Notice to employees

  • You are able to go to any licensed optometrist, ophthalmologist and/or dispensing optician you choose as there is no vision network.  You will pay at the time of service and later send a copy of your itemized bill reflecting the provider’s fees to the Claims Administrator for reimbursement.  Please make sure your name is printed on the top of the bill, you will be reimbursed according to the Allowed Charge up to the amount allowed by the Plan as displayed in the attached.

    The address for the Claims Administrator is:

    Summit Administration Services
    Claims Administrator
    P.O. Box 25160
    Scottsdale, AZ  85255-0102



Participant Notice

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