Attempting to Understand New Insurance Policy

On January 1, 2009 my primary employer changed insurance companies. At first glance, based on an employee meeting, the changes will be a good one for all involved. Some out of pocket expenses are a bit higher (ie. employee contribution, co-pays) but overall I believe this may be a better policy. Our insurance covers medical, dental, vision, and Rx drugs.

Currently I am trying to figure out our vision policy. I need two pair of eyeballs--everyday use and ANSI approved safety glasses. Al tho tinting has been suggested it is not required, but I do require bifocals. I plan on using an in-network provider which in our case is Wal*Mart (I'm not thrilled by this but through word of mouth I have discovered that our "local" Wal*Mart is very good.) Also by comparing prices I have determined that financially Wal*Mart has by far the best prices compared to our local independent store even without insurance; 2 pair can be had at a lower cost than purchasing just one pair locally. (As much as I would prefer to shop here in town, I just can't justify the added cost.)

But I digress. If I am reading my policy correctly the following will hold true:

• $10 co-pay for eye exam
• $10 co-pay for "materials" a single co-pay that applies to entire purchase of glasses (lenses & frames)
• one pair lined bifocals covered in full
• standard scratch resistant coating applied at no charge
• $130 frame allowance

So for a $20 co-pay my everyday glasses are covered BUT what about my ANSI eyeballs?

My company offers a $70 PPE account (personal protective equipment). Since I purchase my steel-toed shoes at Wal*Mart I have been "saving" this account for just this occasion. According to my insurance literature:

In addition to your covered-in-full (after applicable copay) eyeglass benefit UHV also offers a safety eyewear plan,,,With UHV's safety eyewear plan, safety glasses are covered without a copay. You will receive a(n),,,allowance toward the purchase of safety frames,,,or a $69 retail allowance at network retail providers. In addition, polycarbonate lenses with side shields are covered-in-full,,,This safety eyewear plan is separate from your regular benefits plan, and your selected eyewear must included both safety frames and lenses.

So how should I read this? Are my safety glasses "free" if I stay under $69 ($139 if PPE account is included)? Something I will have to ask my HR person.

If this holds true then my total out-of-pocket expenses would be $20 which IMHO makes the $75/mth I pay totally worth it. (I will be having dental work done in next few months also.)