Page 15 - 2016 Enrollment
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Vision Coverage Find an In-Network
Provider
Your Comprehensive Eye Care Coverage 1. Visit www.eyemed.com
You have the opportunity to elect vision coverage through EyeMed. Eye 2. Click on “Find a Provider” near
doctors detect problems in vision, review overall eye health, and detect the top of the homepage
signs of health conditions like diabetic eye disease, high blood pressure, 3. Fill in all search criteria to locate
and high cholesterol. We know your eye sight is precious so we offer an in-network provider near you
vision beneits to make sure your trip to the eye doctor is reasonably
priced.
Vision In-Network Out-of-Network
Copay
Exam $10 copay
Lenses
Single $10 copay $29 allowance
Bifocal $25 copay $23 allowance
Trifocal $25 copay $23 allowance
Lenticular $25 copay $64 allowance
Frames
$130 allowance $46 allowance
Contacts
Medically necessary Paid in full $210 allowance
Conventional $130 allowance $100 allowance
Disposable $130 allowance $100 allowance
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu of glasses) 12 months
Frames 24 months
Cost of Coverage
Monthly Vision Contributions
Employee $5.46
Employee + spouse $8.88
Employee + child(ren) $8.88
Family $14.55
2016 Benefits Guide
Vision Coverage Find an In-Network
Provider
Your Comprehensive Eye Care Coverage 1. Visit www.eyemed.com
You have the opportunity to elect vision coverage through EyeMed. Eye 2. Click on “Find a Provider” near
doctors detect problems in vision, review overall eye health, and detect the top of the homepage
signs of health conditions like diabetic eye disease, high blood pressure, 3. Fill in all search criteria to locate
and high cholesterol. We know your eye sight is precious so we offer an in-network provider near you
vision beneits to make sure your trip to the eye doctor is reasonably
priced.
Vision In-Network Out-of-Network
Copay
Exam $10 copay
Lenses
Single $10 copay $29 allowance
Bifocal $25 copay $23 allowance
Trifocal $25 copay $23 allowance
Lenticular $25 copay $64 allowance
Frames
$130 allowance $46 allowance
Contacts
Medically necessary Paid in full $210 allowance
Conventional $130 allowance $100 allowance
Disposable $130 allowance $100 allowance
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu of glasses) 12 months
Frames 24 months
Cost of Coverage
Monthly Vision Contributions
Employee $5.46
Employee + spouse $8.88
Employee + child(ren) $8.88
Family $14.55
2016 Benefits Guide
