Voluntary Vision Plan

NOTE: Links to the Vision Plan Handbook will open in a new window. Be sure to close each new window BEFORE selecting another link.

• 
• Certificate
• Internal Appeal Procedure
• Outline of Coverage
• Definitions
• Eligibility
• Dependent Eligibility
• Effective Date
• Termination Date
• Continuation of Coverage
• Covered Expenses
• Limitations
• Schedule of Services
• General Provisions

Forms & Publications

• Vision Enrollment/Change Form
• Vision Claim Form
• Continuation of Vision Insurance Coverage (COBRA) (SFN 53536)
• Dependent Continuation of Group Vision Coverage - COBRA (SFN 53885)
• Voluntary Vision Plan Handbook
• Rates

Claim Filing

Ameritas Life Insurance Corp.
Group Claim Office
P O Box 82520
Lincoln NE 68501
1-800-255-4931

Policy Holder: North Dakota Public Employees Retirement System
Group Policy Number: 010-350308-00000