Vision

The Public Employees Benefits Board (PEBB) Program provides a variety of vision plans for PEBB employers.

Plan availability

Standalone vision plans offered by the PEBB Program are available to all benefits eligible employees whose employer offers the full benefits package. These vision plans are not available to employer groups who offer the medical only benefits package.

Effective January 1, 2025, routine vision coverage will be separate from medical coverage.  Employees will have the opportunity to choose a standalone vision plan during the annual Open Enrollment (OE) period, which is October 28th through November 25th, 2024.  Employees who do not make an election during OE will be enrolled by default into the MetLife Vision plan.

Before selecting a plan or provider, employees should compare vision plans to find out what services are covered, which providers are in-network, and the costs for care.

What do the vision plans cover?

  • Each plan will have a network of providers that offers services like routine eye exams, eyeglass frames and lenses, contact lenses, and discounts on treatments like LASIK.
  • All plans will offer private practice optometrists and ophthalmologists in Washington State and nationwide, but each plan’s network will include different providers. These plans were chosen to cover as many counties in Washington as possible, but not all plans will have network providers in all areas.
  • In addition to private practice locations, each plan will offer a selection of retail locations, such as Costco Optical, Walmart, Sam’s Club, America’s Best, Visionworks, LensCrafters, Pearle Vision, and Target Optical.

PEBB Program vision plans

Cost for vision coverage

The cost for vision coverage is included in the total rate, paid by the employer for eligible employees of state agencies and higher education institutions. PEBB Participating employer groups determine what portion of the rates eligible employees pay. Find your organization's PEBB Program rates.

Davis Vision by MetLife

As of June 1, 2023, Davis Vision is underwritten by the Metropolitan Life Insurance Company (MetLife).

Plan documents

Davis Vision Certificate of Coverage (COC)

Preauthorization criteria

Preauthorization is when a covered individual seeks approval from their health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that the plan will pay for those services, supplies, or drugs.

Davis Vision preauthorization criteria

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit the Davis Vision provider directory.

Contact information

Phone: 1-877-377-9353 (TTY: 1-800-523-2847)
Online: Davis Vision

EyeMed

EyeMed Vision Care is underwritten by Fidelity Security Life Insurance Company (FSL).

Plan documents

EyeMed Vision Certificate of Coverage (COC)

Preauthorization criteria

Preauthorization is when a covered individual seeks approval from their health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that the plan will pay for those services, supplies, or drugs.

EyeMed Vision Care preauthorization criteria

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit the EyeMed Vision Care provider directory.

Contact information

Phone: 1-800-699-0993 (TTY: 1-800-699-0993)
Online: EyeMed Vision Care

MetLife Vision

Plan documents

MetLife Vision Certificate of Coverage (COC)

Preauthorization criteria

Preauthorization is when a covered individual seeks approval from their health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that the plan will pay for those services, supplies, or drugs.

MetLife Vision preauthorization criteria

These criteria do not imply or guarantee approval. Please check with the plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.

Find a provider

Visit the MetLife Vision provider directory.

Contact information

Phone: 1-855-638-3931 (TTY: 1-800-428-4833)
Online: MetLife Vision

Member ID cards

Once a member is enrolled in vision, no matter what the carrier/plan, members are sent a welcome packet that includes two copies of an ID card with the subscribers name.

Welcome packets also include instructions on how to set up an online account, where members can download and print additional copies of cards, access forms, and check eligibility and benefits.

Members do not need to present an ID card in order to receive services. In-network providers have access to secure portals to look up eligibility and benefit information based on the subscribers name.

Description
The agency is amending WAC 182-545-200 to expand payment criteria for occupational therapy.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending WAC 182-507-0130 and WAC 182-509-0001 to update the income and resource eligibility standards for the refugee medical assistance program.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is amending 182-550-1900 and 182-550-2100 to update which transplant procedures are covered and where the transplants can be performed. The agency is also repealing WAC 182-550-2200 Transplant requirements – COE, as this section will no longer be necessary due to the changes being proposed to 182-550-1900 and 182-550-2100. As a result of these changes, the agency is also amending WAC 182-531-0650 and 182-531-1750.

Agency contacts

Rulemaking contact
Rulemaking status history

Preproposal (CR101)

Proposal (CR102)

Permanent Adoption (CR103P)

Description
The agency is repealing
these rule sections because they contain redundant and or outdated language and cross reference(s) to nonexistent rules.
The same information can be found within Title 182 or within another agency’s rules. Detailed information is listed below:
WAC 182-556-0100 - References chapter 388-877B which is no longer in existence. Chemical dependency is also an
outdated term. WAC 182-502-0002 includes substance use disorder professionals for the treatment of substance use
disorders, as well as mental health providers and peer counselors. WAC 182-501-0060(6)(d) includes behavioral health
services in the coverage table, and WAC 182-501-0065(2) also includes behavioral health services. Behavioral health is
defined in WAC 182-538D-0200. Therefore, this rule section should be repealed and is no longer necessary.
WAC 182-556-0300 – Personal care services is listed in WAC 182-501-0060(6)(d), under the coverage table, and is also
referenced in WAC 182-501-0065(2)(bb), Health care coverage – Description of service categories. Therefore, this rule
section is not necessary and should be repealed.
The following sections should be repealed as they are no longer necessary and the information is found in other rule(s):
WAC 182-556-0400(1) – See WAC 182-550-1900(2).
WAC 182-556-0400(2) – See WAC 182-540-005 and 182-540-015 under the Kidney Disease Program and Kidney Center
Services, Chapter 182-540 WAC
WAC 182-556-0400(3) – See WAC 182-550-1100(4) Hospital care – General
WAC 182-556-0400(4) – See WAC 182-533-0701, 182-533-0730, and 182-550-1100(5)(a)
WAC 182-556-0400(5) – Outdated language and cross references that no longer exist. See WAC 182-501-0060)(d) and
WAC 182-501-0065(2)(c) for Behavioral health services.
WAC 182-556-0400(6) – See WAC 182-531-0200(6)
WAC 182-556-0400(7) – See WAC 182-501-0065, 182-550-5800, 182-531-1700
182-556-0600 – See WAC 182-531-1400
The agency is also changing the title of this chapter to Chiropractic Services (reflecting the remaining section in this chapter).
See the agency’s other rulemaking, filed under WSR 24-13-055, regarding chiropractic services.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Expedited Adoption (CR105)

Permanent Adoption (CR103P)

00423: The system is throwing SQL exception error when submitting single digit date format for some claims DDE fields
Discovery log number
00423
Discovery description

When submitting claims via DDE, the system will throw an undescriptive SQL exception (error) when trying to submit single digit dates for some fields.  Instead, the System should display a screen error reflecting an appropriate message, so that the claim can be corrected.

Dental claims: "Appliance Placement Date"

Institutional Claims: Statement To/From Date, Medicare Adjudication Date, Occurrence Code Date, Occurrence span code date, procedure date, Medicare paid date.

Professional: Medicare Adjudication date, Medicare paid date

Date reported
ETA
Provider impact
All Providers
Workaround
Make sure dates being submitted are in the format MM/DD/YYYY.
Date closed