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As a vision insurance broker, you create value by helping clients explore a wide range of products that can contribute to improving their eye health and building affordable, customized packages that address their vision care needs.
Vision care plans are one of the product types you can focus on to supplement traditional health insurance products and help the more than 150 million Americans who suffer from refractive errors and need glasses or contacts to correct them.
While a health care plan will cover a medical condition like an eye injury or eye disease, a vision care plan is needed for common, non-emergent eye health issues. Typical benefits include routine eye exams and prescription eyewear or contact lenses.
Your first step should be to learn more about the available vision care plans, understand the different types of coverage, and review various plan carriers.
The Role of Brokers in Vision Care
The world of vision care plans can be challenging to navigate for consumers. Different plan structures, coverage limitations, and other considerations can feel overwhelming.
As a vision insurance broker, you have an important role in helping clients understand benefits and compare plans. Taking a personalized approach and reviewing each client’s needs will often result in picking a plan that creates the most value and satisfaction.
If you work with employers to build benefit packages, you can add value by recommending vision care products as add-ons or core benefits to help employers with goals like employee retention.
Comparing Different Types of Vision Care Plans
Vision care plans can leverage different structures and reimbursement models:
- Optional riders vs. ancillary plans are common options and differ slightly. Optional riders are add-ons to existing health insurance policies, while ancillary plans are separate products. Ancillary plans are typically more flexible and comprehensive.
- Many employers are opting for self-funded products. With this model, the employer funds an account from which claims are paid. The main benefit is reducing the plan’s cost if usage is low.
- The alternative is to offer fully insured plans. These plans come with a premium the employer pays out of pocket or through employee contributions. Unlike self-funded plans, the cost of a fully insured plan remains the same regardless of usage.
- A pre-paid vision plan with negotiated savings can be an appealing alternative to traditional insurance products. Instead of being reimbursed for vision products and services, plan holders benefit from lower prices at the point of sale.
There are a few additional considerations when comparing plans:
- Find out more about who accepts the plan. A plan with a strong local network of optometrists who accept it will create more value for your clients.
- All plans have exclusions, minimum prescription restrictions, or other limitations. Research the services and products covered to ensure they align with the needs of the plan holders. For instance, specialized vision plans tailored to the needs of older adults can be a good match for some of your clients.
Vision Plan Enrollment and Management Best Practices
Adopting a few simple best practices can go a long way in offering a positive experience:
- As a vision insurance broker, you should have a portfolio of vetted products you can recommend with confidence. Update it regularly and keep track of KPIs like plan performance and user satisfaction to get an idea of which plans are likely to meet clients’ expectations.
- Become an expert by learning everything there is to know about the different plans you recommend. You should be able to answer questions comprehensively and help clients make an informed decision.
- Get to know each client and assess their unique needs so you can match them with the right plan. Communicate plan benefits and connect them to the pain points they’re experiencing.
- You can streamline account management by offering a digital experience for buying and reviewing plan information through your platform or by partnering with plan carriers with a strong digital focus.
- Keep track of when plan renewals are due. Schedule a call to review each client’s needs and recommend a renewal or another option.
Learn more about how Vision Care Direct of Oklahoma supports these best practices and more in this eGuide.
Regulatory Compliance and Industry Standards
As a broker, you’re no stranger to the fact that compliance requirements and industry standards are becoming increasingly challenging to navigate.
Familiarizing yourself with regulations that apply to vision plans will establish your expertise as a vision insurance broker while helping employers meet compliance requirements for the benefits they offer.
Federal Regulations
Vision care plans typically fall under ERISA for employers who offer them as a group benefit. However, not all plans meet minimum coverage levels and documentation requirements.
As the FDA approves or bans vision care products, keeping up with the list of FDA-approved products and recommending plans that include these products can create value. It’s especially true as modern products like advanced contacts become available.
It’s also important to keep up with changing regulations. For instance, the Dental and Optometric Care (DOC) Access Act proposal could regulate pricing and prevent plan carriers from penalizing plan holders who don’t use preferred brands.
State Regulations
Some states have laws regulating which services optometrists can offer. If a client located in a state that doesn’t allow full-spectrum optometry buys a plan, a less comprehensive product could be a good match.
You should also familiarize yourself with states’ patient protection laws and be aware of plan restrictions that could go against these rules.
Marketing Strategies for Brokers
Brokers can leverage multiple channels to develop a solid digital presence and educate potential clients about the benefits of vision care. Paid ads, social media, email, and blogs are options to explore.
These channels are ideal for highlighting the growing need for affordable vision care through topics like exposure to blue light, the aging population, or the higher number of children and young adults with myopia.
Offline marketing is just as important. You can connect with local clients via print, radio, or TV ads. Networking at local events is another effective way of meeting potential clients and other brokers who might be interested in exchanging referrals.
Whichever marketing channel you use, you should prioritize educating your audience about vision care before demonstrating the value of vision plans.
Technology in Vision Care
The vision care industry is evolving at a fast pace and embracing technology. As a vision insurance broker, you should identify plan carriers who are actively keeping up with these changes and updating their product offerings to allow plan holders to take advantage of the latest innovations.
For instance, plan carriers who offer streamlined digital experiences for enrollment, submitting claims, or managing benefits can result in a better experience for your clients.
You should also select products that facilitate access to the latest treatments and services.
New products to explore include waveform or free-form lenses or even smart AI-powered tools that will assist the visually impaired in the future.
Success Stories
Storytelling can be a powerful tool for showing the benefits of vision care plans. The following facts can help illustrate the benefits of vision care when building benefits packages:
- A routine eye exam can help diagnose a wide range of health conditions, including vascular disease, cancer, or multiple sclerosis. Detecting these conditions early often results in better health outcomes for patients.
- For more than 80% of employees, vision benefits are just as important as access to other aspects of health care. A vision plan can have a direct effect on employee satisfaction and retention.
Industry Trends and Future Outlook
Experts are predicting a strong outlook for the vision care market, with an estimated worth of $136 billion by 2030.
Keeping up with the latest industry trends will help you stay ahead of the competition as a vision insurance broker and ensure that you continue recommending plans that align with clients’ expectations.
The use of AI in diagnosing and treating vision health issues is on the rise. Brokers and plan carriers are also leveraging AI to automate enrollment, personalized plan recommendations, and claims processing.
Consumers are also becoming aware of new products such as blue light-blocking glasses or new contact lens technologies. Recommending plans that make these new products accessible can help you stand out as a vision insurance broker.
Educating Clients about Eye Health
Educating clients about important eye health issues is often the first step in convincing them of the value of investing in a vision plan.
Your educational content should be approachable, reliable, and relevant to your target audience. These resources from VCD give a basic overview of what clients need to know:
- The U.S. population is aging, which leads to changing vision care needs for many. Employers should consider vision benefits for older employees.
- There is a growing demand for family plans that support vision care for children. Educate your audience about why vision problems can be challenging to diagnose in children and how vision health directly impacts academic performance.
- Discuss common eye health problems and their symptoms. Myopia, farsightedness, age-related macular degeneration, color blindness, and diabetic retinopathy are examples of topics to cover.
- Your content can discuss the latest trends in vision care, such as the rise of genetic ophthalmology.
- Educate employers about what makes vision plans valuable and how eye health can affect productivity.
- There is a growing trend to view eye health holistically. You can discuss vision care as part of overall wellness or draw attention to the link between nutrition and eye health.
- Tailor your content to your audience and its unique work environment and lifestyle, whether it’s eye health problems linked to screen time or vision problems that stem from working outdoors.
- Seasonal content can be a great way to generate leads. For instance, summertime activities can be an opportunity to draw attention to common eye health problems, especially those caused by swimming.
Resources and Tools for Brokers
Leverage these tools and resources to develop marketing content and provide unique value to your audience:
- The VCD blog is great for keeping up with the latest industry trends and learning more about eye health.
- Take a look at additional forms and educational material from VCD.
- The National Eye Institute has helpful resources about various eye conditions, including resources tailored to specific groups.
- Learn more about common eye health conditions from the American Optometric Association. The AAO also offers engaging videos and PowerPoint presentations.
- Educate your audience about the importance of eye health insurance with resources from Prevent Blindness.
- The Essilor Vision Foundation has some great resources for children.
- We also recommend checking the CDC’s Vision Health Initiative website.
Networking and Professional Development
Networking can help you connect with other brokers and employers needing vision benefits. Developing your professional network will help you anticipate shifts in demand while generating leads more consistently.
Your online presence is a decisive factor in building your professional network. Developing quality content and being active on social media can help.
You should also seek in-person connections by attending events or supporting local non-profit organizations focusing on eye health. Your state’s optometry association is a great place to start for finding relevant events.
FAQs for vision insurance brokers and Their Clients
Learn more about eye health and vision plans with these frequently asked questions.
Does health insurance cover an eye exam?
Traditional health insurance plans may or may not cover routine eye exams. The Affordable Care Act requires that health plans cover an annual eye exam for children 18 and under.
What are the four most common eye problems?
The most common eye problems typically appear with age. They include cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration.
Can an optometrist diagnose eye problems?
Optometrists can diagnose various eye problems using visual refraction tests, ophthalmoscopy, pupil dilation tests, corneal topography, and more.
Why Might it be Beneficial to Have Two Vision Care Plans?
Many people are surprised at their optometrist’s office to discover that their vision care plan cannot be used once they are diagnosed with a medical condition. This is because traditional insurance plans coordinate benefits. In short, this means that if you have traditional vision insurance, your regular health plan will supersede your vision care plan in the case of a medical diagnosis, rendering it useless.
Not so with Vision Care Direct. Their unique Flex Plans do not coordinate benefits, allowing you to benefit from having two plans. Even if your regular healthcare plan is activated by your diagnosis, you will still be able to use your Vision Care Direct coverage at your vision care provider’s office.
For example, let’s say your optometrist diagnoses you with glaucoma; by law, your comprehensive eye exam is coded to your healthcare plan—not your vision care plan. If your eyecare plan coordinates benefits, you won’t be able to use it along with your regular healthcare plan.
However, with Vision Care Direct, if your doctor files your diagnosis with your healthcare plan, you won’t use the value of the plan. Instead, you will receive a credit that can be used towards your copay, nicer frames, or anything else in your ophthalmologist’s office.
Are vision plans worth it?
Given the prevalence of vision refraction issues, most people will use their vision plan to purchase eyeglasses or contacts at some point. Access to affordable eye exams to catch potential issues early is another benefit.
What is a common exclusion with vision plans?
Some vision plans have limitations regarding the type of contact lenses covered. Lasik surgery is another common exclusion. However, Vision Care Direct offers a $1000 discount on Lasik within our Lasik network, plus an additional $200 rebate in lieu of glasses or contact lenses. In other words, coverage varies by plan.
How can you improve eye health?
You can improve your eye health by reducing digital eye strain with frequent breaks, eating a healthy diet rich in vitamins, not smoking, and wearing sunglasses when going out. Addressing eye health issues early and scheduling regular exams are also important.
