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Vision Insurance (United Healthcare)

United HealthCare
Customer Service: 1-800-638-3120
Policy Number: 903022

2020 Annual Enrollment information
The period of time to enroll or make changes to your plan is October 1st - November 15th.  Changes are effective January 1st. If you are not making any changes, it is recommended that employees review and complete their Workday open enrollment event to make sure all dependents are listed and that coverage is correct. All active employee changes will need to be made in Workday by 4:30 pm on November 15th. Please review the Workday job aid for additional details. Retiree changes will need to be submitted to HR by 4:30 pm on November 15th.  

No ID Cards!
Once plan members schedule an appointment with an in-network provider, they simply tell them that they have United HealthCare Insurance. Plan members will be asked to provide their name and date of birth in order to verify benefits. An insurance card is not required.  Plan members can set up an online account through and print out an ID card if they would like a card.

Forms and Resources 
1) Click here to review the Annual Enrollment guide. Information regarding the vision plan can be found on page 12.
1) Enrollment Form - retirees can make changes during annual enrollment and should submit the form to LSUS HR. Active employees will make changes in Workday.
2) Vision Summary of Benefits
3) Vision Plan Document
Vision Out-of-Network Claim Form

In-Network Benefits at a glance

Comprehensive Eye Exam Every 12 months No co-pay
Pair of eyeglass lenses Every 12 months No co-pay
---Single vision, lined, bi-focal, lined tri-focal or lined lenticular lenses, Standard and Deluxe Progressive and Oversized Lenses Every 12 months No co-pay
---Standard scratch coating, Solid and Gradient Tint, ultraviolet Glass and Plastic Coating Covered in full Covered in full
Frames Every 12 months $130 allowance
Lens Options See benefit summary for details
Covered selection of Contact Lenses (lens fitting included) Every 12 months

No co-pay

Up to 4 boxes

Elective Contact Lenses

---Contact lenses that fall outside the covered selection. (Co-pay does not apply)

Every 12 months $130 allowance
---Additional Materials 20% off

Monthly Premiums

Level of Coverage Premium 12 month employee Premium 9 month employee
Employee Only $7.39 $9.85
Employee + Spouse $12.45 $16.60
Employee + Children $12.72 $16.96
Family $20.50 $27.33

Vision premiums will be deducted on a pre-tax basis (Premiums Only Plan).

Search for in-network providers
Please go to to search for in-network providers or call 1-800-839-3242 to locate a provider.  This number is toll-free is available 24-hours a day, 7 days per week.
Can't find your provider? Nominate the provider to become an in-network provider. Click here for the nomination form. 

Employee Eligibility
Any active employee of LSUS is eligible for vision insurance provided the following:
Employed at 75% of full-time effort or greater (at least 30 hours per week);
Appointed for a duration of at least one semester or 121 days or greater Enrollment

Dependent Eligibility

- The covered employee's legal spouse
- A child from the date of birth up to 26 years of age (regardless of student status or tax status)

New Hires and Mid-Year Changes

New Hires must complete the enrollment in Workday within the first 30 days of employment.
Mid-year changes are allowed for IRS "qualifying events" within 30 days of the event. Qualifying events are: change in family status (birth, marriage, divorce, legal separation, change in employment status of employee or spouse), changes required by judgment, FMLA qualified leaves of absence, significant cost or coverage changes. Proof of the qualifying event is required in order to make a mid-year change. Employees who have a mid-year change must complete the change in Workday within the 30 day window.

Effective Dates of Coverage
Annual enrollment changes are effective January 1st of each calendar year. The effective date for new hires is the first of the month following a full month of employment. For example, a person who is hired on August 20th, and elects coverage within the first 30 days of employment will have coverage begining October 1st.

Terminating employees have the option to continue vision benefits through COBRA.

Continuing Coverage as a Retiree
Vision insurance is eligible to be continued into retirement. Retirees pay premiums directly to United Healthcare. Retirees are not eligible to add this insurance after they have retired.

Tools and Other Resources
Click here for Information on Using your Vision Insurance
Click here for Frequently Asked Questions (FAQs).
Click here for Hearing Aid Discounts.
Click here for savings on LASER Vision Correction.

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