The Fund provides benefits for one eye exam and lens(es) per calendar year. The Plan’s fee schedule is as follows:
- Eye exam ($20)
- Lenses ($50)
The Fund presently has an arrangement with three vision care networks; General Vision Services (“GVS”), Comprehensive Professional Systems (CPS) and Vision Screening that have agreed to accept the Fund’s fee schedule for the selected eye care as payment in full. There is no out-of-pocket expense provided the lenses and frames you select are within the variety of lenses and frames offered under the Fund. Please call the Fund Office or click on the vision care network links above for lists of participating GVS, CPS and Vision Screening locations and phone numbers to call to schedule an appointment.
To submit vision claims, you must complete and return the appropriate form to the Fund Office:
Davis Vision is a participating vendor for Lasik surgery only. The Fund allows $1,000 per eye for Lasik surgery. You may contact Davis Vision directly at 800-584-2866 or log onto http://www.davisvision.com/ Once logged onto the Davis Vision website the client code for Local 94 Health and Benefit Fund is 7084. Learn more.
You may also obtain Laser Vision correction services from any non-participating provider you choose.
If you choose a non-participating provider, you will be responsible for paying any cost beyond the Health and Benefit Fund’s maximum allowance of $1,000 per eye for Laser Vision correction surgery.
In order to receive payment for a non-network provider you must complete the Empire Blue Cross claim form and submit the claim directly to Empire Blue Cross.
If you have to file a medical claim with Empire for reimbursement, download and fill out the Empire Claim Form (PDF). Once you fill out the form, mail it and any applicable documents to:
Empire BlueCross BlueShield
P.O. Box 1407
Church Street Station
New York, NY 10008-1407
Need to Find a Doctor, Dentist or Vision Specialist?
How do I add my newborn child to my plan?
You must provide the Fund Office with a copy of the child’s birth certificate within 90 days of birth to enroll your child with the applicable date (child’s birthdate). If you fail to do so, within the applicable 90-day period, dependent coverage will not be available under the Plan for your new dependent child until the first of the month following the date in which you provide the Fund Office with the required documentation or any other verifying information requested. A Coordination of Benefits Form (COB) must be completed if your child has other coverage. You should also visit the Life Events page on this site to see what you need to do for your other benefits.