Page 9 - NC OE Guide
P. 9
Vision Coverage
Included With Medical Plan
When you elect medical coverage, your election also includes access to an enhanced
vision beneit through the Davis Vision network. Mitchell Gold + Bob Williams’
plan provides coverage for one routine comprehensive eye exam per plan year.
In addition, the plan will reimburse up to $130 plus a 10 percent coinsurance for
anything over $130 for lenses and frames. For questions or help searching for a
network provider, call 888.897.9350.
Medical/Vision Plan Cost
Coverage Tier HRA Participation
Weekly
Employee $24.85
Employee + spouse $79.71
Employee + child(ren) $61.21
Family $116.33
Bi-Weekly
Employee $49.70
Employee + spouse $159.41
Employee + child(ren) $122.43
Family $232.67
Monthly
Employee $107.68
Employee + spouse $345.39
Employee + child(ren) $265.26
Family $504.11
9
Included With Medical Plan
When you elect medical coverage, your election also includes access to an enhanced
vision beneit through the Davis Vision network. Mitchell Gold + Bob Williams’
plan provides coverage for one routine comprehensive eye exam per plan year.
In addition, the plan will reimburse up to $130 plus a 10 percent coinsurance for
anything over $130 for lenses and frames. For questions or help searching for a
network provider, call 888.897.9350.
Medical/Vision Plan Cost
Coverage Tier HRA Participation
Weekly
Employee $24.85
Employee + spouse $79.71
Employee + child(ren) $61.21
Family $116.33
Bi-Weekly
Employee $49.70
Employee + spouse $159.41
Employee + child(ren) $122.43
Family $232.67
Monthly
Employee $107.68
Employee + spouse $345.39
Employee + child(ren) $265.26
Family $504.11
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