Ameritas Group a UNIFI CO with over $ 25 Billion of Consolidated Assets
FUSION: THE ULTIMATE CHOICE PRODUCT DESCRIPTIONS
Employee receives dental and eye care benefits in one plan at an affordable price.
Plan maximums and frequencies are combined for dental and eye care. Members may visit any dentist
or eye care office and receive benefits -- this cost-saving plan is available everywhere. Simply you may go
FUSION Combined Dental and Eye Care Plans then you may see your good teeth!
EYE CARE LIMITATIONS
PAGE VISION PERFECT Eye Med >(LUX NYSE Exchange)
Reimbursements with service at “any vision office”
Ameritas Fusion Plan to Subscribers
Subscriber using contracted Eye Med offices have a maximum fee that may be charged.
Examples: ** Single Vision
Lenses $50, Bifocal $70, Trifocal $105 any frame 35% off retail price
EYE CARE PLAN HIGHLIGHTS
These benefits are paid to any vision office
Deductible - Calendar Year Deductible:
(other than contact lenses) or
Maximum - Exams and Materials -
Per Benefit Period Paid by the Insurance CompanyNone
Includes case history; external examination
of the eye and adnexa; ophthalmoscopic examination; determination of refracture status;
binocular balance; tonometry test for glaucoma; gross visual field when indicated; summary finding; prescribing of
Lenses (Per pair of lens - Patient pays remainder)
Single $40 Bifocal $
60 Trifocal $ 75
Eye Med Providers
have a maximum fee that they may charge for additional savings
Single $50 Bifocal
$70 $ Trifocal $105 thus you would pay only the difference
No line bifocal or progressive power & Lenticular $80
See Maximum fees providers may charge and compare.Contact Lenses
(annual per year per family member) $120
Online Application click to submit below when finished.
The Fusion Ameritas PPO Plan
is separate and not related or affiliated in anyway whatsoever to the Dental HMO plans
that are provided by different companies. These plans are provided to give you more
options by your group.
Please, answer all questions, if you have a question on premium amount or anything
please email us below.
If you wish to make a payment and you are already enrolled you may provide your
information here and indicate it is only a payment at the last question
The Fusion Dental & Vision Plan includes the PPO option.
If you wish to have this plan and a Dental HMO then you would select "both" in the online application below.
To see the submit button to click go all the way to the right and click once
No need to pre-select Eye Care offices for the Eye Care benefits with either
the Dental HMOs (discount from Coast to Coast)
or the Fusion 50 State +DC Planwith "free choice"
of Eye Careoffice and receive insurance reimbursement or use contracted offices for added advantages.
Eligibility is the First of the Month after the second payroll deduction (or first of the
month after Expediting Enrollment by Credit Card, Bank Draft, or Quarterly and the
premium and all requirements are received by the administrator AMA
Postal Employees are required to return a signed copy, in two places, of the alloment
form and authorization, and writing "copy" on it even though they have started
payroll deduction by "PostalEASE."
Thank you for enrolling.
If you did not provide a primary email address above, even though you enrolled online we did not receive information on your email
address this was setup this way for your privacy.
You will now need to download
the 1199 Payroll Deduction Form and mail it with the $20 Enrollment Fee for all Fusion
PPO Plans with Free Choiceof Dental or Eye Care Provider, regardless of family size to American Marketing Administrators. (AMA).
To pay the enrollment fee
you may fax or mail a copy of the 1199 Payroll Deduction form and use Check-O-Matic
or provide credit card information, an additional shipping and handling fee applies to credit card use, to (AMA).
enrollment fee for the Dental HMO Plans is $20. Check payable to American National Dental or use credit or debit card.
Credit Card number, expiration date, name on the card, 3 digit security code from the back of the card, and
the billing address for the credit card if it is different. You may email this to: