Vision Care Plans Carriers Eye Care Providers

Vision care plans - prohibited contract provisions - enforcement by the commissioner of insurance. The act prohibits a carrier or entity that offers a vision care plan from requiring an eye care provider with whom the carrier or entity contracts to:

• Provide services or materials to a covered person at a fee set by, or subject to the approval of, the carrier or entity unless certain conditions are met;
• Charge a covered person for noncovered services or noncovered materials in any amount less than the usual and customary amount that the eye care provider charges individuals who do not have coverage for such materials and services; or
• Participate, as a condition of participation in a vision plan, in any of the carrier's or entity's other vision plan networks.

The act prohibits a carrier or entity from changing the terms of a contract between the carrier or entity and an eye care provider without communication with the eye care provider.

The act requires the commissioner of insurance to institute a corrective action plan or use any of the commissioner's enforcement powers against a carrier or entity that is not in compliance with the above requirements.

(Note: This summary applies to this bill as enacted.)