Vision Insurance Adoption Hits 96 Percent as Employers Optimize Plans

Vision insurance is now offered by 96% of employers, according to SHRM's 2025 benefits survey — making it effectively a baseline expectation rather than a differentiator. But adoption rate and utilization rate are two different numbers, and the gap between them is where employer benefits dollars quietly disappear. Industry data consistently shows that high employer adoption doesn't translate automatically into high employee utilization, particularly when plan design, network access, or employee awareness fall short.

For employers reviewing what worked and what didn't from last year's open enrollment, vision insurance is a useful case study. The premium cost is relatively modest compared to medical or dental, but the ROI depends almost entirely on whether employees actually use the benefit. Employers who are paying for vision coverage that sits unused are absorbing a cost with no workforce return.

The Utilization Gap Employers Should Be Measuring

Vision care utilization varies significantly based on three controllable factors: plan design, network adequacy, and employee awareness. The Vision Council's "Focused inSights 2025: Managed Vision Care" research documents that consumer engagement with vision plans is highly sensitive to how benefits are structured and communicated. Unmet eye care needs remain widespread despite near-universal employer coverage — which means the problem isn't access to insurance, it's whether employees understand and can navigate what they have.

Age cohort behavior adds another layer. Younger employees tend to underutilize vision benefits, often because they don't perceive an immediate need or aren't aware of what's covered beyond glasses and contacts. Older employees show higher utilization rates. For employers with mixed-age workforces, this demographic pattern means overall utilization numbers can mask significant underuse in specific segments — and those are the segments where proactive communication has the most room to improve outcomes.

Employers evaluating vision insurance plan design and ancillary benefit optimization should pull carrier utilization reports by benefit category — exam utilization, frames allowance usage, contact lens allowance usage — before assuming the plan is performing. Many employers discover that exam utilization is reasonable but materials allowances go largely unclaimed, which often points to a communication gap rather than a plan design problem.

What Standard Vision Plans Cover — and Where Design Choices Matter

Most managed vision plans cover annual eye exams, frames, lenses, and contact lenses, with exam copays typically ranging from $10 to $25. Frames allowances generally fall between $100 and $200, and contact lens allowances between $100 and $150. Preventive services — the annual exam — are often covered at 100% under managed vision plans, which means the exam cost barrier is low for employees who are enrolled.

The plan design choices that actually drive utilization differences are network breadth, out-of-network reimbursement, and tier structure. Employees are significantly less likely to use vision benefits if their preferred provider isn't in-network — and in the New York market, where vision care costs run above national averages, out-of-pocket exposure for out-of-network visits can be substantial. Network adequacy is increasingly a competitive differentiator among carriers, and employers who haven't reviewed their carrier's provider directory recently may be operating with a narrower network than they realize.

Tiered plan designs — offering a base plan and an enhanced option — allow employers to serve workforce segments with different needs without overbuilding coverage for employees who only want exam coverage. This structure also gives employees agency, which generally improves satisfaction scores even when the base plan is relatively modest.

2026 Market Trends Shaping Employer Decisions

The vision insurance market is projected to reach $15.75 billion by 2033, growing at a 6.4% compound annual rate. That growth is driving carrier investment in plan flexibility and technology — and creating more options for employers who are willing to benchmark their current offering against the market. Vision Care Direct's 2026 benefits trends analysis identifies personalization, transparency, and cost optimization as the primary employer priorities reshaping vision benefit design this year.

Telehealth and virtual vision services are gaining traction as a supplement to traditional in-office care, particularly for prescription renewals and basic screenings. These services can improve utilization among employees who struggle to schedule in-person appointments, though they don't replace comprehensive eye exams for employees with changing prescriptions or underlying health conditions. Employers adding virtual vision options should ensure they're positioned as supplements, not substitutes, in employee communications.

For Long Island employers managing benefits across a competitive labor market, bundling vision with dental and medical under a coordinated ancillary strategy creates administrative efficiencies and simplifies the employee experience. Carriers that offer integrated ancillary packages often provide better aggregate pricing and consolidated billing, which reduces employer administrative burden without sacrificing plan quality.

Four Actions for Q1 Vision Benefit Review

• Pull carrier utilization data by benefit category. Request exam utilization rates, frames allowance redemption, and contact lens allowance usage separately. Low materials utilization with reasonable exam utilization is a communication problem. Uniformly low utilization may indicate a network or awareness issue.
• Audit your network against your workforce geography. Verify that your carrier's in-network providers are accessible to where your employees actually live and work. Nassau and Suffolk County employees may have different access patterns than employees in New York City, and a network that works for one population may underserve the other.
• Benchmark your allowances against current market standards. Frames allowances that haven't been updated in several years may now fall below what employees can realistically apply toward the eyewear they want, which reduces perceived plan value even when the coverage structure is sound.
• Review how vision benefits are communicated during enrollment. Employers working on HR strategy for benefits optimization and total rewards design frequently identify vision as a benefit where employees know they have coverage but don't know what it actually covers or how to use it. Enrollment education that walks employees through the specific steps — how to find a provider, what the allowance covers, how to submit an out-of-network claim — directly increases utilization.

Vision insurance at 96% employer adoption is no longer a differentiator — it's table stakes. What separates competitive employers is whether employees understand and use what they're enrolled in. You're paying for benefits your employees don't even know they have. That's money with zero ROI. Benton Oakfield's enrollment education is designed to close that gap, ensuring your investment in vision coverage actually pays off in utilization, satisfaction, and retention.

Employers with questions about vision plan design or ancillary benefit strategy can reach us at info@bentonoakfield.com.

This content is for informational purposes only and does not constitute legal, tax, or benefits advice. Requirements vary based on employer size, location, and plan structure. Information is current as of 2026-02-20. Employers should consult qualified advisors for guidance on their specific circumstances.