9-07 - Vision.pdf
PDF 118 KB Posted
- Solicitation number
- 26-71-P
- Issued by
- Denton County, Little Cypress CDP, Texas
About this file
This is a vision benefits proposal form for the City of Lewisville's annual Employee Health and Welfare Benefits contract. The City of Lewisville Purchasing Division issued this document as part of a competitive sealed proposal process for comprehensive employee benefits coverage, which includes vision insurance along with medical, dental, pharmacy administration, stop loss coverage, basic and voluntary life insurance, disability, EAP, and health savings and flexible spending accounts. The document requests carriers to provide detailed vision benefit information including coverage for annual eye exams, frames and lenses, contact lenses, and LASIK procedures across both network and non-network providers, with specified frequency limits for exams, lenses, and frames. Bidders must provide complete pricing quotes in addition to the information detailed on the proposal form.
The vision benefits proposal requires carriers to submit monthly and annual premium rates for multiple coverage tiers (employee only, employee and spouse, employee and child(ren), and employee and family) along with the dollar and percentage changes from current plan pricing. Additional submission requirements include employer contribution amounts, effective dates, rate guarantee periods, network composition details (percentage of private practice and retail providers), network websites, dependent age limits, and geographic access information. All proposals must comply with the Americans with Disabilities Act, and award determinations will be made according to Texas Local Government Code Chapter 252. The form indicates this is part of a restated plan year with specific participation and contribution requirements to be outlined by the successful bidder.
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Text version
26-71-P Employee Health and Welfare Benefits CARRIER NAME CARRIER NAME Vision Benefits Proposed - Current Proposed - Plan Option Annual Eye Exam
Network Non-Network
Frames / Lenses* Single Vision - Network/Non-Network Bifocal Lenses - Network/Non-Network Trifocal Lenses - Network/Non-Network Frames - Network/Non-Network Retail Frame Allowance
Contacts Network
Medically Necessary Elective
Non-Network Medically Necessary Elective
Standard Contact Lens Fitting Fee Specialty Contact Lens Fitting Fee Lasik Benefit Exam Frequency Lens Frequency Frames Frequency Contacts + Glasses in Same Benefit Period
FINANCIALS
Employee Only Employee & Spouse Employee & Child(ren) Employee & Family
Monthly Premium Annual Premium $ Change from Current % Change from Current Participation Requirements Employer Contribution Requirements Effective Date Restated Plan Year Date Rate Guarantee % Private Practice Providers % Retail Providers In Network Retail Providers Dependent Age Limit Geo Access Results Disruption Results Network Website Network Name
CITY OF LEWISVILLE PURCHASING DIVISION – REQUIRED DOCUMENT
Please provide a quote in addition to providing pricing on this page.
Vision
File details come from the government source that posted it. Updated .