Cole Lux Merger And Its Effect On 3rd Party Business

[cinders831]

So with all of the wild business with Cole and Luxottica we are hoping as Eyemed providers we would be able to be added back on the provider panel as we reside in a pretty heavily populated GM town and Gm has vision with Cole. So is there any hope.....does anyone know? Luckily we have been able to maintain a large part of our patient base beacuse of our ability to provide excellent service. We are lucky that the exsisiting know about us but its not the greatest when people are looking for a new provider and are calling around and we say we cant except, most keep looking. Anyhow any insight would be greatly appreciated.

[For-Life]

I posted this before. Why don't you American Independent Opticians gather together and start your own vision-care insurance plan like the farmers have done in the past?

[Mikef]

letter from luxottica

Standard EyeMed Access Plans Dear EyeMed Provider,

We are pleased to announce our first major step in the integration of EyeMed Vision Care and Cole Managed Vision Care and to let you know that EyeMed's provider-friendly principles will continue to be the foundation of what we do. We will continue our commitment to support your ability to profitably prescribe to your patient's needs and wants, as well as your ability to choose fabrication laboratories, lens brands, lens options, frame brands and your right to not participate in plans with non-standard reimbursements. Over the next few weeks, we will have more to tell you about this integration and the plans we are developing to improve your managed vision care experience. As a first step, we are pleased to introduce new EyeMed standard plans, known as the EyeMed Access plans that we will be marketing to all new prospective clients beginning in February 2005. Once we begin marketing these new EyeMed Access plans,we will no longer be selling new clients the current EyeMed standard plans(known as EyeMed Plus plans). As part of our integration process, we have talked to providers about how we can continue to make managed care work better for them. Based on their input and Colelearning, the new EyeMed Access plans include:
* Higher standard progressive lens reimbursements* Higher standard polycarbonate lens reimbursements
* Higher tint reimbursements
* Higher UV coating reimbursements
* Higher reimbursements on components of complete pairs purchased separately for EyeMed Access plans C and D (e.g., frame only, lens only transactions)
* Comparable or higher exam, lens and frame reimbursements We will be offering five new standard EyeMed Access Plans: New EyeMed Standard For Reference:Plan Names: Plan Type: Current EyeMed Standard Plan Names EyeMed Access Plan A Funded exam, fit & follow up and materials Not currently offered EyeMed Access Plan B Funded exam and materials EyeMed Premier PlusEyeMed Access Plan C Funded exam + discount plan for materials EyeMed Preferred PlusEyeMed Access Plan D Discount plan for exam and materials EyeMed Primary PlusEyeMed Access Plan E Material only allowance plan Not currently offered The new EyeMed Access plans offer many enhancements to the current standard EyeMed plans.Please review all of the details of the new EyeMed Access plans outlined on the attachedsheets as well as in the Frequently Asked Questions section. Your agreement with EyeMedallows you to opt out of any new standard plans; therefore, if for any reason you shouldchoose not to participate in the new EyeMed Access plans, please complete and return theform included. We are still in the process of developing our strategy and plans with respect to the ColeManaged Vision Care plans; we expect to provide you with more details as soon as possible.

Should you have questions regarding our new EyeMed Access plans, please contact EyeMed VisionCare toll-free at 1-888-794-7705.

Sincerely, John W. Lahr, O.D., F.A.A.O.Medical Director

Frequently Asked Questions

1. When will I begin seeing patients from the new EyeMed Access plans? You may begin seeing new EyeMed Access plan members as soon as April 1, 2005.New EyeMed prospective clients with contract effective dates beginning April 1,2005 will be offered the new EyeMed Access plans. Current EyeMed clients withcontract renewal dates beginning July 1, 2005 will be encouraged to move to thenew EyeMed Access plans.
2. Am I required to accept the new standard EyeMed Access plans? No. You always have the choice to opt out of any new standard EyeMed plans,but we expect you will want to accept the new EyeMed Access plans. EyeMedAccess plans generally should provide you with better reimbursements thancurrent standard EyeMed plans. Beginning in February 2005, our marketingwill emphasize the EyeMed Access plans.
3. Will I continue to have the option to "opt out" of new standard or non-standard plans? Yes. Should EyeMed sell additional new standard plans or any non-standard plans youwill have the opportunity to "opt out".
4. What about the EyeMed frame requirement? For private practitioners, EyeMed has eliminated the frame requirement for participationin the EyeMed provider network.
5. Will EyeMed's Xtra10sm program apply to the EyeMed Access plans? Yes. The Xtra10 program will apply to all qualified claims filed by an eligible providerservicing the new EyeMed Access plans. The Xtra10 program will pay you an extra $10 forevery electronically filed claim for the new EyeMed Access plans in which a frame isactually dispensed and included in the claim. This is true whether or not you dispensea Luxottica frame to the patient. Just keep your Luxottica account in good standing,maintain your exchange/return rates at 20% or less and purchase a specified amount ofLuxottica frames and sunglasses. (See additional details and requirements @ www.eyemedvisioncare.com)
6.Will I be able to file claims electronically for the new EyeMed Access plans? Yes. In fact, we encourage you to file all funded EyeMed claims through our"On-Line Claims" system.
Doing so has many advantages including:
*FASTER reimbursement
*AUTOMATIC benefit calculation
*EASIER to file claims
*ELIMINATES mail time and lost mail
*INSTANT authorizations
*MANY other features If you are not filing claims through our "On-line Claims" system, it's easy to get started:Access our website at www.eyemedvisioncare.com *Select "On-Line Claims"
*Select "To register to use this site, click here"
*You will need your EyeMed Provider ID and your federal tax number to request a User ID and password
*Login using your new User ID and password IT'S THAT SIMPLE! -Detailed plan design information will be provided in the packet via mail. Packets will begin arriving the week of January 24.

[ziggy]

cinders,I heard tham the union for the big 3 (NAW?) was rather up set over the merger. Now part of the health care(eyecare) is owned by a non U.S. company. Let us know if you hear anything.

[cinders831]

Its the UAW and I heard the same thing. trust I am not in love with Eyemed Or Luxottica but I can participate with Eyemed and in this third party world especially in my demographics its essential for the health of our business and our future. Like I say we are blessed most patients stayed but not to many new patients with that type of insurance and new is how we grow.

[jediron1]

For-Life said:I posted this before. Why don't you American Independent Opticians gather together and start your own vision-care insurance plan like the farmers have done in the past?

Last time I looked Cole had about 65 million members in it's Cole Managed Vision segment and EyeMed had 55 million total 120 mil. Kind of hard to start a new Managed Vision segment when your up against numbers like those. Why do you think Lux took over Sears, BJ's and Target ect for it's people? Not a chance they wanted access to those 65 million people and the only way was to take over Cole. Just my 2 cents!

[For-Life]

Last time I looked Cole had about 65 million members in it's Cole Managed Vision segment and EyeMed had 55 million total 120 mil. Kind of hard to start a new Managed Vision segment when your up against numbers like those. Why do you think Lux took over Sears, BJ's and Target ect for it's people? Not a chance they wanted access to those 65 million people and the only way was to take over Cole. Just my 2 cents!

If the independents can create a better insurance plan companies will switch over. It might be slow at first, but most vision plans are under contracts of only a few years. Opportunities will open.

[rep]

Attempted to set up a managed care plan. The biggest issue was

"Who was going to sell it"

Rep

[LENNY]

No !

The biggest question is Who is going to give bribes to sign up the Unions and others!

[For-Life]

No !

The biggest question is Who is going to give bribes to sign up the Unions and others!

If you are giving members $250 per glasses compared to what Davis and that are giving I do not think you will have a problem.

[jediron1]

For-Life:
If you are giving members $250 per glasses compared to what Davis and that are giving I do not think you will have a problem.[/QUOTE]

I know of no plan that will pay out "$250 per glasses" as you say. Most don't even give half that amount. You have hugh over head with starting any plan
and that is why most of these plans only give a low stipent toward glasses or contacts maybe Canada it's different!

[For-Life]

For-Life:
If you are giving members $250 per glasses compared to what Davis and that are giving I do not think you will have a problem.

I know of no plan that will pay out "$250 per glasses" as you say. Most don't even give half that amount. You have hugh over head with starting any plan
and that is why most of these plans only give a low stipent toward glasses or contacts maybe Canada it's different![/QUOTE]

That is what I am saying. Most plans in Canada give $150 to $250. So if other plans are giving much less there obviously there is a huge opportunity to come in and give that.