Page 17 - 2015 DAN Benefits Guide

Dentsu Aegis Network (DAN)

Vision Plan Vision Plan Summary
The vision plan administered by VSP provides afordable eye care with
discounts on rouine eye exams, frames, prescripion glasses, and/
or contact lenses. For more details see the vision plan summary plan
descripion posted on www.DANbeneitsplus.com.

Vision Service Plan
In-Network Out-of-Network
2015 Employee Contribuions Per Pay Period
Employee $2.92
Employee + Spouse $5.84
Employee + Child(ren) $6.25
Family $9.99
Plan Feature*
Well Vision Exam $10 copay Up to $45
(every calendar year)
Lenses/Prescripion Glasses $25 copay Single: up to $30
(every calendar year) Bifocal: up to $50
Trifocal: up to $65
Lenicular: up to $100
Frames (every 12 months) $160 allowance + 20% of Up to $70
amount over allowance
Elecive Contact Lens Care $160 allowance for Up to $105
(every 12 months) contacts; iing and
evaluaion up to $60 copay
Medically Necessary Covered in full Up to $210
Contact Lens Care (every 12
months)
Laser Vision Correcion Average 15% of regular Not covered
(contracted faciliies only) price or 5% of promoional
price

Find an In-Network
VSP provider at
www.vsp.com or call
1-800-877-7195.

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