Page 18 - HWS 2021 Benefit Guide
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Vision plan
The vision plan provides coverage for 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 a vision
plan through Ameritas.
Plan Provisions
Once every 12 months In-Network Out-of-Network
$10 Exam $10 Exam
Exam – Once every 12 months
$25 Eye Glass Lenses or Frames* $25 Eye Glass Lenses or Frames*
Frames – Once every 12 months $130** Up to $70
Lenses – Once every 12 months Covered in full Up to $30
Contact Lenses – Once every 12 months Up to $130** Up to $105
*Deductible applies to a complete pair of glasses or frames, whichever is selected.
**The Costco allowance will be the wholesale equivalent
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