Full benefits

The following documents—called a Certificate of Coverage (COC)—provide in-depth descriptions of the benefits for the plan.

• Davis Vision by MetLife COC
• EyeMed COC
• MetLife Vision COC

How do the vision plans compare?

Before you enroll in a vision plan, use the Vision Benefits At-a-Glance Comparison to get the details you need to help you decide. 

For information on specific benefits and exclusions, review the plan's certificate of coverage (COC) or call the plan.

What does a vision plan cover?

Vision plans cover:

• An eye exam (once every year)
• A set of lenses (Benefit resets every January 1 of odd years)

Vision plans give an allowance toward new frames or contacts (in lieu of glasses) every January 1 of odd years (2025, 2027, etc.)

Some plans may also include discounts on laser vision correction, or LASIK.

Does my medical plan cover vision?

Your medical plan covers general eye health.

If you have an eye problem that’s related to a medical condition, such as cataracts, diabetes, or an injury, then your medical plan will more than likely cover you. These types of claims would fall under medical insurance; whereas a vision exam and glasses would fall under vision insurance.

For example: If your eye doctor was fitting you for contact lenses and discovered a torn retina, your medical plan would cover further exams and visits until it was resolved. A torn retina is a medical problem, not a vision correction issue.

What providers can I see?

Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.

Davis Vision by MetLife

Visit Davis Vision by MetLife's provider search.

EyeMed

Visit EyeMed's provider search.

MetLife Vision

Visit MetLife Vision's provider search.

Preauthorization criteria

Preauthorization is when you seek approval from your 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 your plan will pay for those services, supplies, or drugs.

• Davis Vision
• EyeMed
• MetLife Vision

These criteria do not imply or guarantee approval. Please check with your 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.

Full benefits

The following documents—called a Certificate of Coverage (COC)—provide in-depth descriptions of the benefits for the plan.

• Davis Vision by MetLife COC
• EyeMed COC
• MetLife Vision COC

How do the vision plans compare?

Before you enroll in a vision plan, use the Vision Benefits Comparison to get the details you need to help you decide. 

For information on specific benefits and exclusions, review the plan's certificate of coverage (COC) or call the plan.

What does a vision plan cover?

Vision plans cover:

• An eye exam (once every year)
• A set of lenses (Benefit resets every January 1 of odd years)

Vision plans give an allowance toward new frames or contacts (in lieu of glasses) every January 1 of odd years (2025, 2027, etc.)

Some plans may also include discounts on laser vision correction, or LASIK.

Does my medical plan cover vision?

Your medical plan covers general eye health.

If you have an eye problem that’s related to a medical condition, such as cataracts, diabetes, or an injury, then your medical plan will more than likely cover you. These types of claims would fall under medical insurance; whereas a vision exam and glasses would fall under vision insurance.

For example: If your eye doctor was fitting you for contact lenses and discovered a torn retina, your medical plan would cover further exams and visits until it was resolved. A torn retina is a medical problem, not a vision correction issue.

What providers can I see?

Before you select a vision plan, call the plan to see if your vision provider is in the plan's network.

Davis Vision by MetLife

Visit Davis Vision by MetLife's provider search.

EyeMed

Visit EyeMed's provider search.

MetLife Vision

Visit MetLife Vision's provider search.

Preauthorization criteria

Preauthorization is when you seek approval from your 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 your plan will pay for those services, supplies, or drugs.

• Davis Vision
• EyeMed
• MetLife Vision

These criteria do not imply or guarantee approval. Please check with your 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.

Why is frenotomy and frenectomy being reviewed?

Frenectomy and frenotomy for breastfeeding support were selected for a health technology assessment (HTA) because of high concerns for efficacy, and medium concerns for safety and cost.

Primary criteria ranking

• Safety = Medium
• Efficacy = High
• Cost = Medium

Documentation

What is a CCBHC?

A CCBHC is a provider who has met the SAMHSA requirements for eligible providers and the criteria to provide all required services. They must provide service to any individual who presents in their clinic, regardless of ability to pay or insurance.

Read the scope of services and activities.

Areas of service

Clinics must provide nine total areas of service:

• Screening, assessment, diagnosis
• Patient-centered treatment planning
• Outpatient mental health/substance use disorder treatment
• Crisis services (24-hour mobile crisis, crisis stabilization)*
• Peer support
• Psychiatric rehab
• Targeted case management
• Primary health screening and monitoring
• Armed forces and veteran’s services

A minimum of 51 percent of the services must be provided by the CCBHC, with the remainder provided by either the CCBHC or a Designated Collaborating Organization (DCO).

Our state has the goal to increase the number of CCBHCs so that every Washingtonian can easily access the services. Visit the CCBHC locator to find a clinic near you.

*After-hours crisis services may be provided by a state-sanctioned system.

Meetings

All the Cost Board’s Nominating Committee meetings are public meetings. We encourage you to join us and share your input. Find upcoming meetings and more on the Cost Board's meetings and materials page.

Committee members

The Nominating Committee is made up of three members of the Cost Board.

Ingrid Ulrey

Chief executive officer, Washington Health Benefit Exchange

Ingrid Ulrey is the chief executive officer for Washington Health Benefit Exchange (Exchange). She is a health care executive with an extensive history and passion for expanding access to care, driving health system transformation, and advancing equity. In her role as Exchange CEO, she oversees the entirety of the Exchange’s activities and works closely with the Governor-appointed Exchange Board, leadership, and staff to define and execute their mission.

Prior to her appointment as Exchange CEO, Ulrey served in the Biden Administration as regional director for the U.S. Department of Health and Human Services (HHS) — serving Alaska, Idaho, Oregon, Washington, and the 272 federally recognized tribes. Before HHS, Ulrey was policy director for public health — Seattle & King County, where she was a lead strategist of the region’s COVID-19 response.

Ulrey’s leadership in the health sector is informed by work at the national level, including five years with the Service Employees International Union based in Washington, DC; at the state level, including eight years state legislative sessions in Olympia as advocacy director for AARP; and with a global perspective on health from more than five years in the Middle East and Southeast Asia, most recently with PATH, based in Yangon, Myanmar. She has a master’s in public policy, public policy analysis from Georgetown University and a bachelor’s in cultural anthropology from University of California, Santa Cruz.

Kim Wallace

Medical administrator, Office of the Medical Director, Washington State Department of Labor & Industries

Over the past 25 years, Kim has held numerous public and private sector leadership positions in health care policy and finance, health IT, health benefits management, and public health. She has an MBA from Wharton and a B.S. in Clinical Dietetics from the University of Washington.

Carol Wilmes

Director, Member Pooling Programs, Association of Washington Cities (AWC)

Carol Wilmes oversees AWC's Employee Benefit Trust, Risk Management Service Agency, Workers' Comp Retrospective Rating Program, and Drug & Alcohol Consortium. For most of her 38 years with the AWC, Carol administered the Employee Benefit Trust, insuring 36,000 members from over 280 municipalities and special purpose districts. She serves as a resource for labor-management task forces addressing the complexities of health care coverage, and frequently speaks at the state and national level on governmental entity health pools and public sector risk management trends.

She was appointed to the Washington State Health Benefit Exchange Advisory Committee in 2015; serves as chair to the Board of Directors to the National League of Cities Risk Insurance Sharing Consortium; and serves on the Washington Health Alliance Board of Directors and Executive Committee.