Page 15 - 2025-26 Gas Clip Technologies Benefit Guide2

Vision Option:

Lincoln Financial

2025-26 Rate Information

Per Pay Period Semi-Monthly
Dependent Information
Employee Only $0.81
Gas Clip Technologies offers employees the oppor-
Employee + Spouse $1.53 tunity to cover their spouses and dependent children.
Children can join or remain on a parent’s vision plan
Employee + Child(ren) $1.79 until age 26. When a child turns 26, they will lose vision

coverage on the last day of their birth month.
Employee + Family $2.52

Benefits (In-Network) Plan Coverage

Copays:
Exam $10 Copay

Materials $25 Copay

Frequency: (Based on Date of Service)
Exams Every 12 Months
Lenses Every 12 Months

Frames Every 24 Months
Contact Lenses Every 12 Months in lieu of eyeglass lenses.

Standard Lenses:
Single Vision 100% Covered in $25 Materials Copay
Lined Bifocal 100% Covered in $25 Materials Copay

Lined Trifocal 100% Covered in $25 Materials Copay

Progressive Lenses (Tier 1,2,3) $55—$150 Copay
Tint $14 Copay

UV Coating $16 Copay
Scratch Resistant Coating No Additional Charge

Photochromic (Up to age 19) No Additional Charge

Plan Includes Warby Parker. You can have
Frames:
Complete Pair of Glasses for $25.00
$130 Retail allowance;
Frames Allowance
then up to 30% off balance over $130.
Contact Lenses in lieu of eye glasses: $125 Allowance;

15 Please note: This summary is intended for general information purposes.
It is not a guarantee of benefits. Please reference the Benefit Summary or contact the carrier for specific details.