A Conversation With ... Richard Stone

Vision care is hit or miss on employer health plans. Do you see more companies adding or subtracting the voluntary vision?
The trend would be to offer it more. Vision plans really deal with vision correction, so when you have an eye exam, glasses or contacts. That kind of thing is virtually always voluntary; 95 percent of the time, it’s voluntary and the employer is not paying for it, but they offer it in the group scenario for better rates. Most people offer it, and the employee has really driven that because they want that kind of benefit.

At small businesses, are there a certain number of enrollees required to tip the scale?
I think you have to have at least three to insure a group. But generally, it does have a better benefit than what you’re paying for contacts or eyeglasses.

What is typically covered in vision plans versus health plans?
What are covered under the health plan are injuries to an eye, certain changes in the eye – macular degeneration, retina detachments, cataracts. So really the vast majority of a person’s eye care is under the health plan. Its just correction that comes under that supplemental plan or it’s self pay.

What is the breakdown at Missouri Eye Institute for self pay versus insurer pay?
Over 90 percent is insurance related. But let’s say you’re having a cataract surgery done. They will pay for a lens implant to upgrade those lenses to lessen your need for glasses – a multifocal lens, a toric lens that corrects astigmatism. That isn’t covered by insurance or Medicare; that would be an additional cost to the member. A lot of people see the benefit in that. They will pay that expense. It’s kind of a hybrid. In our cataract business, it’s probably 30 percent who will upgrade that lens.

Who is MEI’s typical eye patient?
Typically, you’re seeing older patients for the cataracts because if you live long enough, you will have a cataract. It’s a guaranteed thing. But where it used to be 65-plus who get cataracts, more younger people are developing cataracts. It could be due to injuries, certain medical conditions or medications, that lead to somebody in their 40s having a cataract that needs to be extracted.

How much business do cataract surgeries represent?
It’s very large, 75-80 percent.

Do you see a day Lasik is covered under a benefits plan?
I don’t think so. It would be surprising. What’s going to drive it is the cost. I think the demand would drive up the cost of the coverage so much that I don’t think that would occur. In a flex spending account, that’s something you can have covered under that.

What are the upsides and downsides for an employer to provide vision care?
There’s not much downside, other than the administration of the plan. You have to understand it at some level to describe to employees and there’s a certain amount of paperwork and the exchange of money from the employee to XYZ company. It’s usually voluntary, so the company’s not paying anything and the employee is who pays it. Now, the downside to not doing it is you don’t become competitive in the market as an employer. If you start stripping away enough of those things, you don’t look like an attractive employer.

What is the trend for vision premiums?
I see it personally because I manage our benefits. When it comes to the voluntary vision coverage, it goes up a bit. The recent trends I’ve seen is going up 4-5 percent. I haven’t seen our rates for 2016, but it’s pretty well a constant.