Optical Benefits

Benefits are payable according to the stipulations below for covered optical charges incurred while the member and dependent(s) - if any - remain eligible to receive them.

NOTE: For greater safety and protection, all eyeglasses supplied under this Plan comply with the recent Food and Drug Administration requirement that all lenses be "impact resistant".

OPTICAL BENEFITS OFFICE

National Optical Services

Who Is Covered

This Plan provides complete optical services for members, and any eligible dependent (s).

What Charges Are Covered

The following are covered by the Plan:

Eye examination (refraction test)
Complete set of eyeglasses (including lenses and frames)
Complete set of eyeglasses (with bifocal lenses and frames)
Tinted glasses (where medically indicated)
Contact lenses

NOTE: The following conditions apply:

Under this Plan the member and any eligible dependent(s) are entitled to one pair of eyeglasses once per person every 12 months from last date of service.
The annual, maximum reimbursement is $350 for covered individuals with an annual maximum of $700 per family as of 7/1/2021.
All claims must be submitted with 120 days from the date purchased.

What Charges Are Not Covered

Sunglasses (plain or prescription) are not covered by the Plan.

Claim Procedure For Direct Reimbursement

In order to be reimbursed directly, the member shall:

Use an optical voucher form supplied by the National Optical;
Have a qualified optician complete the optical voucher form;
Sign and date claim form
Submit the completed voucher form to the Welfare Fund;
Submit an original receipt.

New York City Electrical Division Welfare Fund Local 3 Optical Benefits

In-Network Benefits

Optical benefits are available yearly.
Eligibility is year to date.
- Yearly and date to date eligibility applies to both
family and individual benefit periods
Benefits provided by extensive list of participating locations.
Family optical benefits include up to four (4) free 11-point eyeglass examinations.
- Free complete pair of glasses or contact lenses value up to $900.00 per family. (See level options below for per person breakdown).
- Max. 4 family members per year.
- One family member may not use entire family allowance alone.
In lieu of eyeglasses, members may opt for contact lenses.
- Contact lens benefits include: exam, fitting fee, & contact lenses.

Benefit Level Options (Material Allowance)
(applies to both eyeglasses & contacts)


Option One	Two (2) family members max out yearly benefits at $400 allowance each per year
Option Two	Three (3) family members max out yearly benefits with: One member receiving $400 allowance Two members receiving $225 each
Option Three	Four (4) family members max out yearly benefits at $225 allowance each per year.

Eyeglasses & Lenses Benefits Include:

Upgraded section of union frames (including selection of designer frames depending on level option)
Lenses
- Single Vision, Bifocal, Trifocal
Lens Options Included:
- Tinted
- Over-sized
- No-scratch

Additional Benefits

Member Support
No Paperwork
Assistance finding provider locations
Claim forms sent directly to location of choice
All upgrades allowed (member pays overage)
20% discount on additional full pair of eyeglasses.
Benefits may not be applied to store specials or discounted items.

Out-Of-Network Benefits

Optical Reimbursement

Optical benefits are available yearly.
Eligibility is year to date.
- Yearly and date to date eligibility applies to both family and individual benefit periods.
Yearly benefit reimbursements include: Eye exam, & Eyeglasses (Lens & Frame) or Contact Lenses.
Maximum yearly family reimbursement up to $700.00.
Maximum yearly individual reimbursement up to $350.00.
One family member may not use entire family benefit ($700.00).
Exams and materials must be obtained at the same time in order to be eligible for reimbursement.
- Services and materials may not be split between in-network and out-of-network providers.
Reimbursement forms are sent directly to location of choice.
Members must submit original timed claim forms, along with original itemized receipts to union for reimbursement.