Page 9 - 2020 NextCare Enrollment

2020
NextCare Holdings Benefits Enrollment

VISION

NextCare offers vision insurance through Delta Dental of Arizona
using the EyeMed network. You will receive an ID card in the mail after
enrollment.

In-Network Out-of-Network
Exam (every 12 months) $10 copay Up to $30
reimbursement
Single Lenses (every 12 months) $10 copay Up to $25
reimbursement
Bifocal Lenses (every 12 months) $10 copay Up to $40
reimbursement
Trifocal Lenses (every 12 months) $10 copay Up to $55
reimbursement
Lenticular Lenses (every 12 months) $10 copay Up to $55
reimbursement
Frames (every 12 months) $150 allowance, plus Up to $75
20% of amount over reimbursement
allowance
Elective Contacts (every 12 months Conventional: $150 Up to $120
in lieu of glasses) allowance, plus 15% reimbursement
of balance over $150

Disposable: $0
copay; $150
allowance, plus
balance over $150

Employee Vision Cost Per Pay Period

Employee Only $3 .76
Employee and Spouse $6 .01
Employee and Child(ren) $6 .14
Family $9 .90

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