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This document summarizes the vision benefits provided by National Vision Administrators (NVA) for members of Baltimore County Public Schools, effective January 1, 2023. It outlines the coverage for eye examinations, lenses, frames, and contact lenses, along with copay amounts and reimbursement options for participating and non-participating providers.
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How to fill out nva vision benefit summary

01
Gather your NVA vision benefit card and any required personal information.
02
Locate the NVA vision benefit summary form provided by your employer or NVA.
03
Fill in your personal details including name, member ID, and contact information.
04
Review the benefit details included in the summary, such as coverage limits and eligible services.
05
Sign and date the form to acknowledge the accuracy of the information provided.
06
Submit the completed form to your employer or designated contact for processing.

Who needs nva vision benefit summary?

01
Employees enrolled in an NVA vision benefits plan.
02
Human Resources personnel assisting with employee benefits.
03
Dependent family members who utilize vision benefits under the plan.
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The NVA Vision Benefit Summary is a document that outlines the vision insurance benefits provided to members, including coverage details, co-pays, and limits on services.
Employers or administrators of vision insurance plans are required to file the NVA Vision Benefit Summary for their enrolled participants.
To fill out the NVA Vision Benefit Summary, include details such as the employer's information, the plan specifics, coverage amounts, and any relevant co-pays or exclusions.
The purpose of the NVA Vision Benefit Summary is to provide clarity to members about their vision benefits and to ensure compliance with regulatory requirements.
The information that must be reported includes the name of the plan, coverage details, co-pays, the scope of services covered, and any limitations or exclusions.
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