal Allowance |
Covered in full |
$75 allowance |
|
Trifocal Allowance |
Covered in full |
$75 allowance |
|
Lenticular Allowance |
Covered in full |
$100 allowance |
Contact Lenses*(retail allowance): | ||
|
Elective |
$150 allowance |
$150 allowance |
|
Therapeutic |
$150 allowance |
$150 allowance |
Frame Retail Allowance*(one per frequency) |
$150 allowance |
$150 allowance |
*CIGNA Vision members may not receive contact lenses and eyeglasses in the same benefit year In-Network
Benefits Include:
-
One vision and eye health evaluation including but not limited to eye health examination, dilation, refraction and prescription for glasses;
-
One pair of prescription plastic or glass lenses, all ranges of prescriptions (powers and prisms)
-
Polycarbonate lenses for children under 18 years of age
-
Oversize lenses
-
Rose #1 and #2 solid tints
-
20% savings non-covered lens options
-
Progressive lenses covered up to bifocal lens amount with 20% savings on the difference;
-
-
One frame of choice covered up to retail plan allowance, plus a 20% savings on amount that exceeds frame allowance;
-
One pair or a single purchase of a supply of contact lenses - in lieu of lens and frame benefit (may not receive contact lenses and eyeglasses in the same benefit year.) Allowance can be applied towards cost of supplemental contact lens professional services (including the fitting and evaluation), and contact lens materials.
*Benefits are valid once per benefit period and cannot be used in conjunction with other discounts, promotions or prior orders. A member who elects to use other discounts and/or promotions in lieu of his/her vision benefits may file a claim to receive reimbursement according to Out-of-Network Reimbursement amounts.
Premium Rates - ALL Eligible Employees
| Coverage | Monthly | Biweekly** |
|---|---|---|
| Single | 9.37 |
4.69 |
| 2-Person | 17.95 |
8.98 |
| Family | 29.12 |
14.56 |
**The vision premiums for biweekly employees will be deducted in 24 equal installments over the course of the calendar year. In those 2 months during the year when there is a third biweekly pay period, employees will have no premium deducted.
More Information
To obtain more information about the UMS Vision Plan, contact CIGNA or visit our frequently asked questions webpage.
Related Information
Contact Benefits
The above is a brief summary of benefits offered by the University of Maine System. If you have a question about benefits enrollment, call toll-free 866-269-9635 (or 973-3373) or email benefits@maine.edu. Have your Employee ID number for faster service.
Last Updated: October 12, 2012->