Page 13 - Murphy Benefits Guide
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Vision
We partner with Anthem to offer you and your family members
vision insurance. You may choose from many private practice doctors,
local optical stores, and national retail stores including LensCrafters,
Target Optical, and most Pearle Vision locations. You may also use
your in-network beneits to order eyewear online at Glasses.com and
ContactsDirect.com. To locate a participating network eye care doctor
or location, go to anthem.com and select the Blue View Vision network.
You may also call member services for assistance at 866.723.0515.
If you choose to, you may instead receive covered beneits outside of
the Blue View Vision network. Just pay in full at the time of service,
obtain an itemized receipt, and ile a claim for reimbursement up to your
maximum out-of-network allowance.
In-Network Out-of-Network
Copay Monthly
Exam $10 copay Up to $42 Contributions
Lenses Employee $6.78
Single $25 copay Up to $40 Employee and $13.58
Spouse
Bifocal $25 copay Up to $60 Employee and $13.72
Trifocal $25 copay Up to $80 Child(ren)
Frames Employee and Family $21.90
$130 allowance, then Up to $45
20% of
Contacts
Elective Conventional $130 allowance, then Up to $105
15% of
Elective Disposable $130 allowance Up to $105
Medically Necessary Covered in full Up to $210
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu of glasses) 12 months
Frames 12 months
This is a high level summary of your beneit coverage. Full coverage details are available in your
summary plan description (SPD). In the event there is a discrepancy between what is relected in
this guide and what is communicated in your SPD, the terms of your SPD will prevail.
Murphy 13
We partner with Anthem to offer you and your family members
vision insurance. You may choose from many private practice doctors,
local optical stores, and national retail stores including LensCrafters,
Target Optical, and most Pearle Vision locations. You may also use
your in-network beneits to order eyewear online at Glasses.com and
ContactsDirect.com. To locate a participating network eye care doctor
or location, go to anthem.com and select the Blue View Vision network.
You may also call member services for assistance at 866.723.0515.
If you choose to, you may instead receive covered beneits outside of
the Blue View Vision network. Just pay in full at the time of service,
obtain an itemized receipt, and ile a claim for reimbursement up to your
maximum out-of-network allowance.
In-Network Out-of-Network
Copay Monthly
Exam $10 copay Up to $42 Contributions
Lenses Employee $6.78
Single $25 copay Up to $40 Employee and $13.58
Spouse
Bifocal $25 copay Up to $60 Employee and $13.72
Trifocal $25 copay Up to $80 Child(ren)
Frames Employee and Family $21.90
$130 allowance, then Up to $45
20% of
Contacts
Elective Conventional $130 allowance, then Up to $105
15% of
Elective Disposable $130 allowance Up to $105
Medically Necessary Covered in full Up to $210
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu of glasses) 12 months
Frames 12 months
This is a high level summary of your beneit coverage. Full coverage details are available in your
summary plan description (SPD). In the event there is a discrepancy between what is relected in
this guide and what is communicated in your SPD, the terms of your SPD will prevail.
Murphy 13
