Online Benefits Directory

VISION

You and your legal dependents are eligible for on the first day of the month following 30 days of employment.

COVERAGE	VSP In-Network Benefit***	OUT-OF-NETWORK	Frequency Period**
Exam Copay	$10	N/A	12 Months
Exam Allowance (once per frequency period)	Covered 100% after copay	Up to $45	12 Months
Materials Copay	$20	N/A	12 months
Eyeglass Lenses Allowances:
(One pair per frequency period)	Covered 100% after copay	Up to $32	12 months
Single Vision	Covered 100% after copay	Up to $55	12 months
Lined Bifocal	Covered 100% after copay	Up to $65	12 months
Trifocal Lenticular	Covered 100% after copay	Up to $80	12 months
Contact Lenses Allowances: (one pair or single purchase per frequency period)	Up tp $130	Up to $105	12 months
Elective Therapeutic	Covered 100%	Up to $210	12 months
Frame Retail Allowance (one per frequency period)	Up tp $130	Up to $71	24 Months
** Your Frequency Period begins on January 1 (Calendar year basis)

In-Network Coverage Includes***:

One vision and eye health evaluation including but not limited to eye health examination, dilation, refraction, and a prescription for glasses;
One pair of standard prescription plastic or glass lenses, all ranges of prescriptions (powers and prisms)
– Polycarbonate lenses for children under 19 years of age
– Oversize lenses
– Rose #1 and #2 solid tints
– Minimum 20% savings* on all additional lens enhancements you choose for your lenses, including but not limited to: scratch/ultraviolet/anti-reflective coatings; polycarbonate (adults); all tints/photochromic (glass or plastic); and lens styles.
Progressive lenses covered up to bifocal lens amount with 20% savings on the difference;
One frame for prescription lenses – frame of choice covered up to retail plan allowance, plus a 20% savings on amount that exceeds frame allowance;
One pair of contact lenses or a single purchase of a supply of contact lenses – in lieu of lenses and frame benefit, (may not receive contact lenses and frames in same benefit year). Allowance applied towards cost of supplemental contact lens professional services (including the fitting and evaluation) and contact lens materials* Provider participation is 100% voluntary; please check with your Eye Care Professional for any offered discounts.
*** Coverage may vary at participating discount retail and membership club optical locations, please contact Customer Service for specific coverage information