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 Vision (Direct)
Benefit Highlights
In-Network
Exams
$25 copay (combined for exam and materials)
Single Vision Lenses
$0 after exam copay
Bifocal Lenses
$0 after exam copay
Trifocal Lenses
$0 after exam copay
Frames
Up to $130 allowance + 20% off remaining balance
Contacts (in lieu of glasses)
Up to $130 allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months
Out-of-Network Reimbursement
Exams
Up to $50 allowance
Single Vision Lenses
Up to $50 allowance
Bifocal Lenses
Up to $75 allowance
Trifocal Lenses
Up to $100 allowance
Frames
Up to $70 allowance
Contacts (in lieu of glasses)
Up to $105 allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 24 months
Contacts
Once every 12 months
Semi-Monthly Plan Cost
Employee Only: $0.00
Employee and Spouse/DP: $2.50
Employee and Child(ren): $2.50
Employee and Family: $5.00
VSP Buy-Up Vision
Benefit Highlights
In-Network
Exams
$25 copay (combined for exam and materials)
Single Vision Lenses
$0 after exam copay
Bifocal Lenses
$0 after exam copay
Trifocal Lenses
$0 after exam copay
Frames
Up to $250 allowance + 20% off remaining balance
Contacts (in lieu of glasses)
Up to $250 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
Up to $50 allowance
Single Vision Lenses
Up to $50 allowance
Bifocal Lenses
Up to $75 allowance
Trifocal Lenses
Up to $100 allowance
Frames
Up to $70 allowance
Contacts (in lieu of glasses)
Up to $105 allowance
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Semi-Monthly Plan Cost
Employee Only: $3.01
Employee and Spouse/DP: $8.25
Employee and Child(ren): $8.25
Employee and Family: $14.34