Vision Benefits

Exams

Every 12 months, one exam is covered in full after $10 copay

Prescription Glasses
Lenses

1 pair covered every 12
months

Frames

Up to $150
Once every 12 months
20% off amount over
allowance.

     Single
     Lined bifocal lenses
     Lined trifocal lenses
     Polycarbonate lenses for dependent children (<18)

$25 copay
$25 copay
$25 copay
$25 copay

Lens Enhancements

Standard Progressive lenses covered once every 12 months with a

$0 copay.

Most other popular lens enhancements are covered after a copay.

Elective Contacts

Covered up to $150 every 12 months
Contact lenses can be chosen instead of glasses

Contact fitting and evaluation

Up to $60 copay

Necessary Contacts

Covered in full after $25 copay every 12 months

Employee

$ 0

Employee + Spouse

$2.10

Employee + Child(ren)

$2.10

Family

$6.77