Page 9 - 2018 NextCare Enrollment

Vision

NextCare offers vision insurance through MetLife. The beneits highlighted below are intended to describe your
vision coverage with MetLife network providers. Coverage with a retail chain afiliate may be different.

Description Copay Frequency
Well Vision Care Focuses on your eyes and $10 Every calendar year
overall wellness
Prescription Glasses
Frames $130 allowance for a wide $25 Every calendar year
selection of frames/20% off
amount over your allowance
Lenses Single vision, lined bifocal, Included with $25 copay for Every calendar year
and lined trifocal lenses/ frames
Polycarbonate lenses for
dependent children
Lens Options Standard progressive lenses $55 Every calendar year
Premium progressive lenses $95—$105 Every calendar year
Custom progressive lenses $150—$175 Every calendar year
Average 20-25% off other lens options
Contacts (instead of glasses) $130 allowance for contacts; $0 Every calendar year
copay does not apply
Contact lens exam Up to $60 Every calendar year
(itting and evaluation)
Extra Savings and Glasses and sunglasses—20% off additional glasses and sunglasses, including lens options,
Discounts within 12 months of your last Well Vision Exam
Lasik vision correction—average 15% off the regular price of 5% off the promotional price;
discounts only available from contracted facilities

Please see the plan documents on the NextCare Intranet beneits page for out-of-network beneits.

Employee Vision Cost Per Pay Period
Employee Only $3 .87
Employee and Spouse $6 .20
Employee and Child(ren) $6 .33
Family $10 .20

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