Who Is Eligible

All covered members and their eligible dependents (family coverage) are entitled to this benefit.

What Is The Benefit

Covered members and their spouses/domestic partners are entitled to full benefits (eye examination, lenses and frames) once every 24 months. Dependent children are covered for full benefits once every 12 months. The eligibility period is calculated from the date of the last claim.

No Expense Option

There is no out–of-pocket expense when services are rendered by a participating provider. The exception is for the purchase of items not included in the “no-expense” package, such as designer frames, special lenses, etc. The no-expense package includes the following:

A comprehensive, eleven point eye examination by an optometrist (including glaucoma screening for adults), and one of the following:

• A complete set of single vision eyeglasses;

• A complete set of bi focal eyeglasses;

• A complete set of tri focal eyeglasses;

• Basic daily wear or extended wear contact lenses for member and spouse (available at most locations).

• A complete set progressive lenses eyeglasses

• A complete set of blended segment eyeglasses

• Scratch-resistant coating; ultra-violent coating and tint are also included.

You may select from a wide variety of high quality frames. The no expense package has a retail value of $225 for adults and $150 for children. There are also discounts for high index lenses, polarized lenses; premium progressive lenses and anti-reflective coating. The staff at a participating provider will inform you as to which products are included. For additional information, please call the Fund Office, at (212) 777 9000, ext. 3060.

Discounts

Hi Index lenses up to 1.56 % = 35% off retail or an out of pocket of $40 whichever discount is greater.

Polarized lenses 35% off retail or an out of pocket of $75 whichever discount is greater.

Progressive lenses Premium 35% off  retail or an out of pocket of $70 whichever discount is greater.

Anti-reflective coating 35% off retail or an out of pocket of $39 whichever discount is greater.

How To Obtain The No Expense Optical Benefit

You may use your Optical Benefit at any participating optical provider.

When you are ready to use your Optical Benefit, you may access a list of participating optical providers on the Fund’s website at www.mightyunion.org. Then call the participating optical provider of your choice to schedule an appointment and identify yourself as a member (or eligible dependent) of the Welfare Fund by providing the last four digits of the Fund member’s social security number.

To file a claim for reimbursement of covered services, you may attach the original bills or receipts indicating the services rendered and their costs) and forwarded to the Fund Office.

Coverage For Non-Covered Services

The Optical Benefit claim forms are used when optical services are received from a non-participating provider, or a covered member decides to purchase frames or lenses from a participating provider that are not included in the “no-expense” package. (The “no-expense” package includes an eye examination, frames and lenses; this package has a retail value of $225.00 for adults and $150 for children). If items not included in the package are desirable, e.g., designer frames, special lenses, etc., then it is to your advantage to pay for all services and items out-of-pocket and file a claim for reimbursement with the Fund Office.

Reimbursement Option

The Optical Benefit also reimburses as described below for expenses resulting from the following services rendered by any optometrist, ophthalmologist, physician, or optician who is not a participating provider:

• A complete eye examination for vision only (excluded from coverage are eye examinations for medical conditions, e.g. conjunctivitis, etc.);

• The purchase of prescription lenses (including contact lenses);

• The purchase of frames for prescription lenses;

• The adjustment and repair of prescription glasses.

The Fund will reimburse up to $125 each per member and spouse/domestic partner for full benefits during a 24-month period and up to $75 for each dependent child during a 12-month period.  In instances where both spouses/domestic partners  are covered members, both members and their dependent children are eligible to receive benefits from each member’s coverage, up to two full optical benefits per covered person i.e. – the Fund will pay to a maximum of $250 per 24-month period for each member, and $150 per 24-month period for each dependent child.

How to obtain the Reimbursement Option

To file a claim for reimbursement for covered services, have your optical provider complete the appropriate portion of the Optical benefit claim form (or you may attach the original bills or receipts indicating the services rendered and their costs), then sign the claim form and forward it to the Fund office.