FCA - Stellantis Represented Employees Client Details
(AKA Fiat Chrysler Automotive or Chrysler Stellantis)
FCA - Stellantis Represented Employees receive the following custom benefit provisions:
- $7.50 Copay applies to ECL
15% Discount off CL Materials Overages
- Interim Benefits for Myopia Management of Dependent Children
- Interim Benefits for Type 1 Diabetics
Contact Lens Benefit
Patients have an Exam And $90 Contact Lens Allowance with a $7.50 copay plus a 15% discount off contact lens material overages.
Elective Contact Lens Copayment Exception
This client requires subtracting their $7.50 copay from the total charged, rather than from the contact lens allowance. Subtract copay from total of discounted fitting, evaluation and U&C material charge. Follow instructions below.
How to Calculate Patient’s Contact Lens Professional Fees and Materials Out-of-Pocket Costs
First, did the patient receive any contact lens professional services? If no, skip to section: example when only materials are provided.
If yes, then determine whether your total charges (85% of U&C fitting & evaluation plus materials) is more or less than the patient’s $90 contact lens allowance. Then follow the corresponding example within section: examples when both professional services and materials are provided.
Examples – When only Materials are Provided
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1. Determine your U&C material charge and subtract $7.50 copay. |
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Your U&C fee for contact lens materials: |
$150 |
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Patient’s copay: |
- $7.50 |
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Remaining balance: |
$142.50 |
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2. Subtract the $90 contact lens allowance from the remaining balance. |
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Contact lens allowance: |
-$90 |
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Contact lens materials overage: |
$52.50 |
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3. Deduct 15% from any Contact Lens materials overage. |
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Remaining overage: |
$52.50 |
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15% materials discount: |
-$7.87 |
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Final Patient Out-of-Pocket Cost: |
$44.63 |
Examples - When both Professional Services and Materials are Provided
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Remaining balance is less than Contact Lens $90 Allowance |
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1. Subtract the $7.50 copay from your Total Fess to determine the remaining balance. |
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Total Fees (Professional Services and CL Materials): Patient's copay: |
$80 -$7.50 |
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Remaining balance: |
$72.50 |
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2. Subtract the $90 contact lens allowance from this total. |
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Contact lens allowance |
-$90 |
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Final balance due: |
$0 |
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Remaining balance is more than Contact Lens $90 Allowance |
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1. Subtract the $7.50 copay from your professional fees. |
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85% of your U&C fee for fitting and evaluation: Patient’s copay: |
$30 -$7.50 |
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Remaining professional fee balance: |
$22.50 |
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2. Subtract the professional fee balance from the $90 contact lens allowance from professional fee balance. |
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Contact lens allowance: |
$90 |
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Remaining professional fee balance: |
-$22.50 |
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Remaining contact lens allowance: |
$67.50 |
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3. Subtract remaining contact lens allowance from U&C materials. |
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Your U&C fee for contact lens materials: |
$150 |
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Remaining contact lens allowance: |
-$67.50 |
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Contact Lens Materials Overage: |
$82.50 |
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4. Deduct 15% from any Contact Lens materials overage. |
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Remaining overage: |
$82.50 |
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15% materials discount: |
-$12.37 |
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Final Patient Out-of-Pocket Cost: |
$70.13 |
Note:
Our online Savings Statement will not automatically calculate copays or overages for ECL members of this client.
Interim Benefits
The FCA - Stellantis Represented Employees have the following interim benefits when benefit criteria are met:
Interim Benefits for Type 1 Diabetics
Insulin-dependent diabetics (Type 1) will be eligible for an eye exam every January 1 after last eligible exam covered by the vision plan with a $5 copay. If the exam reveals a prescription change of .50 diopter or more and/or 10 degrees of axis change or more, new lenses will be provided with a $7.50 copay according to vision benefits provided by the plan annually. Ensure you indicate your patient’s Type 1 diabetes in their chart.
Interim Benefits for Dependent Children with Progressive Myopia Management
Dependent children up to their 19th birthday are eligible to receive a yearly exam with a $5 copay and new lenses, subject to a $7.50 copay with a prescription change of a -.50 diopter or more for.
Authorization
To receive an authorization for either Interim Benefit, contact VSP.
Questions
For assistance concerning this custom benefit, contact VSP at 800.615.1883.