Page 18 - Future Steps
P. 18
Vision
Vision Benefits
Your eyes are the only place in your body which can provide a clear view of your
blood vessels, arteries, and a cranial nerve which can tell your doctor a lot about
your overall health. Which is why GESM partners with EyeMed to offer you vision
insurance. The vision plan helps you pay for eye exams, eyeglasses (lenses and
frames), and contact lenses. The plan includes both in-network and out-of-network
beneits. EyeMed has more than 56,000 in-network providers, including retail chins
like LensCrafters, Pearle Vision, Target Optical, and Sears Optical. To locate an in-
network provider, visit eyemedvisioncare.com or call 866.723.0513.
Vision Benefits At-a-Glance
In-Network Out-of-Network
Exams Covered in full, after $15 Up to $30
(every 12 months) copayment
Lenses (every 12 months)
Single $15 copay Up to $25
Bifocal $15 copay Up to $40
Trifocal $15 copay Up to $60
Lenticular $15 copay Up to $60
Approved Frames (every 12 months)
$130 allowance; 20% off Up to $65
balance
Approved Contact Lenses (every 12 months in lieu of glasses)
Elective—Conventional or $130 allowance; 15% off Up to $104
Disposable balance
Medically Necessary 100% Up to $210
Vision Plan Premiums—No Increase in 2017
Bi-Weekly
Employee Only $3.06
Employee and Spouse $5.83
Employee and Child(ren) $6.13
Employee and Family $9.02
GESM
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Vision Benefits
Your eyes are the only place in your body which can provide a clear view of your
blood vessels, arteries, and a cranial nerve which can tell your doctor a lot about
your overall health. Which is why GESM partners with EyeMed to offer you vision
insurance. The vision plan helps you pay for eye exams, eyeglasses (lenses and
frames), and contact lenses. The plan includes both in-network and out-of-network
beneits. EyeMed has more than 56,000 in-network providers, including retail chins
like LensCrafters, Pearle Vision, Target Optical, and Sears Optical. To locate an in-
network provider, visit eyemedvisioncare.com or call 866.723.0513.
Vision Benefits At-a-Glance
In-Network Out-of-Network
Exams Covered in full, after $15 Up to $30
(every 12 months) copayment
Lenses (every 12 months)
Single $15 copay Up to $25
Bifocal $15 copay Up to $40
Trifocal $15 copay Up to $60
Lenticular $15 copay Up to $60
Approved Frames (every 12 months)
$130 allowance; 20% off Up to $65
balance
Approved Contact Lenses (every 12 months in lieu of glasses)
Elective—Conventional or $130 allowance; 15% off Up to $104
Disposable balance
Medically Necessary 100% Up to $210
Vision Plan Premiums—No Increase in 2017
Bi-Weekly
Employee Only $3.06
Employee and Spouse $5.83
Employee and Child(ren) $6.13
Employee and Family $9.02
GESM
18
