PFT Retirees — National Vision Administrators Vision Program

(N.V.A. VISION PROGRAM)

Benefit Periods

  • There are no limitations
  • Retiree pays entire reduced cost

Purpose

  • To provide thorough vision analysis (including Tonometry test), lenses manufactured to exacting standards and a wide selection of quality frames at a controlled cost.
  • To control the cost of more expensive frames and cosmetic items such as tints and photograys so that the member may save money. The savings could be as much as 50% of the retail cost.

If you elect to use one of the participating optometrists, ophthalmologists, or opticians, there is a basic charge for:

  • Examination—Up to $25.00
  • Administrative fee—$6.69
  • Regular lenses (two)—Up to $28.00
  • Bifocal (two)—Up to $39.00
  • Trifocal (two)—Up to $48.00
  • Any frame which the wholesale cost is $24.00 or less
    • The $24.00 basic charge is applied to the wholesale cost of the frames. These typically sell for approximately $48.00.
    • If you pick more expensive frames, you pay the difference between the $24.00 and the actual wholesale cost, plus 20% of this difference.
    • A basic pair of regular—sized glasses, including the examination, could cost less then $83.00 (depending on the frames selected, with no extra)

ALL CHARGES ARE MONITORED BY N.V.A – INCLUDING EXTRAS

Extras

Lens options purchased from a participating NVA provider will be provided to the member at the amounts listed in the fixed option pricing list below:

 

  • $75 Polarized
  • $40 Blue Light Blocker (Standard)
  • $60 Blue Light Blocker (Premium)
  • $150 Blue Light Blocker (Ultra)
  • $12 Fashion Gradient
  • $20 Glass Photogrey (Single Vision)
  • $30 Glass Photogrey (Multi-Focal)
  • $55 High Index
  • $12 Ultraviolet Coating
  • $25 Polycarbonate (Single Vision)
  • $30 Polycarbonate (Multi-Focal)
  • $10 Scratch-Resistant Coating (Standard
  • $65 Transitions Single Vision (Standard)
  • $70 Transitions Multi-Focal (Standard)
  • $10 Solid Tint
  • $40 AR Coating – Tier 1
  • $50 AR Coating – Tier 2
  • $65 AR Coating – Tier 3
  • $80 AR Coating – Tier 4
  • 20% discount AR Coating – Tier 5
  • $30 Blended Bifocal (Segment)
  • $39 Retinal Screening
  • $100 Progressive – Tier 3
  • $120 Progressive – Tier 4
  • $140 Progressive – Tier 5
  • $165 Progressive – Tier 6
  • $190 Progressive – Tier 7
  • 20% discount Progressive – Tier 8

 

For lens options & services purchased from a participating NVA provider, NVA members will only pay the fixed maximum amount or the provider’s wholesale cost, whichever is less. Options not listed will be priced by NVA providers at their wholesale cost. Fixed prices are available in-network only. In certain states, members may be required to pay the full retail amount and not the negotiated discount amount at certain participating providers. Some optometrist affiliated with Optical Retail locations (i.e., Visionworks, etc.) are independent providers and may not participate in the NVA program.

Participating providers are not contractually obligated to offer sale prices in addition to outlined coverage. Regardless of medical or optical necessity, vision benefits are not available more frequently than specified in your policy.

Payments

Your basics are billed to you by the Fund. You pay optometrist or ophthalmologist for the extras. These maximum charges are listed on the form and checked by N.V.A. All basic charges are billed to you directly from the PFT Health & Welfare Fund. Basic charges include the examination, regular-sized lenses, administration fee, and regular-sized frames (up to $24.00 wholesale price) You pay the doctor directly for extras (prices listed and signed for by you when you order your glasses) when you pick up the glasses.

FAILURE TO PAY THE PFT H&W FUND BILL WITHIN 30 DAYS WILL RESULT IN THE RETIREE LOSING THE PRESCRIPTION AND DENTAL BENEFITS.

How does an eligible person use the PFT Retirees N.V.A. Vision Program?

  • Click on the link for a list of eligible providers
  • Make an appointment and notify the NVA participating provider that our coverage is administered by NVA and sponsored by The Philadelphia Federation of Teachers
  • You pay the provider for listed extras when you pick up your glasses.
  • After you order your glasses you will receive a bill for the basic portion of your order from the Fund office. Pay the bill within 30 days.
  • Remember, failure to pay the Fund bill could result in loss of the Prescription Benefit.