Page 12 - 2022 Thrall Benefits Guide

Vision Plan

The vision plan provides coverage for annual routine eye exams and pays for all or a portion of the cost of glasses or
contact lenses. You can choose any provider; however, you always save money if you see in-network providers. We
offer our vision plan through Vision Plan Service (VSP).

Plan Provisions In-Network Out-of-Network Reimbursement
Exam
$10 Copay Up to $50

Frames $30 Copay, then $120-140 allowance;
20% off amount over allowance Up to $70

Lenses
Single $30 Copay Up to $50
Lined Bifocal $30 Copay Up to $75
Lined Trifocal $30 Copay Up to $100
Lenticular $30 Copay Up to $125
Standard Progressive $50 Copay Up to $75
Premium Progressive $80 - $90 Copay Up to $75
Custom Progressive $120 - $160 Copay Up to $75

Contacts (in lieu of frames)
Contact Lens Exam $60 Copay Not covered
Contact Lenses $120 allowance Up to $105
Frequency Limit
Exams Once every 12 months
Frames Once every 12 months
Lenses Once every 12 months

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