Plan Covenants: (Terms of Service)

Annual enrollment in the PVCS vision plan is for 12 consecutive months of coverage from the original effective date. Annual enrollment requires 12 consecutive monthly payments before the enrollee may drop coverage. Each subsequent annual enrollment also requires 12 consecutive monthly payments. In the event an Employee’s plan year for vision coverage does not coincide with the Employer’s open enrollment period, he/she may discontinue coverage during open enrollment but may receive a bill for the remaining annual premium if services have been used. Federal regulations governing IRC, Section 125 plans shall take precedence.

If coverage is terminated, whether during open enrollment or termination of employment, three options are available: (1) if no services have been provided during the enrolled period, discontinuance of enrollment in the plan is allowed; however, there will be no refund of any payments; (2) with a lump sum payment of the remaining annual premium, the enrollee may continue coverage until the end of his/her plan year; and (3) if services have been provided under this plan, PVCS will bill for the entire unpaid balance of the remaining months of the consecutive 12 month period; upon payment of the entire unpaid balance, the plan may be used for the remaining enrolled period of time.

The plan shall remain continuously in effect unless the Employer is properly notified. The contracted fee schedule shall remain in effect for the 12 month period of the contract. Thereafter, any fee changes shall be negotiated between the PVCS Plan Administrator and the contracting organization and be placed in force at Plan update.

Services provided under this plan are being provided at a significant discount from customary fees charged by cooperating doctors. Therefore, appointments you schedule and are unable to keep should always be canceled at the earliest possible time to ensure maximum courtesy in recognition of the doctor’s time and to help keep overall plan fees as low as practical.

Materials charges should be paid for by check or cash at the time of order. No billing services will be offered. Failure to pay for materials may result in a discontinuation of services.

PVCS Plan services are not currently taxed by any government entity. However, if a government entity establishes a tax for such services any time during the plan period, PVCS reserves the right to add such tax charges to the cost of this offering. Your signature on this agreement constitutes your acknowledgment of notification and approval of such additional charges.

The panel doctor selected by the employee or patient shall be solely responsible for the performance or non-performance of professional services under this contract. Neither the employer nor PVCS shall incur any liability for the actions of the service provider (doctor), whether arising from breach of contract, negligence, or willful misconduct, nor for any financial obligation or liability owed to the service provider by the patient. Any incidence of non-compliance should be immediately reported to the PVCS Plan Administrator.