Vision Benefits

Exam

Focus on your eyes and overall wellness

$10 Copay

Up to $30

Prescription Glasses:

$25 Copay

Frames

$100 allowance
20% savings off balance over your allowance

Included in Prescription Glasses

$50 Allowance

Lenses

Single Vision

Lined Bifocal

Lined Trifocal

Lenticular

Included in Prescription Glasses

Up to $25
Up to $40
Up to $60
Up to $100

Lens Enhancements

Scratch-Resistant Coating

Standard Progressive Lenses

Premium Progressive Lenses

$15
$25
$110 and Up

Up to $40
for Standard
Progressive
Lenses Only

Contacts
(instead of glasses, applies to materials only)

Conventional

$100 Allowance
15% off Balance Over $100

$80 Allowance

Medically Necessary Contact Lenses

Disposable
Medically Necessary

$100 Allowance
$0 Copay

$80 Allowance
$200 Allowance

Frequency:

Exam

12 Months

12 Months

Lenses

12 Months

12 Months

Lenses

12 Months

12 Months

Employee

$2.77

Employee + Spouse

$5.55

Employee + Child(ren)

$5.27

Family

$8.28