Vision Plan

VISION

CSU Vision Plan- Basic

All eligible employees and their eligible dependents are automatically enrolled in the VSP Basic Plan.

• Premiums are paid by the CSU.
• By choosing an Advantage Network provider in the Vision Service Plan (VSP), the insurance will cover more out-of-pocket costs.

• Group Plan Number #: 30059426
• Please visit the VSP website for more detailed information about your coverage or contact VSP directly at 800-877-7195.

The VSP Basic plan includes:

• One comprehensive eye exam every calendar year.
• One pair of lenses every other calendar year (or calendar year if your prescription changes significantly) and one frame every other calendar year.
• Contact lenses every other calendar year when contact lenses are provided in lieu of all other lens and frame benefits.
• For more detailed information, please review your VSP Vision Benefits Summary.

CSU Vision Plan - Premier

All CSU active employees are eligible to participate in the CSU VSP Basic Plan are eligible to enroll in the Premier Vision Plan for a small monthly employee cost share.

• Employees must enroll in the Premier Plan within 60 days of hire or during open enrollment.
• Eligible employees must enroll through VSP directly by calling (800) 400-4569 or by filling out the VSP Vision Care Premier Enrollment Form and faxing it to 916-389-8305. Employees can also mail the completed form to:

VSP TPA Client Services
P.O. Box 997100
Sacramento, CA 95899 
OR
Fax to: 916.389.8305
OR
Email to: CSUniv@vsp.com

• Group Plan #: 30077022
• The additional cost will be deducted directly from the employee’s pay warrant.
• If the employee elects the Premier Plan, any dependents they wish to cover must also be enrolled into the Premier Plan coverage.
• Employees cannot choose to enroll in both the Basic and Premier Vision Plan coverage at the same time, or split their enrollment leaving any dependents on the Basic Vision Plan. 
• Please visit the VSP website for more detailed information about your coverage or contact VSP directly at 800-400-4569.

 The VSP Premier plan includes:

• One comprehensive eye exam every calendar year.
• One pair of lenses/frames every calendar year with higher allowances.
• Contact lenses every calendar year when contact lenses are provided in lieu of all other lens and frame benefits.
• Extra Savings on Retinal Screening.
• For more detailed information, please review your VSP Vision Benefits Summary. 

Out of Network Providers

• A claim form is not required when using standard in-network benefits.
• Services provided by a non-VSP provider must be paid in full by the employee. For reimbursement, please complete a VSP Out-of-Network Reimbursement Form and mail it to VSP directly.

CSU Vision Insurance Miscellaneous Information:

• Vision Benefits Summary
• Vision Plan Directory
• VSP Basic Evidence of Coverage
• VSP Premier Evidence of Coverage
• VSP Out-of-Network Reimbursement Form
• VSP Video Display Terminal Confirmation Form
• VSP Premier Enrollment Form