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Effective January 1, 2008

Vision Insurance Program
Beginning in 2008, the University will offer a fully-insured, employee paid vision insurance program. This new optional vision program, administered by Davis Vision, includes these benefits: eye examination, spectacle lenses, frames, and contact lenses. Contact lenses purchased from the Davis Vision Formulary at independent network provider offices include fitting and follow-up charges. Retail locations and optometrists affiliated with these locations do not offer the Davis Vision Formulary or the Davis Vision Eyeglass Collection options. Note, this vision insurance plan is optional coverage and not included as part of your UVA Health Plan. Those enrolled in the UVA Health Plan will continue to receive the Discount Vision Plan as part of their UVA Health Plan package. Participation in the UVA Health Plan is not necessary to enroll in the new optional vision insurance offered by Davis Vision.

Eligibility
In order to be covered under the Davis Vision Plan, an employee must be a salaried employee of the University of Virginia who is either regularly scheduled to work at least twenty hours per week (50% effort), or a Health System employee who works 40 hours a week or who has signed a Medical Center Flexible Staffing Contract. An employee who is a member of the faculty must have a University appointment of at least six months in order to be covered. Part-time salaried employees who work at least 20 hours per week (50% effort) but less than 32 hours a week (80% effort) are eligible to be covered under the Plan but are required to pay both the employer and employee portion of the health plan premium.

Those persons eligible to be dependents on the plan are legally recognized spouses and unmarried children who are less than twenty-three years old. Children include:
  • natural children who live at home with the employee-participant, live with the other biological parent if the parents are divorced, or live at college or boarding school and are eligible to be declared as dependents on the employee-participant’s income tax return
  • legally adopted children if they are eligible to be declared as dependents on the employee-participant’s income tax return and live with the employee-participant
  • children for whom the employee is the legal guardian with sole permanent custody and who live with the employee-participant in a regular parent-child relationship and are declared as dependents on the employee-participant’s most recent income tax return There is one exception to sole custody if the employee or spouse shares custody with a minor child who is the parent of the “other child” living in the home of the employee. The other child, the parent of the other child, and the spouse who has custody must be living in the same household as the employee
  • stepchildren who live with the employee-participant full time in a regular parent-child relationship and are declared as dependents on the employee-participant’s most recent income tax return
  • children for whom the employee-participant is the proposed adoptive parent, if they are eligible to be declared as dependents on the employee-participant’s income tax return.
A dependent child will no longer be eligible for coverage as of the last day of the calendar year in which an unmarried dependent reaches age twenty-three or the last day of the calendar month in which a dependent marries or otherwise loses eligibility as described above. Even if the dependent is eligible by age to be covered, eligibility as a dependent ends due to marriage, ineligibility to be declared on the employee’s income tax return, and residency in a place other than the employee-participant’s home/school.

Coverage for dependent children who are incapable of self-support due to mental retardation or physical handicap may continue beyond age twenty-three if proof of the handicap is furnished to and approved by the Claims Administrator PRIOR to the dependent's 23rd birthday, they meet all other eligibility requirements for dependents, and are declared on the employee’s federal 1040 income tax form.

Enrollment Rules and Coverage Effective Date
Coverage begins on the first day of the first full month of employment, if an enrollment form is filed within 60 days of employment. If an employee's first day of work is the first working day of the month, coverage begins on the first day of that month when the employee's application is received within 60 days of employment. Changes in membership may only be made at the annual Open Enrollment, or subsequent to a valid mid-year qualifying event. Events that constitute a mid-year qualifying event include:
  • marriage, divorce, or annulment
  • birth or adoption/placement for adoption
  • loss of dependent eligibility (child marries or leaves home and cannot be declared as a dependent on the employee’s federal income tax return)
  • employment status of Employee, dependent, or spouse which affects eligibility to participate in the employer’s health plan
  • commencement of or returning from an unpaid leave of absence
  • judgment, decree, or order changing legal custody
  • cost and/or coverage changes in employee’s, dependent’s or spouse’s health plan
  • entitlement to or loss of eligibility for Government-sponsored programs ;or
  • death of spouse or dependent
Applications for changes in membership must be accompanied by documentation and received in the University Human Resources Benefits Division within 60 days of the qualifying event or within the same plan year as the mid-year qualifying event and are effective the first of the month following receipt of the form or that day if the form is received on the first of the month unless they are terminating due to ineligibility. Those enrollment changes are effective the first of the month following the qualifying event. Premium changes due to ineligibility are effective the first of the month following receipt of the form if the form is received within the same plan year as the qualifying event or within days of the qualifying event. Applications for changes due to birth or adoption of a child that are received within sixty days of the event are applicable the first of the month in which the birth or adoption occurs. If you submit an application more than 60 days after the date of birth or adoption but within the same plan year, the coverage will be effective the first of the month following receipt of the application. Applications not submitted on a timely basis will be processed when the next open enrollment period occurs.

Any ineligible dependents found on the Davis Vision Plan will be terminated on the last day of the month in which they became ineligible. Changes in the employee's coverage category to match this termination of dependent's coverage are subject to IRS Section 125 Regulations. Employee-participants with ineligible dependents enrolled on their policy will be responsible for the costs of incurred claims and may be suspended from the Plan for up to three (3) years.

Davis Vision is actively recruiting vision providers in the Charlottesville/Albemarle area. Check their website at www.davisvision.com for the most current provider information. From their home page, click on ‘Find a Provider’, enter ‘Control Code’ 4680 in the lilac section, and click on ‘Submit’.

Links and Forms:
Plan Benefits and Vision Information