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 – Base
Benefit Highlights
In-Network
Exams
$10 copay
Single Vision Lenses
$25 copay
Bifocal Lenses
$25 copay
Trifocal Lenses
$25 copay
Frames
Up to $150 reimbursement
Contacts (in lieu of glasses)
Up to $150 reimbursement
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Out-of-Network
Exams
Up to $45 reimbursement
Single Vision Lenses
Up to $30 reimbursement
Bifocal Lenses
Up to $50 reimbursement
Trifocal Lenses
Up to $65 reimbursement
Frames
Up to $70 reimbursement
Contacts (in lieu of glasses)
Up to $105
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Monthly Plan Cost
Employee Only: $0.00
Employee + Spouse/DP: $0.00
Employee + Children: $0.00
Employee + Family: $0.00
VSP Vision – Premier
Benefit Highlights
In-Network
Exams
$10 copay
Single Vision Lenses
$10 copay
Bifocal Lenses
$10 copay
Trifocal Lenses
$10 copay
Frames
Up to $250 reimbursement
Contacts (in lieu of glasses)
Up to $250 reimbursement
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Out-of-Network
Exams
Up to $45 reimbursement
Single Vision Lenses
Up to $30 reimbursement
Bifocal Lenses
Up to $50 reimbursement
Trifocal Lenses
Up to $65 reimbursement
Frames
Up to $70 reimbursement
Contacts (in lieu of glasses)
Up to $105 reimbursement
Frequency
Exams
Once every 12 months
Lenses
Once every 12 months
Frames
Once every 12 months
Contacts
Once every 12 months
Monthly Plan Cost
Employee Only: $5.10
Employee + Spouse/DP: $10.20
Employee + Children: $10.91
Employee + Family: $17.44