It's easy to take your eyes for granted. From the moment you wake up to focus on the noisy alarm clock to the end of the day when you drift off to sleep, your eyes perform thousands of tasks to help you navigate through your activities. According to VSP, a national provider of eye care insurance, 80% of life is experienced visually, so it is essential to take good care of our eyes.
Unfortunately, not all Americans enjoy good vision. The U.S. Department of Health and Human Services estimates that 64% of American workers need some form of vision correction.
According to the National Eye Institute, by 2020, approximately 5.5 million Americans will experience blindness or low vision. Recognized as one of the top 10 most frequent causes of disability, vision loss is quickly becoming a major public health concern. With the aging workforce in the United States, reports of major eye diseases will continue to increase.
The majority of vision problems for Americans are caused by eye diseases, injuries, or computer-related eye stress, resulting in eyestrain and blurred vision. Employees need eye care solutions.
Eye Diseases
There are four primary eye diseases linked to vision loss or blindness, which can be detected through regular eye exams:
o Age-related macular degeneration (AMD) affects the part of the retina responsible for sharp central vision -- important for reading, using computers, driving, or watching TV. It is a leading cause of blindness for white Americans over age 50. More than 1.7 million Americans have AMD, and it has blinded approximately 100,000 individuals nationwide. A new case of AMD is diagnosed every three minutes.
o Glaucoma is considered a silent stealer of sight because there are no symptoms of the disease in the early stages. It affects more than four million Americans over age 40 -- half of whom don't know they have it until they experience sudden vision loss.
o Cataracts cloud the natural clear lens in the eye. While the exact cause is uncertain, it may be related to a lifetime exposure to ultraviolet light or lifestyle choices such as smoking, alcohol consumption, and diet.
Cataracts are another leading cause of blindness, affecting nearly 20.5 million Americans age 65 and older.
o Diabetic retinopathy is a common complication of diabetes and is a leading cause of blindness. Retinopathy occurs when blood vessels break down, leak, or become blocked, impacting vision.
Recent medical research determined that more than four million Americans over age 40 have diabetic retinopathy, with at least 12,000 new cases reported each year.
On-The-Job Eye Injuries
More than 2,000 eye injuries occur daily in the workplace, resulting in employers paying in excess of $500 million a year for medical bills and workers' compensation expenses. About one in 10 injuries require one or more missed workdays for healing and recovery, and 10% to 20% cause temporary or permanent vision loss.
Health and safety experts report that 90% of on-the-job eye injuries could have been prevented or the severity lessened if employees had worn the right eye protection.
Computer-Related Eye Problems
Some 75 million Americans have jobs that require them to sit in front of a computer for several hours a day, according to the National Institute for Occupational Safety and Health. More than half of these workers will sooner or later experience a medical condition called computer vision syndrome (CVS), which causes blurred vision, headaches, and dry, inflamed eyes. Individuals who are nearsighted and intensive computer users are at highest risk of developing glaucoma, which can lead to blindness.
Nearly 90% of people who work with computers more than three hours a day experience problems with their eyes.
New eyeglasses have been designed to combat problems associated with CVS. The upper part of the lens allows users to see the monitor clearly, while the bottom part helps them focus on the keyboard or other nearby items.
Wellness Care
Comprehensive eye examinations explore the health of patients' eyes for prevention and early detection of medical concerns, such as thyroid disease, high blood pressure, retinitis pigmentosa, and eye tumors, as well as eye diseases described above.
Health experts also reinforce the importance of comprehensive wellness exams for children. Approximately one child in four has vision problems significant enough to affect academic performance. Not all eye care benefits include comprehensive wellness examinations, so evaluate the plan design before making a recommendation to employers.
Eye Care Solutions
Eye care insurance is important for the early detection of problematic eye conditions, and it has become a popular benefit with employees. Vision is the one sense that employees value most. The cost of eye care insurance is relatively low, especially when compared to treatment costs and to the spiraling prices of medical insurance. For many employers, eye care insurance has been a voluntary benefit option providing employees access to a quality plan.
Eye Care as a Special Benefit
Across the country, many employers are adopting consumer-driven health plans, which feature high-deductible medical insurance designed to encourage employees to take responsibility for their health care spending decisions. While this option promises significant cost savings for employers, employees report incurring higher out-of-pocket costs.
To help offset these additional expenses, some employers are now offering eye care insurance as a value-added benefit at no cost to employees. Employees appreciate this special benefit, so this low-cost benefit is becoming a great recruitment and retention tool.
As with all insurance benefits, every plan is designed differently with variable options and prices. Review the features and any coverage restrictions, along with the price, to ensure that the plan will match employers' needs.
Provider Network, Or Not?
Eye care plans have usually featured a network of high-quality eye care providers. However, this plan design tends to limit employer participation to those in larger markets where there are numerous eye care offices.
Employers in smaller markets, where there are few eye care doctors, have limited eye care insurance benefit options. Instead, they encourage employees to use their Flexible Spending Accounts for eye care expenses (or to pay for costs out of pocket). Due to limited financial resources, many employees opt not to have the more expensive, comprehensive eye-wellness examinations, choosing only vision testing so they can purchase corrective eyeglasses or contacts.
A New Solution Without Restrictions
Some eye care carriers are now offering a "no-network" eye care benefit, providing employees in smaller markets with access to insurance options similar to the larger network plans. This is an "eye-opening" vision benefit that is common with other kinds of benefits, such as medical and dental. Early vision benefits were introduced with provider panels, and that is the only kind of vision coverage that many employers and employees have known. With no network restrictions, employees can visit the eye care providers of their choice. Most of these plans are based on a schedule of benefits so employees know exactly what the plan will reimburse. Prices can be very affordable for the voluntary market, and employers get a solution that fits everyone's needs.
Evaluating Plans and Carriers
Eye care insurance is relatively simple in design, and the premiums are usually one-tenth of a standard health plan. While many carriers offer eye care insurance plans, producers should carefully review the plan features to determine whether comprehensive wellness examinations and services are covered.
When comparing eye care carriers, evaluate their qualifications in these areas:
o Experience with eye care insurance;
o Quality of the eye care insurance coverage offered;
o Flexibility in plan design so modifications can be made to accommodate employee changes and growth;
o Quality and size of the eye care provider panel -- ask carriers how the doctors are evaluated to ensure they are credentialed and qualified to perform the services offered;
o Relationship with network physicians, and;
o Reputation for customer service, high-quality care, and employee satisfaction.
High-Quality Care -- Vision Protection
There are many eye care insurance plan options available for employers. Be persistent to find the one that is the best solution. Work with a carrier interested in partnering with employers to provide high-quality eye care benefits. The carrier should have the flexibility to support employers' changing needs, along with quality customer service and administrative support.
The right carrier can help ensure your clients' satisfaction with their eye care insurance benefits, and can also make your job easier. Make sure your clients have a high-quality eye care insurance plan that protects their most important asset: their employees' eyes!
Karen M. Gustin, LLIF, is vice president-group marketing and managed care for Ameritas Group Dental and Eye Care. Ms. Gustin began her career at Ameritas in 1983. Twelve years later she was appointed to assistant vice president-marketing and managed care. In 2001, Ms. Gustin was promoted to her current position, with responsibilities for group communication, advertising, product development, market research, training, and PPO functions
