Open Enrollment
2026-2027 Open Enrollment will take place from April 20 - May 1st, with on-site enrollment available from April 20-24.
Willard Benefits Guide
Medical Open Enrollment Resources
2026-2027 Medical Plans Summary
Willard Public Schools Medical Plan Summary & Rates as of July 1-June 30 2027
To access a pdf version of the Medical Plan Summary, click here.
| SHOW-ME BENEFIT CONSORTIUM |
MERCY NETWORK PLANS | COX NETWORK PLANS | CIGNA DUAL ACCESS NETWORK PLANS |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Plan Description | $3000 Mercy PPO | $3400 Mercy HDHP | $6000 Mercy HDHP | $3000 Cox PPO | $3400 Cox HDHP | $6000 Cox HDHP | $1800 Cigna Dual PPO | $3500 Cigna Dual HDHP | ||
| In Network Benefits | In Network Benefits | In Network Benefits | In Network Benefits | In Network Benefits | In Network Benefits | In Network Benefits | In Network Benefits | |||
| Individual Deductible | $3,000 | $3,400 | $6,000 | $3,000 | $3,400 | $6,000 | $1,800 | $3,500 | ||
| Family Deductible | $6,000 | $6,800 | $12,000 | $6,000 | $6,800 | $12,000 | $3,000 | $7,000 | ||
| Individual Out of Pocket Max | $7,500 | $5,000 | $8,000 | $7,500 | $5,000 | $8,000 | $6,000 | $7,000 | ||
| Family Out of Pocket Max | $15,000 | $10,000 | $16,000 | $15,000 | $10,000 | $16,000 | $12,000 | $14,000 | ||
| Coinsurance | 80%/20% | 80%/20% | 80%/20% | 80%/20% | 80%/20% | 80%/20% | 70%/30% | 80%/20% | ||
| Lifetime Maximum | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited | Unlimited | ||
| Copay Covered Services (PPO Plans) | ||||||||||
| Office Visit-Primary Care** | $20 copay | 20% AD* | 20% AD* | $25 copay | 20% AD* | 20% AD* | $25 copay | 20% AD* | ||
| Office Visit- Specialist** | $40 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | ||
| Preventive Care | $0 copay | $0 copay | $0 copay | $0 copay | $0 copay | $0 copay | $0 copay | $0 copay | ||
| Chiropractic | $40 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | ||
| Physical Therapy Hospital /Outpatient Setting |
$40 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | ||
| Urgent Care*** | $75 copay | 20% AD* | 20% AD* | $75 copay | 20% AD* | 20% AD* | $50 copay | 20% AD* | ||
| Emergency Room (*copay waived if admitted) |
$350 copay | 20% AD* | 20% AD* | $350 copay | 20% AD* | 20% AD* | $200 copay + 30% | 20% AD* | ||
| Covered Services AFTER DEDUCTIBLE | ||||||||||
| Outpatient Lab Services | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | $0 copay | 20% AD* | ||
| Outpatient Radiology | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 30% AD* | 20% AD* | ||
| Inpatient/Outpatient Hospital Care | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 30% AD* | 20% AD* | ||
| Surgeries In Physician Office Setting | 2 visits per calendar year at Office Visit copay, additional visits 20% AD* |
20% AD* | 20% AD* | 2 visits per calendar year at Office Visit copay, additional visits 20% AD* |
20% AD* | 20% AD* | 2 visits per calendar year at Office Visit copay, additional visits 30% AD* |
20% AD* | ||
| Inpatient Injectables | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 20% AD* | 30% AD* | 20% AD* | ||
| Outpatient Injectables | $0 through SMBC Program |
$0 through SMBC Program |
$0 through SMBC Program |
$0 through SMBC Program |
$0 through SMBC Program |
$0 through SMBC Program |
$0 through SMBC Program |
$0 through SMBC Program |
||
| Pharmacy | ||||||||||
| Generic | $10 copay | $10 copay AD* | $10 copay AD* | $15 copay | $10 copay AD* | $10 copay AD* | $15 copay | $10 copay AD* | ||
| Formulary Brand | $35 copay | $35 copay AD* | $35 copay AD* | $35 copay | $35 copay AD* | $35 copay AD* | $35 copay | $35 copay AD* | ||
| Non-Formulary Brand | $75 copay | $75 copay AD* | $75 copay AD* | $75 copay | $75 copay AD* | $75 copay AD* | $75 copay | $75 copay AD* | ||
| Specialty Medications | Excluded unless through MAP**** |
Excluded unless through MAP**** |
Excluded unless through MAP**** |
Excluded unless through MAP**** |
Excluded unless through MAP**** |
Excluded unless through MAP**** |
Excluded unless through MAP**** |
Excluded unless through MAP**** |
||
| 2026-2027 Rates | ||||||||||
| Employee Only | $20 | $19 (HSA contribution) | $96 (HSA Contribution) | $31 | $8 (HSA Contribution) | $87 (HSA Contribution) | $139 | $9 | ||
| Employee & Spouse | $700 | $614 | $528 | $724 | $627 | $540 | $926 | $654 | ||
| Employee & Child(ren) | $492 | $424 | $365 | $514 | $433 | $373 | $682 | $454 | ||
| Family | $1,119 | $998 | $859 | $1,153 | $1,020 | $878 | $1,420 | $1,059 | ||
This is a partial description of the benefits offered. It does not include all the terms, coverage, exclusions, limitations and conditions of the actual policy. See the policies and contracts for the actual language. The Summary of Benefits (SBC) and Plan Documents will supersede this illustration. This illustration is not a contract and offers no contractual obligation on behalf of HPMG.
* AD - After Deductible
** Office Visit copay applies only to an Office Visit setting. If billed as an Outpatient setting, charges will apply to the Deductible and Coinsurance.
*** Urgent Care charges apply to the Deductible &/or Coinsurance if billed as Hospital or Outpatient services.
****Manufacturer Assistance Program
Employee cost includes board allowance up to the lowest cost premium, not to exceed $577
Board Paid Contribution towards the HSA is based on enrollmet into the plan AND eligibility
Dental Open Enrollment Resources
Managing your Dental Plan
Easily Manage Your Dental Benefits
Here's what you can do now to get the most from your plan.
To access the pdf version of this information, click here.
Create your secure online member account today
- Go online: Visit ameritas.com/sign-in and select ‘Member Sign In’ under 'Dental, Vision & Hearing.’
- Register: Under first-time users, select ‘Register Now’ and complete the form. Log into your new account and complete the verification process.
- Authenticate: Provide the personal information used at enrollment including name, date of birth and ZIP Code. Mark if you are the insured member and enter your member ID.
Due to HIPAA regulations, only the primary member/policyholder has full account access. Learn more about access levels.
Go paperless. Sign up to receive your explanation of benefits (EOB) statements online. To receive electronic EOBs instead of
paper statements, select the go paperless option once you are logged in or when setting up your member account.
Member account to-do list:
- Print out or save your ID card to your smartphone
- Review your plan details including maximum benefit
- Check if your current provider is part of the Ameritas Dental Network
- Locate your claims status page so you can see how benefits are calculated and payments are processed
Additional plan benefits found in your secure member account
Additional savings
Ameritas offers money-saving discounts to help with hearing, prescription and eyewear expenses. These savings arrangements are not insurance and are available to Ameritas plan members at no additional cost to the plan premium. Access savings cards through your secure account at ameritas.com.
Worldwide support
AXA Assistance helps find a provider and schedule an appointment if you have a dental or vision emergency while traveling outside the U.S.
Save these numbers:
866-662-2731 (toll free)
and 312-935-3727 (collect)
Watch this short video to learn more about navigating your secure member account.
Evaluate your potential out-of-pocket costs
- Located in your secure member account, the dental cost estimator lets you compare estimated procedure charges based on ZIP Code. You can search estimates for both in-network and out-of-network providers.
- Ask your dentist to submit a pretreatment estimate for any dental work you consider expensive. Then Ameritas will let you know the amount insurance will cover so you can budget for the remainder. The pretreatment estimate is based on your plan benefits and submitted claims.
Save Money
You can use your dental benefits with any provider. The thing to consider is out-of-network dentists will charge you their regular rates, whereas
Ameritas network providers have agreed to charge you 25-50% less. After your plan benefits are applied, you pay the remaining balance.
Find out if your dentist is in the network
Visit ameritas.com, Find a Health Provider, to find a new dentist or see if your current provider is in the Ameritas Dental Network. For a list of providers that allow you to use your in-network benefits in Mexico, select Find a Contracted Provider in Mexico.
Nominate your dentist
If your dentist is not in the network already, just go to ameritas.com, search for "nominate a provider" and complete the online form.
Here to help
For plan information any time, visit ameritas.com and sign in to your secure member account. Or download the Ameritas Benefits app available for iOS and Android. Log in with the same user ID and password you use for your secure member account. If you have questions about your plan benefits, use the chat feature located in your secure member account or call the Ameritas customer connections team.
Claims, benefit and provider network questions:
group@ameritas.com I 800-487-5553
Monday - Thursday, 7 a.m. - Midnight (CST)
Friday, 7 a.m. - 6:30 p.m. (CST)
Mobile App
Download the Ameritas Benefits App
To access the pdf version of this information, click here.
If you have have an Ameritas secure member account, you can download the Ameritas Benefits app to easily search for providers, view dental benefits and processed claims, and access ID cards once benefits become effective.
Log in with the same user ID and password you use for your secure member account.
Dental Plan 1 Benefit Summary
Show Me Benefit Consortium
Dental Highlight Sheet
| Plan Benefit | |
|---|---|
| Type 1 | 100% |
| Type 2 | 80% |
| Deductible | $50/Calendar Year Type 2 Waived Type 1 $150/family |
| Maximum (per person) | $1,250 per calendar year |
| Waiting Period | None |
| Annual Open Enrollment | Included |
Sample Procedure Listing (Current Dental Terminology © American Dental Association.)
Type 1
- Routine Exam (1 in 6 months)
- Bitewing X-rays (1 in 12 months)
- Full Mouth/Panoramic X-rays (1 in 3 years)
- Cleaning (1 in 6 months)
- Fluoride for Children 18 and under (1 in 12 months)
- Sealants (age 15 and under)
- Space Maintainers
Type 2
- Periapical X-rays
- Fillings for Cavities
- Restorative Composites (anterior and posterior teeth)
- Simple Extractions
- Complex Extractions
- Anesthesia
Monthly Rates
| Employee Only (EE) | $28.68 |
|---|---|
| EE + Spouse | $56.44 |
| EE + Children | $73.48 |
| EE + Spouse & Children | $110.88 |
Ameritas Information
We're Here to Help
This plan was designed specifically for the associates of Show Me Benefit Consortium. At Ameritas Group, we do more than provide coverage - we make sure there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions.
Our customer relations associates will be pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling toll-free: 800-487-5553. For plan information any time, access our automated voice response system or go online to ameritas.com.
Dental Health Scorecard
How would you rate your dental health?
In 2016, you can receive your Dental Health Report Card by signing into your secure member account online. Your assessment is based on claims submitted. The report card also offers suggestions if you strive to improve your dental health. Ameritas members can access the personalized report card by going to ameritas.com, click Account Access in the top right corner and choose the Dental/Vision/Hearing drop down. Select the Secure Member Account link and sign in to see your report.
Rx Savings
Our valued plan members and their covered dependents can save on prescription medications at over 60,000 pharmacies across the nation including CVS, Walgreens, Rite Aid and Walmart. This Rx discount is offered at no additional cost, and it is not insurance.
To receive this Rx discount, Ameritas plan members just need to visit us at ameritas.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card.
Eyewear Savings
Ameritas plan members may receive up to 10% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. Members may also bring in their current vision prescription from any vision care provider and purchase eyewear at Walmart. This savings arrangement is not insurance: it is available to members at no additional cost to their plan premium.
To receive the eyewear savings identification card, Ameritas plan members can visit ameritas.com and sign-in (or create) a secure member account. Members must present the Ameritas Eyewear Savings Card at time of purchase to receive the discount.
Dental Network Information
To find a provider, visit ameritas.com and select FIND A PROVIDER, then DENTAL. Enter your criteria to search by location or for a specific dentist or practice. California Residents: When prompted to select your network, choose the Ameritas Network found on your ID Card or contact Customer Connections at 800-487-5553.
Your provider network is Ameritas Classic and Plus Network.
Pretreatment
While we don't require a pretreatment authorization form for any procedure, we recommend them for any dental work you consider expensive. As a smart consumer, it's best for you to know your share of the cost up front. Simply ask your dentist to submit the information for a pretreatment estimate to our customer relations department. We'll inform both you and your dentist of the exact amount your insurance will cover and the amount that you will be responsible for. That way, there won't be any surprises once the work has been completed.
Open Enrollment
If a member does not elect to participate when initially eligible, the member may elect to participate at the policyholder's next enrollment period. This enrollment period will be held each year and those who elect to participate in this policy at that time will have their insurance become effective on July 1. If you do not enroll during your company's open enrollment period, then you will be subject to the Late Entrant Provision.
Late Entrant Provision
We strongly encourage you to sign up for coverage when you are initially eligible. If you choose not to sign up during this initial enrollment period, you will become a late entrant. Late entrants will be eligible for only exams, cleanings, and fluoride applications for the first 12 months they are covered.
Section 125
This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period.
Dental Cost Estimator
Members can use our dental cost estimator at any time to find average procedure charges in their area. The estimates do not include network discounts or plan benefits. Find the dental cost estimator at ameritas.com/applications/group/estimator.
After coverage begins, members can view average in-network charges in their secure member account. Members also may ask their dentist’s office to submit a pretreatment estimate so they can see exactly how a proposed service would be covered and avoid any surprises. The pretreatment estimate is based on their plan benefits.
Worldwide Support
If a member has a dental emergency outside the U.S., AXA Assistance can help. AXA provides credible provider referrals and can even help with making the appointment. Providers referred by AXA are not members of the Ameritas network. AXA contact information is available in the secure member account.
Language Services
We recognize the importance of communicating with our growing number of multilingual customers. That is why we offer a language assistance program that gives you access to: Spanish-speaking claims contact center representatives, telephone interpretation services in a wide range of languages, online dental network provider search in Spanish and a variety of Spanish documents such as enrollment forms, claim forms and certificates of insurance.
This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of insurance and does not include exclusions and limitations.
Dental Plan 3 Benefit Summary
Show Me Benefit Consortium
Dental Highlight Sheet
| Plan Benefit | |
|---|---|
| Type 1 | 100% |
| Type 2 | 100% |
| Type 3 | 80% |
| Deductible | $25/Calendar Year Type 2 & 3 Waived Type 1 No Family Maximum |
| Maximum (per person) | $1,250 per calendar year |
| Waiting Period | None |
| Annual Open Enrollment | Included |
Orthodontia Summary - Child Only Coverage
| Allowance | U&C |
|---|---|
| Plan Benefit | 50% |
| Lifetime Maximum (per person) | $1,000 |
| Waiting Period | None |
| Takeover Benefit | Initial Insureds Only |
Sample Procedure Listing (Current Dental Terminology © American Dental Association.)
Type 1
- Routine Exam (1 in 6 months)
- Bitewing X-rays (1 in 12 months)
- Full Mouth/Panoramic X-rays (1 in 5 years)
- Cleaning (1 in 6 months)
- Fluoride for Children 18 and under (1 in 12 months)
- Sealants (age 15 and under)
- Space Maintainers
Type 2
- Periapical X-rays
- Fillings for Cavities
- Restorative Composites (anterior and posterior teeth)
- Endodontics (nonsurgical)
- Simple Extractions
- Complex Extractions
- Anesthesia
Type 3
- Onlays
- Crowns (1 in 10 years per tooth)
- Crown Repair
- Endodontics (surgical)
- Periodontics (nonsurgical)
- Periodontics (surgical)
- Denture Repair
- Implants
- Prosthodontics (fixed bridge; removable complete/partial dentures) (1 in 10 years)
Monthly Rates
| Employee Only (EE) | $39.84 |
|---|---|
| EE + Spouse | $78.80 |
| EE + Children | $99.20 |
| EE + Spouse & Children | $148.64 |
Ameritas Information
We're Here to Help
This plan was designed specifically for the associates of Show Me Benefit Consortium. At Ameritas Group, we do more than provide coverage - we make sure there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions.
Our customer relations associates will be pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling toll-free: 800-487-5553. For plan information any time, access our automated voice response system or go online to ameritas.com.
Dental Health Scorecard
How would you rate your dental health?
In 2016, you can receive your Dental Health Report Card by signing into your secure member account online. Your assessment is based on claims submitted. The report card also offers suggestions if you strive to improve your dental health. Ameritas members can access the personalized report card by going to ameritas.com, click Account Access in the top right corner and choose the Dental/Vision/Hearing drop down. Select the Secure Member Account link and sign in to see your report.
Rx Savings
Our valued plan members and their covered dependents can save on prescription medications at over 60,000 pharmacies across the nation including CVS, Walgreens, Rite Aid and Walmart. This Rx discount is offered at no additional cost, and it is not insurance.
To receive this Rx discount, Ameritas plan members just need to visit us at ameritas.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card.
Eyewear Savings
Ameritas plan members may receive up to 10% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. Members may also bring in their current vision prescription from any vision care provider and purchase eyewear at Walmart. This savings arrangement is not insurance: it is available to members at no additional cost to their plan premium.
To receive the eyewear savings identification card, Ameritas plan members can visit ameritas.com and sign-in (or create) a secure member account. Members must present the Ameritas Eyewear Savings Card at time of purchase to receive the discount.
Orthodontia - Initial Insureds Only
Ameritas will provide coverage on current orthodontic treatment programs and pay up to Ameritas’ orthodontic maximum minus any benefits the member has received from the prior carrier. These takeover benefits only apply to initial employees and their dependents on the plan’s effective date and are not available to new enrollees who enroll after case implementation.
Dental Network Information
To find a provider, visit ameritas.com and select FIND A PROVIDER, then DENTAL. Enter your criteria to search by location or for a specific dentist or practice. California Residents: When prompted to select your network, choose the Ameritas Network found on your ID Card or contact Customer Connections at 800-487-5553.
Your provider network is Ameritas Classic and Plus Network.
Pretreatment
While we don't require a pretreatment authorization form for any procedure, we recommend them for any dental work you consider expensive. As a smart consumer, it's best for you to know your share of the cost up front. Simply ask your dentist to submit the information for a pretreatment estimate to our customer relations department. We'll inform both you and your dentist of the exact amount your insurance will cover and the amount that you will be responsible for. That way, there won't be any surprises once the work has been completed.
Open Enrollment
If a member does not elect to participate when initially eligible, the member may elect to participate at the policyholder's next enrollment period. This enrollment period will be held each year and those who elect to participate in this policy at that time will have their insurance become effective on July 1. If you do not enroll during your company's open enrollment period, then you will be subject to the Late Entrant Provision.
Late Entrant Provision
We strongly encourage you to sign up for coverage when you are initially eligible. If you choose not to sign up during this initial enrollment period, you will become a late entrant. Late entrants will be eligible for only exams, cleanings, and fluoride applications for the first 12 months they are covered.
Section 125
This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period.
Dental Cost Estimator
Members can use our dental cost estimator at any time to find average procedure charges in their area. The estimates do not include network discounts or plan benefits. Find the dental cost estimator at ameritas.com/applications/group/estimator.
After coverage begins, members can view average in-network charges in their secure member account. Members also may ask their dentist’s office to submit a pretreatment estimate so they can see exactly how a proposed service would be covered and avoid any surprises. The pretreatment estimate is based on their plan benefits.
Vision Open Enrollment Resources
Vision Benefits
Start Using Your Vision Benefits
Featuring the VSP vision network
To access the pdf version of this information, click here.
Maintaining good vision and eye health is a priority. Now that you’ve enrolled, here’s what you can do to
make the most of your vision benefits.
- Create a VSP Account: Register at VSP.com. Enter the last 4 digits of the primary member's SSN or Member ID number and complete all required fields. Select 'Create an Account' to complete your registration.
- Review your plan details and print or save your ID card: Log in and locate your benefit plan to verify your coverage and eligibility. If you lose your ID card or need extras, you can access a digital version to print or save to your smartphone.
- Verify your network and find a provider: You are free to see the vision provider of your choice, and you save more when seeing a VSP network provider. Log into your member account to verify your network and use the ‘Find a Doctor’ tool to locate a network provider.
VSP Network
VSP offers the nation’s largest network of independent doctors. Retail locations include:
- Costco
- Walmart
- Sam's Club
- Visionworks
Online options
Browse and buy online at eyeconic.com and get the most current deals on eyewear. Eyeconic.com is in the VSP network, and your vision benefits are applied directly to your online order. Find more ways to save with VSP Exclusive Member Extras.
4. Schedule an appointment: Select a provider and schedule your appointment. When you arrive, tell them you have VSP. No ID card is necessary. Your provider will be able to look up your benefits by providing your social security number or unique ID.
5. Check your claims in your member account: You can check your claim status on the benefits history page on your account dashboard.
Member account to-do list:
Manage your eye care needs anytime and anywhere by downloading the VSP Vision Care App. Search for the app on the App Store (iOS) or Google Play (Android).
Frequently Asked Questions
Can I use my benefits if I visit a provider outside the network?
Yes, if you visit an out-of-network provider, you pay your provider the full balance and submit a claim with your itemized receipt for
reimbursement based on out-of-network plan benefits. Greater benefits are available with network providers, and they submit the claim
for you.
Can I get glasses and contacts in the same year?
No, your benefit can be applied to contacts OR glasses during the benefit year. In other words, you will not receive an allowance for
contacts if you already chose to apply your vision benefits to a new pair of lenses and/or frames during the same benefit year.
Are prescription safety glasses covered?
Yes. You can use your benefits towards prescription safety glasses in lieu of regular eyeglasses or contacts.
Who do I contact if I have questions?
Contact VSP for benefit, claims or network questions.
800-877-7195
Monday – Saturday, 8 a.m. - 7 p.m. (CST)
Contact Ameritas for billing, administration, ID card or network questions.
group@ameritas.com
If you enrolled through an employer: 800-487-5553
If you purchased online: 800-300-9566
Monday - Thursday, 7 a.m. - Midnight
Friday, 7 a.m. - 6:30 p.m. (CST)
Mobile App
Download the VSP Vision Care On the Go App
Manage your eye care needs anytime and anywhere by downloading the VSP Vision Care App. Search for the app on the App Store (iOS) or Google Play (Android).
VSP Vision Plan 2 Summary
Show Me Benefit Consortium
Eye Care Highlight Sheet
| VSP Choice Network + Affiliates | Out of Network | |
|---|---|---|
| Deductibles | $10 Exam $10 Eye Glass Lenses or Frames* |
$10 Exam $10 Eye Glass Lenses or Frames |
| Annual Eye Exam | Covered in full | Up to $45 |
| Lenses (per pair) Single Vision |
Covered in full | Up to $30 |
| Bifocal | Covered in full | Up to $50 |
| Trifocal | Covered in full | Up to $65 |
| Lenticular | Covered in full | Up to $100 |
| Progressive | See lens options | NA |
| Contacts Fit & Follow Up Exams |
Member cost up to $60 | No benefit |
| Elective | Up to $150 | Up to $120 |
| Medically Necessary | Covered in full | Up to $210 |
| Frame Allowance | $150** | Up to $75 |
| Frequencies (months) Exam/Lens/Frame |
12/12/24 Based on date of service |
12/12/24 Based on date of service |
*Deductible applies to a complete pair of glasses or to frames, whichever is selected.
**The Costco and Walmart allowance will be the wholesale equivalent.
Lens Options (member cost)*
| VSP Choice Network + Affiliates (Other than Costco) |
Out of Network | |
|---|---|---|
| Progressive Lenses | Up to provider’s contracted fee for Lined Bifocal Lenses. The patient is responsible for the difference between the base lens and the Progressive Lens charge. | Up to Lined Bifocal allowance. |
| Std. Polycarbonate | Covered in full for dependent children $33 adults |
No benefit |
| Solid Plastic Dye | $15 (except Pink I & II) |
No benefit |
| Plastic Gradient Dye | $17 | No benefit |
| Photochromatic Lenses (Glass & Plastic) | $31-$82 | No benefit |
| Scratch Resistant Coating | $17-$33 | No benefit |
| Anti-Reflective Coating | $43-$85 | No benefit |
| Ultraviolet Coating | $16 | No benefit |
*Lens Option member costs vary by prescription, option chosen and retail locations.
Monthly Rates
| Employee Only (EE) | $8.88 |
|---|---|
| EE + Spouse | $17.80 |
| EE + Children | $19.84 |
| EE + Spouse & Children | $30.20 |
Additional Focus® Choice Network Features
| Contact Lenses Elective | Allowance can be applied to disposables, but the dollar amount must be used all at once (provider will order 3 or 6 month supply). Applies when contacts are chosen in lieu of glasses. For plans without a separate contact fitting & evaluation (which includes follow up contact lens exams), the cost of the fitting and evaluation is deducted from the allowance. |
|---|---|
| Additional Glasses | 20% off additional complete pairs of prescription glasses and/or prescription sunglasses.* |
| Frame Discount | VSP offers 20% off any amount above the retail allowance.* |
| Laser VisionCare | VSP offers an average discount of 15% off or 5% off a promotional offer for LASIK Custom LASIK and PRK. The maximum out-of-pocket per eye for members is $1,800 for LASIK and $2,300 for custom LASIK using Wavefront technology, and $1,500 for PRK. In order to receive the benefit, a VSP provider must coordinate the procedure. |
| Low Vision | With prior authorization, 75% of approved amount (up to $1,000 is covered every two years). |
Based on applicable laws, reduced costs may vary by doctor location.
Rx Savings
Our valued plan members and their covered dependents can save on prescription medications at over 60,000 pharmacies across the nation including CVS, Walgreens, Rite Aid and Walmart. This Rx discount is offered at no additional cost, and it is not insurance.
To receive this Rx discount, Ameritas plan members just need to visit us at ameritas.com and sign into (or create) a secure member account where they can access and print an online-only Rx discount savings ID card.
Eye Care Plan Member Service
Focus eye care from Ameritas Group features the money-saving eye care network of VSP. Customer service is available to plan members through VSP's well-trained and helpful service representatives. Call or go online to locate the nearest VSP network provider, view plan benefit information and more.
VSP Call Center: 1-800-877-7195
- Service representative hours: 5 a.m. to 7 p.m. PST Monday through Friday, 6 a.m. to 2:30 p.m. PST Saturday
- Interactive Voice Response available 24/7
Locate a VSP provider at: ameritas.com
View plan benefit information at: vsp.com
Section 125
This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next Annual Election Period.
Language Services
We recognize the importance of communicating with our growing number of multilingual customers. That is why we offer a language assistance program that gives you access to: Spanish-speaking claims contact center representatives, telephone interpretation services in a wide range of languages, online dental network provider search in Spanish and a variety of Spanish documents such as enrollment forms, claim forms and certificates of insurance.
This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of insurance and does not include exclusions and limitations. For exclusions and limitations, or a complete list of covered procedures, contact your benefits administrator.
Eyewear Savings
Eyewear Frames and Lenses Savings
Members can save up to 10% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. No additional premium cost. Only savings.
To access the pdf version of this information, click here.
What is the Eyewear Frames and Lenses Savings?
It provides our plan members up to 10% off savings on the following vision care products at Walmart Vision Centers:
- Top quality frames for the entire family including today’s most popular brands
- Wide selection of lens options; all lenses come with scratch resistant coating for no additional charge
- Safety eyewear
Contact lenses and prescription sunglasses are not included in this savings arrangement. The eyewear savings cannot be combined with any other
insurance, coupon or promotion.
What ID Card Can I Use?
Carefully cut your ID card from this sheet or save a picture of it on your device to retain for future use. Members can also visit ameritas.com and sign in (or create) a secure member account where they can access and print a savings card. When making an appointment at a Walmart Vision Center, you must mention you have eyewear savings through your Ameritas plan and present the savings ID card.
Who Do Members Call for Insurance Benefit Questions?
If members have questions regarding insurance benefits, they can call Ameritas toll free at 800-487-5553 or in New York 800-659-5556. This savings arrangement is not insurance and not intended as a replacement for insurance.
Is a Vision Exam Required to Receive the Eyewear Savings?
No. Members may bring in their current vision prescription from another vision care provider to purchase eyewear frames and lenses.
How to Find a Walmart Vision Center?
Vision Centers are located in more than 2,500 Walmart stores nationwide. To find a Walmart location nearby, visit walmart.com/cservice/ca_storefinder.gsp.
Guarantees
Vision Centers are located in more than 2,500 Walmart stores nationwide. To find a Walmart location nearby, visit walmart.com/cservice/ca_storefinder.gsp.
Walmart Vision Centers stand behind their products and workmanship by offering:
- 60-day frame and lens satisfaction guarantee
- 12-month replacement guarantee on broken or damaged frames or lenses
- Lifetime adjustments and cleanings
Voluntary Benefits
Voluntary Benefits Digital Book
Updated Voluntary Benefits Digital Book coming soon. To access the 2025 Benefits Book, click here.
Good Samaritan Fund
Good Samaritan Fund Information
Show-Me Benefit Consortium
Show-Me Benefit Consortium is excited to introduce a new initiative for employees, the Samaritan Fund Program. This program aims to provide financial relief to those facing significant medical challenges or the burden of high-cost medications. Additionally, employees are not required to pay any fees to take part in the Samaritan Fund Program.
Participation in the Samaritan Fund Program is entirely voluntary and at your discretion. Should you be deemed an ideal candidate, the program will assist in identifying a health plan that both you and your dependents can enroll in. If healthcare providers agree, then the Samaritan Fund Program will source funds for you to help pay for medical expenses. Ultimately, the choice to participate is yours.
The application process for the program is confidential. To apply, complete the HIPAA authorization form using the link here. This form enables a representative of the program to contact you directly and assess whether the program is a suitable fit for your needs.
If approved, we will assist you in enrolling in an individual health insurance plan along with sourcing financial assistance to eliminate out-of-pocket costs for insurance premiums and medical care.
However, it is important to note that there is a limited timeframe for making changes to your group plan selection. Changes can only occur during a qualifying event or within the annual enrollment period. The deadline to complete and submit your HIPAA form is 5/15/2025.
Should you have any questions, please feel free to reach out to the Samaritan Fund Program team at:
service@samaritanfundprogram.com
MedVed
MedVed Information
What We Do
As your partner, we help your self-funded health plan source specialty and brand name medications at reduced pricing through programs and international sourcing. We assist with program applications and coordinate directly with international and domestic pharmaceutical vendors and pharmacies to source your medications at greatly reduced prices.
Participating members have no co-pays when utilizing MedVed.
Next Steps In Order To Support You, The Member
- A MedVed advocate will call, text, or email (member preference) members currently receiving specialty or brand name medications to explain our assistance with program applications or the voluntary international process, check on eligible medications, and answer all questions. We promise you a friendly and helpful experience.
- MedVed advocates will then assist each member with completion of their application or enrollment paperwork and will obtain a health care authorization allowing the advocate to get prescriptions and/or application assistance from the member’s doctor. (Specialty programs are applications and require specific documents including income verification. International sourcing is an enrollment, no application, and all qualifying medications are accessible for members.)
- For international sourcing, MedVed will submit each member’s documentation and request the member’s prescription from their doctor for a 3-month supply with 3 refills (some high-cost medications will remain monthly fills). Specialty program applications are coordinated with the physician’s office.
- Once enrolled in the international sourcing program, a pharmacy representative will call the member to verify information on the order prior to mailing the medication directly to the member’s home.
MedVed assures complete confidentiality of all information utilized in our process and is 100% HIPAA compliant.
Contact Us With Questions:
417-408-8352
MedVedInc.com
