Page 18 - ABM 2021 Benefits Guide SVC 30+
P. 18
VISION BENEFITS
ABM has partnered with EyeMed to provide
vision coverage. Vision beneits are available
on a voluntary basis for team members and
their dependents. EyeMed ofers a network
of more than 58,000 providers at over 20,000
locations, including retail chains such as Target,
LensCrafters, and Pearle Vision. To ind a
vision provider in the EyeMed Insight Network,
use the EyeMed link on Beneitfocus or visit
eyemedvisioncare.com/locator/.
A highlight of the plan is shown in the following
table.
In-Network Out-of-Network
Copay
Exam $10 copay $50
Contact Lens $10 copay, paid in full it $40
Fit and Follow and follow up visits
Standard
Contact Lens $10 copay, 10% of retail, $40
Fit and Follow then $55 allowance
Premium
Materials $20 copay
Lenses
Single $20 copay $50
Bifocal $20 copay $75
Trifocal $20 copay $100
Lenticular $20 copay $125
Frames $0 copay, $200 $100
allowance, 20% of
balance
Contacts
Conventional $0 copay, $150 $120
allowance, 15% of
balance
Disposable $0 copay, $150 $120
allowance, plus balance
Medically $0 copay, covered in full $210
Necessary
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu 12 months
of glasses)
Frames 12 months
Notes Beneits are calendar year
18 2021 Benefits Enrollment
ABM has partnered with EyeMed to provide
vision coverage. Vision beneits are available
on a voluntary basis for team members and
their dependents. EyeMed ofers a network
of more than 58,000 providers at over 20,000
locations, including retail chains such as Target,
LensCrafters, and Pearle Vision. To ind a
vision provider in the EyeMed Insight Network,
use the EyeMed link on Beneitfocus or visit
eyemedvisioncare.com/locator/.
A highlight of the plan is shown in the following
table.
In-Network Out-of-Network
Copay
Exam $10 copay $50
Contact Lens $10 copay, paid in full it $40
Fit and Follow and follow up visits
Standard
Contact Lens $10 copay, 10% of retail, $40
Fit and Follow then $55 allowance
Premium
Materials $20 copay
Lenses
Single $20 copay $50
Bifocal $20 copay $75
Trifocal $20 copay $100
Lenticular $20 copay $125
Frames $0 copay, $200 $100
allowance, 20% of
balance
Contacts
Conventional $0 copay, $150 $120
allowance, 15% of
balance
Disposable $0 copay, $150 $120
allowance, plus balance
Medically $0 copay, covered in full $210
Necessary
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu 12 months
of glasses)
Frames 12 months
Notes Beneits are calendar year
18 2021 Benefits Enrollment