Vision

Healthy eyes and clear vision are an important part of your overall health and quality of life. You may enroll yourself and your eligible dependents or you may waive vision coverage. You do not have to be enrolled in medical coverage to elect vision coverage or cover the same dependents under medical and vision.

Although vision care services and supplies are covered in-network and out-of-network, your benefits are generally greater when you use in-network providers. Your costs are based on the family members you choose to cover.

Vision Plan

Benefit Highlights
In-Network

Exams
$10 copay

Single Vision Lenses
$10 copay

Bifocal Lenses
$10 copay

Trifocal Lenses
$10 copay

Frames
$0 copay then $100 allowance; plus 20% off remaining balance over $100

Contacts (in lieu of lenses/frames)
$0 copay then $115 allowance; plus 15% off remaining balance over $115

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 24 months

Contacts
Once every 12 months

Out-of-Network Reimbursement

Exams
Up to $35 reimbursement

Single Vision Lenses
Up to $25 reimbursement

Bifocal Lenses
Up to $40 reimbursement

Trifocal Lenses
Up to $55 reimbursement

Frames
Up to $50 reimbursement

Contacts (in lieu of glasses)
Up to $100 reimbursement

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 24 months

Contacts
Once every 12 months

Plan Cost

Employee Only: $5.22

Employee and Spouse: $9.20

Employee and Child(ren): $9.64

Employee and Family: $15.38

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