Page 6 - Wiese 2021 Benefits Guide
P. 6
2021
Vision
Vision Plan—EyeMed
Wiese partners with EyeMed to administer vision
coverage.
Service Coverage*
Copay $10 for exam/$25 for eye glass lenses
Annual Eye Exam $10 copay
Lenses (single/ $25 copay
bifocal/trifocal)
Contacts (in lieu of $130 allowance, 15% of balance over
glasses) $130
Frames $130 allowance, 20% of balance over
$130
Team Members Cost Per Week
TM Only $1.42
TM + Spouse $2.74
TM + Child(ren) $2.31
TM + Family $3.63
* The above illustration includes beneit levels for in-network
services only.
To Find a Provider
Visit eyemedvisioncare.com
Click on “Find a Provider”
Enter your ZIP Code
Choose the Insight network
Click on “Get Results”
6
Vision
Vision Plan—EyeMed
Wiese partners with EyeMed to administer vision
coverage.
Service Coverage*
Copay $10 for exam/$25 for eye glass lenses
Annual Eye Exam $10 copay
Lenses (single/ $25 copay
bifocal/trifocal)
Contacts (in lieu of $130 allowance, 15% of balance over
glasses) $130
Frames $130 allowance, 20% of balance over
$130
Team Members Cost Per Week
TM Only $1.42
TM + Spouse $2.74
TM + Child(ren) $2.31
TM + Family $3.63
* The above illustration includes beneit levels for in-network
services only.
To Find a Provider
Visit eyemedvisioncare.com
Click on “Find a Provider”
Enter your ZIP Code
Choose the Insight network
Click on “Get Results”
6
