Vision Plan

Vision coverage is provided by EyeMed. You can enroll in Vision coverage even if you waive medical coverage.

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Vision Plan

In-Network Member Costs

Annual Exam: Covered 100%

Contact Lens Fit

  • Standard: Up to $40
  • Premium: 10% off retail price

Frames

  • $150 allowance
  • 80% off balance of $150

Standard Plastic Lenses

  • Single Vision: $15
  • Bifocal: $15
  • Trifocal: $15
  • Standard Progressive Lens: $50
  • Premium Progressive Lens: $50
  • $150 allowance is combined for standard and contact lenses
 

Contact Lenses

  • Conventional: $150 allowance
    • 15% off balance over $150
  • Disposables: $150 allowance
  • $150 allowance is combined for standard and contact lenses

Frequency

  • Exam: Once every calendar year
  • Frames: Once every calendar year
  • Standard Plastic Lenses OR Contact Lenses: Once every calendar year

Out-of-Network Member Cost

Annual Exam: Covered 100%

Contact Lens Fit

  • Standard: N/A
  • Premium: N/A

Frames

  • Up to 80%

Standard Plastic Lenses

  • Single Vision: Up to $70
  • Bifocal: Up to $80
  • Trifocal: Up to $90
  • Standard Progressive Lens: Up to $80
  • Premium Progressive Lens: Up to $80
  • $150 allowance is combined for standard and contact lenses

Contact Lenses

  • Conventional: Up to $120
  • Disposables: Up to $120
  • $150 allowance is combined for standard and contact lenses

Frequency

  • Exam: Once every calendar year
  • Frames: Once every calendar year
  • Standard Plastic Lenses OR Contact Lenses: Once every calendar year

Vision Weekly Premiums

Emp Emp/Sp Emp/Ch(ren) Emp/Sp/Ch(ren)
Vision
$1.13
$2.25
$2.14
$3.31

Vision Weekly Premiums

Emp Emp/Sp Emp/Ch(ren) Emp/Sp/Ch(ren)
Vision
$1.13
$2.25
$2.14
$3.31

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