Vision Claim Form – Preferred Benefit Administrators

Preferred Benefit Administrators has been selected as the new Claims Administrator for the St. Johns County School District Vision Benefit Plan, effective 1/1/2022.

There are no changes to your vision benefits for the 2022 plan year except where your vision reimbursement requests should be submitted.

How to request a vision plan reimbursement:

• Complete a Vision Request for Reimbursement form.
• Attach an itemized bill or payment receipt from your vision provider.  Be sure it includes the type of service received.

You have several options for submitting your vision reimbursement requests:

• Fax your request to (407)786-2999.
• Mail your request to the address at the bottom of this letter.

If you should have any vision claims/eligibility related questions, please feel free to contact our office for assistance at (888)524-2777:

• Claims Analyst:  Marcia Kerr; Ext. 118; MKerr@PreferredTPA.com
• Eligibility Specialist: Jessica Brandt; Ext. 122; JBrandt@PreferredTPA.com

Important Vision Plan reminders:

• Visit any vision provider you choose; there are no vision network restrictions.
• All Vision Plan requests for reimbursement must be submitted within six (6) months from the date of service for your vision claim to be reimbursed.
• Your Vision Plan Document & Summary Plan Description can be viewed online by visiting our website at www.PreferredTPA.com.