Calendar year
The 12-month period beginning Jan. 1 and ending Dec. 31.
Co-insurance
The amount of money a vision plan will pay for provider
services.
Co-pay
The fixed amount a vision plan member is responsible for
paying each time they receive services from a network provider.
Coverage
The eye care services listed as benefits in a vision
insurance plan.
Deductible
An amount that must be paid by a vision plan member
before the vision plan begins to pay its share.
Flexible spending account (FSA)
Sometimes called a cafeteria plan, an FSA allows an employee to
use pre-tax dollars to purchase certain health benefits, such as vision
insurance, which are not covered by conventional health
insurance.
Vision insurance - group vision insurance
Vision insurance purchased through a group such as a business,
association, or union.
HMO (health maintenance
organization)
A group of health care providers formed to serve certain health plan
members. Health plan members usually are permitted to receive health
care only from HMO providers.
HSA (health savings account)
A savings account employees can pay into with pre-tax income to be
applied to present and future healthcare expenses. To open an HSA, you
must have a high-deductible health insurance policy.
Vision insurance - Individual vision insurance
Eye care coverage sold to an individual as opposed to a group. The
membership fee for an individual plan usually is higher than membership
fees for participants in a group plan.
Managed vision care
Eye care provided to members of a preferred provider eye care network
at below retail costs.
Membership fee
The annual fee paid to keep a vision plan in effect.
Network
Optometrists and ophthalmologists, eyewear and contact lens
manufacturers, optical laboratories, and LASIK/PRK surgeons that have
contracted with a vision insurance organization to provide eye
care services at discounted rates.
Out-of-network
Optometrists and ophthalmologists, eyewear and contact lens
manufacturers, optical laboratories, and LASIK/PRK surgeons that have not
contracted with a vision insurance organization to provide eye
care services at discounted rates.
PCP (primary care provider)
An optometrist or ophthalmologist who is contracted by a vision
insurance company to coordinate eye care for members of vision
insurance plans.
POS (point-of-service)
A group vision insurance plan that allows plan members to
select eye care from out-of-network as well as network providers, but at
a higher cost.
PPO (preferred provider
organization)
A network of healthcare providers organized by an insurance company
to provide healthcare services to insurance policyholders at a fixed
rate well below retail prices. Policyholders may opt to access
out-of-network providers, but at higher costs.
Premium
The annual fee paid to keep a vision plan in effect.
Provider
Optometrists or ophthalmologists, eyeglass and contact manufacturers,
optical laboratories, and LASIK and PRK surgeons that provide eye care.
Vision insurance - Vision benefits
Eye care services provided by a vision insurance or benefits
plan, to which plan members are entitled.
Vision insurance - Vision discount plans
Large buying organizations formed to provide discounts on health
services to its members; these plans technically are not related to
health insurance.
