Page 10 - University of the South-2022-Benefit Guide REVISED 3.30.22 FSA WAIT PERIOD

VISION PLAN

Eligible employees may choose to participate in the University's vision plan.
Coverage in the plan begins on the first day of the month following an
employee's hire. If selection is not made within 30 days of employment,
employees must wait until the annual enrollment period (normally in
November). The employee pays the total premium through payroll
deduction. A detailed description of the plan is available from the Office of
Human Resources.

Your vision plan is provided through Vision
Service Plan (VSP). It provides coverage for BENEFIT IN-NETWORK OUT-OF-NETWORK
routine eye exams and pays for all or a portion
of the cost of glasses or contact lenses. You can
see in-network or out-of-network providers; Exam $10 copay Up to $45
however, you always save money if you see Frequency
in-network providers. Exam 12 months** Every 12 months
Lenses 12 months** Every 12 months
Frames 24 months** Every 24 months

Prescription Glasses $25 copay N/A

$130 allowance; $150
allowance for featured
Frames Up to $70
To find a VSP doctor or retail provider, frame brands; 20%
visit www.vsp.com or call 800-877-7195. savings on balance
At your appointment, tell your doctor Lenses
you have VSP. Single vision lenses Covered at 100%* Up to $30
Bifocal lenses Covered at 100%* Up to $50
Trifocal lenses Covered at 100%* Up to $65
Lenticular lenses Covered at 100%* Up to $100

Medically necessary 100% Up to $210
contact lenses

Elective contact lenses Up to $130 Up to $105
in lieu of glasses (copay doesn’t apply)

Laser VIsion 15% off regular price or N/A
Correction 5% off promotional price
*Less any applicable copayment
**Beginning with the first day of the Benefit Period

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