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.

VSP Core Plan

Benefit Highlights
In-Network

Exams
$10 copay

Single Vision Lenses
$10 copay

Bifocal Lenses
$10 copay

Trifocal Lenses
$10 copay

Frames
$200 Allowance + 20% discount over allowance

Contacts (in lieu of glasses)
$200 Allowance + 20% discount over allowance

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 12 months

Contacts
Once every 12 months

Out-of-Network Reimbursement

Exams
Plan pays up to $50

Single Vision Lenses
Plan pays up to $50

Bifocal Lenses
$Plan pays up to $75

Trifocal Lenses
Plan pays up to $100

Frames
$Plan pays up to $70

Contacts (in lieu of glasses)
Plan pays up to $105

Frequency

Exams
Once every 12 months

Lenses
Once every 12 months

Frames
Once every 12 months

Contacts
Once every 12 months

Plan Cost

Employee Only: $XX

Employee and Spouse: $XX

Employee and Child(ren): $XX

Employee and Family: $XX

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