Vision Benefits

Vision Exam

$10 Copay

$45 Allowance

Standard Lenses

Single

$10 Copay

$30 Allowance

Bifocal

$10 Copay

$50 Allowance

Trifocal

$10 Copay

$60 Allowance

Lenticular

$10 Copay

$100 Allowance

Contact Lenses

$130 allowance

$105 allowance

Contact Lens Fitting Exam
Standard, Specialty

$60 Allowance

Applied to the contact lens allowance

Frames

$130 Allowance + 20% off balance over allowance

$70 Allowance

Lenses

Once every 12 months

Frames

Once every 24 months

Contacts

Once every 12 months

Employee

$0.86

Employee + Spouse

$2.47

Employee + Child(ren)

$2.46

Family

$4.58