Page 11 - Lanter | 2022 Benefits Guide LAF
P. 11
VISION Find a Vision Provider
We partner with UnitedHealthcare to offer you and X Visit www.myuhc.com
your family members vision insurance. X Select Find a Doctor under Links and Tools
X Select your state and select the National Options PPO 30
UHC Vision Plan network
In-Network Out-of-Network X Enter city, state, and/or zip code
Vision Exam $10 copay $40 allowance
Lenses $25 copay
Single-Vision Covered in full $40 allowance
Bifocal Covered in full $60 allowance
Trifocal Covered in full $80 allowance
Lenticular Covered in full $80 allowance
Frames $25 copay
$130 allowance $45 allowance
Contact Lenses
Contact Lens Exam Up to $60 copay Not covered
Fitting
Instead of Lenses and $130 allowance $105 allowance
Frame
Medically Necessary for Covered in full $210 allowance
Speciic Health Conditions
Beneit Frequency
Exam 12 months
Eyeglass Lenses/Contacts 12 months
Frames 24 months
Premium Per Pay Period
Employee $2.95
Employee and Spouse $4.72
Employee and Child(ren) $4.82
Family $7.77
LANTER AIR FREIGHT 11
We partner with UnitedHealthcare to offer you and X Visit www.myuhc.com
your family members vision insurance. X Select Find a Doctor under Links and Tools
X Select your state and select the National Options PPO 30
UHC Vision Plan network
In-Network Out-of-Network X Enter city, state, and/or zip code
Vision Exam $10 copay $40 allowance
Lenses $25 copay
Single-Vision Covered in full $40 allowance
Bifocal Covered in full $60 allowance
Trifocal Covered in full $80 allowance
Lenticular Covered in full $80 allowance
Frames $25 copay
$130 allowance $45 allowance
Contact Lenses
Contact Lens Exam Up to $60 copay Not covered
Fitting
Instead of Lenses and $130 allowance $105 allowance
Frame
Medically Necessary for Covered in full $210 allowance
Speciic Health Conditions
Beneit Frequency
Exam 12 months
Eyeglass Lenses/Contacts 12 months
Frames 24 months
Premium Per Pay Period
Employee $2.95
Employee and Spouse $4.72
Employee and Child(ren) $4.82
Family $7.77
LANTER AIR FREIGHT 11
