Page 12 - Wesco Benefit Guide Effective 9-1-2024

Vision Options:

Humana

Weekly Semi-Monthly
Effective 9-1-2024 Dependent Information
(52) (24)
We offer our full-time employees and their
Employee Only $ 1.58 $ 3.64 Eligible dependents vision benefits..
Children can join or remain on a parent’s
Employee + Spouse $ 3.17 $ 7.27 vision plan until age 26. When a child turns 26,

they will lose vision coverage on the last day of
Employee + Child(ren) $ 3.01 $ 6.91 their birth month.

Employee + Family $ 4.73 $10.86

Benefits Highlights Plan Coverage (In-Network)

Copays:
Exam (Ophthalmologist or Optometrist) $10 Copay
Materials $15 Copay
Contact Lens Fitting (Standard) Up to $40
Frequency:
Exams Every 12 Months
Lens / Contact Lens Fitting Every 12 Months

Frames Every 24 Months
Frequency is based On Date of Service
Standard Lens:
Single Vision $15
Lined Bifocal $15
Lined Trifocal $15
Progressive Lens (Standard) $15
Factory Scratch and Ultraviolet Coat $15
Other Lens Options Copays or Discounts Apply

Frames:
$130 Retail Allowance
Frames Allowance
20% off balance over $130
Contact Lenses in lieu of eye glasses, materi-
als only:
Frequency Every 12 Months
$130 Retail Allowance
Lens Allowance
15% off balance over $130
NOTE: This is only a brief overview. Please see Benefit Summary and policy for more details.

Website: www.humana.com or Customer Service: 800-233-4013

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