Page 14 - 2016 Intertek Enrollment Guide
P. 14
Vision
Safety Goggles Vision Coverage with VSP
Included in Coverage We know your eye sight is precious to you so we provide vision
beneits to make sure your trip to the eye doctor is reasonably
(Safety goggles are in priced. To locate an in-network VSP provider in your area go to
addition to your frames and www.vsp.com or call 800.877.7195.
contacts, not in lieu of)
VSP In-Network Out-of-Network
According to the US Vision Exam
Bureau of Labor Statistics, Exam copay $10 copay Up to $50
approximately 60 percent Lenses
of people who incur eye Single lens $25 copay Up to $50
injuries at work are not Bifocal lens $25 copay Up to $75
wearing proper protective Trifocal lens $25 copay Up to $100
Lenticular lens
wear. Now you can Frames $25 copay Up to $125
receive the right protective Frame beneit $150 allowance Up to $70
eyewear as part of your Contact Lenses
vision insurance coverage. In lieu of glasses $150 allowance, copay does not apply Up to $105
VSP members select from Frequency
the ProTec Eyewear safety Exams 12 months
frames collection. Visit Lens 12 months
www.vsp.com for more Contacts (in lieu 12 months
of glasses)
details. Frames 24 months
Employee Contributions
Employee $1.47
Employee + 1 $3.27
Employee + 2 + $9.71
14
Open Enrollment
Safety Goggles Vision Coverage with VSP
Included in Coverage We know your eye sight is precious to you so we provide vision
beneits to make sure your trip to the eye doctor is reasonably
(Safety goggles are in priced. To locate an in-network VSP provider in your area go to
addition to your frames and www.vsp.com or call 800.877.7195.
contacts, not in lieu of)
VSP In-Network Out-of-Network
According to the US Vision Exam
Bureau of Labor Statistics, Exam copay $10 copay Up to $50
approximately 60 percent Lenses
of people who incur eye Single lens $25 copay Up to $50
injuries at work are not Bifocal lens $25 copay Up to $75
wearing proper protective Trifocal lens $25 copay Up to $100
Lenticular lens
wear. Now you can Frames $25 copay Up to $125
receive the right protective Frame beneit $150 allowance Up to $70
eyewear as part of your Contact Lenses
vision insurance coverage. In lieu of glasses $150 allowance, copay does not apply Up to $105
VSP members select from Frequency
the ProTec Eyewear safety Exams 12 months
frames collection. Visit Lens 12 months
www.vsp.com for more Contacts (in lieu 12 months
of glasses)
details. Frames 24 months
Employee Contributions
Employee $1.47
Employee + 1 $3.27
Employee + 2 + $9.71
14
Open Enrollment
