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Instructions for UC Benefits Representatives:

Retiring employees who wish to continue their vision insurance in retirement should be given the Retiree Vision Benefits Summary and Enrollment Form [PDF] prior to their retirement date. Before printing and distributing the Summary and Form to the retiring employee, a UC Benefits Representative or Departmental Benefit Assistant should complete the bottom section of the form.

Enter the names of the family members enrolled in vision coverage (Last, First, Middle Initial), their date of birth (month/day/year) and relationship to the retiree (enter code)
Enter the effective date (if the retiree were to elect retiree vision)
Enter their own telephone number, campus or lab location, and date.
Print the documents and sign the form.

Eligibility for Retiree Vision

The UC Retiree Vision Plan is available to all retirees receiving monthly retirement or disability or survivor income from a UC-defined benefit plan.
For retirements July 1, 2008 or after, employees may be eligible to continue Retiree Vision if:
- They are enrolled in VSP when they leave UC employment.
- Their retirement date is within 120 days of their separation from employment; and
- Their coverage is continuous until the date their retirement begins.
UCRP retirees from Lawrence Livermore National Lab and Los Alamos National lab are not eligible.
Retirees waive all rights to elect or continue Retiree Vision if they elect a lump sum cashout (LSC). LSC members may still elect continuation of their vision coverage through COBRA and should be provided with a COBRA packet.
The graduated eligibility rules do not apply since there is no University contribution.
Family member eligibility requirements will parallel the family member requirements for the VSP plan for employees.
The plan will not be open for open enrollment every year; at this time, no future open enrollments are planned.

Note: Upon separation, employees who are eligible to continue Retiree Vision do not experience a COBRA qualifying event (similar to medical and dental).Therefore, they should not be provided with a COBRA application packet and are not eligible for COBRA continuation of their Employee VSP plan.