Benefit Summary: Vision


Overview

This benefit helps pay for annual vision examinations and for glasses and contact lenses, subject to the rules of the Plan. The Plan uses a network of opticians, optometrists, and ophthalmologists called Vision Service Plan (VSP) to provide these benefits in an efficient and cost-effective way. Reduced benefits are available when you use a provider outside the VSP network. How often you can use the benefit and your copayment are shown in the benefit schedules below.


Eligibility

The Vision Care Benefit is available to all active employees and their covered dependents, as well as retirees who have chosen dental and vision coverage.



Summary of Benefits

 
VSP DOCTOR
OUT-OF-NETWORK
VISION EXAM-Every calendar year
Covered in full
Up to $35
FRAME-Every two calendar years
Covered up to $175 retail value
Up to $35
LENSES- Every calendar year:
 
 
Single vision
Covered in full
Up to $30/pair
Lined bifocal
Covered in full
Up to $40/pair
Lined trifocal
Covered in full
Up to $55/pair
Contacts
Covered up to $175/pair for exam, fitting, evaluation and lenses

Up to $100/pair for exam, fitting, evaluation and lenses

SAFETY GLASSES - Every two years
(employee only)
Covered In Full
Not Covered