Page 11 - Guide
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Vision 2016–2017 Beneits Enrollment
Vision beneits are essential towards maintaining your overall health and well-being,
which is why we are proud to offer vision coverage.
Benefit Description Copay
Your Coverage with a VSP Doctor
WellVision Exam X Focuses on your eyes and $10
overall wellness
X Every 12 months
Prescription Glasses $25
Frame X $130 allowance for a wide Included in prescription glasses
selection of frames
X $150 allowance for featured
frame brands
X 20% savings on the amount
over your allowance
X Every 24 months
Lenses X Single vision, lined bifocal, and Included in prescription glasses
lined trifocal lenses Vision Provider
X Polycarbonate lenses for Search
dependent children 1. Go to vsp.com
X Every 12 months
Lens Enhancements X Standard progressive lenses $55 2. Select “Find a VSP doctor”
X Premium progressive lenses $95–$105 3. Insert your ZIP Code
X Custom progressive lenses $150–$175 4. Enter remaining search
X Average savings of 20–25% on criteria
other lens enhancements
X Every 12 months VSP doctor network: VSP
choice
Contacts (instead of X $130 allowance for contacts $0
glasses) and contact lens exam (itting
and evaluation)
X 15% savings on a contact lens
exam (itting and evaluation) Monthly Vision
X Every 12 months Contributions
Extra Savings Glasses and Sunglasses
X 20% savings on additional glasses and sunglasses, including lens Monthly Vision Contributions
enhancements, from any VSP doctor within 12 months of your last Employee $7.06
WellVision exam Employee/Spouse $14.13
Retinal Screening Employee/Child(ren) $15.13
X No more than a $39 copay on routine retinal screening as an Family $24.15
enhancement to a WellVision exam
Laser Vision Correction
X Average 15% off the regular price or 5% off the promotional price;
discounts only available from contracted facilities
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Vision beneits are essential towards maintaining your overall health and well-being,
which is why we are proud to offer vision coverage.
Benefit Description Copay
Your Coverage with a VSP Doctor
WellVision Exam X Focuses on your eyes and $10
overall wellness
X Every 12 months
Prescription Glasses $25
Frame X $130 allowance for a wide Included in prescription glasses
selection of frames
X $150 allowance for featured
frame brands
X 20% savings on the amount
over your allowance
X Every 24 months
Lenses X Single vision, lined bifocal, and Included in prescription glasses
lined trifocal lenses Vision Provider
X Polycarbonate lenses for Search
dependent children 1. Go to vsp.com
X Every 12 months
Lens Enhancements X Standard progressive lenses $55 2. Select “Find a VSP doctor”
X Premium progressive lenses $95–$105 3. Insert your ZIP Code
X Custom progressive lenses $150–$175 4. Enter remaining search
X Average savings of 20–25% on criteria
other lens enhancements
X Every 12 months VSP doctor network: VSP
choice
Contacts (instead of X $130 allowance for contacts $0
glasses) and contact lens exam (itting
and evaluation)
X 15% savings on a contact lens
exam (itting and evaluation) Monthly Vision
X Every 12 months Contributions
Extra Savings Glasses and Sunglasses
X 20% savings on additional glasses and sunglasses, including lens Monthly Vision Contributions
enhancements, from any VSP doctor within 12 months of your last Employee $7.06
WellVision exam Employee/Spouse $14.13
Retinal Screening Employee/Child(ren) $15.13
X No more than a $39 copay on routine retinal screening as an Family $24.15
enhancement to a WellVision exam
Laser Vision Correction
X Average 15% off the regular price or 5% off the promotional price;
discounts only available from contracted facilities
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