Page 16 - 2018 Intertek OE Main Guide
P. 16
2018 Benefits Enrollment
Vision
Vision Coverage with VSP
We know your eye sight is precious to you so we make vision beneits
available for you to elect to ensure your trip to the eye doctor is
reasonably priced. To locate an in-network VSP provider in your area
go to vsp.com or call 800.877.7195.
VSP In-Network Out-of-Network
Vision Exam
Exam copay $10 copay Up to $50
Lenses
Single lens $25 copay Up to $50
Bifocal lens $25 copay Up to $75
Trifocal lens $25 copay Up to $100
Safety Goggles Lenticular lens $25 copay Up to $125
Included in Coverage Frames $150 allowance Up to $70
Frame beneit
Safety goggles are in addition to your
frames and contacts, not in lieu of. Contact Lenses
In lieu of glasses $150 allowance, Up to $105
According to the US Bureau of Labor copay does not
Statistics, approximately 60% of apply
people who incur eye injuries at work ProTec Safety Goggles
are not wearing proper protective
wear. You can receive the right Frame and Lenses (employees only) $25 copay Not covered
protective eyewear as part of your Frequency
vision insurance coverage. Covered
employees can select from the ProTec Exams 12 months
Eyewear safety frames collection. Lens 12 months
Visit vsp.com for more details. Contacts (in lieu of glasses) 12 months
Contact lens exam $60 maximum Not covered
(itting and evaluation) copay
Frames 24 months
Your Bi-Weekly Vision Contributions
Employee $1.47
Employee + 1 $3.27
Employee + 2 + $9.41
Your coverage includes
access to popular new
retail locations like
Costco, Cohen’s Fashion
Optical, and Visionworks.
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Vision
Vision Coverage with VSP
We know your eye sight is precious to you so we make vision beneits
available for you to elect to ensure your trip to the eye doctor is
reasonably priced. To locate an in-network VSP provider in your area
go to vsp.com or call 800.877.7195.
VSP In-Network Out-of-Network
Vision Exam
Exam copay $10 copay Up to $50
Lenses
Single lens $25 copay Up to $50
Bifocal lens $25 copay Up to $75
Trifocal lens $25 copay Up to $100
Safety Goggles Lenticular lens $25 copay Up to $125
Included in Coverage Frames $150 allowance Up to $70
Frame beneit
Safety goggles are in addition to your
frames and contacts, not in lieu of. Contact Lenses
In lieu of glasses $150 allowance, Up to $105
According to the US Bureau of Labor copay does not
Statistics, approximately 60% of apply
people who incur eye injuries at work ProTec Safety Goggles
are not wearing proper protective
wear. You can receive the right Frame and Lenses (employees only) $25 copay Not covered
protective eyewear as part of your Frequency
vision insurance coverage. Covered
employees can select from the ProTec Exams 12 months
Eyewear safety frames collection. Lens 12 months
Visit vsp.com for more details. Contacts (in lieu of glasses) 12 months
Contact lens exam $60 maximum Not covered
(itting and evaluation) copay
Frames 24 months
Your Bi-Weekly Vision Contributions
Employee $1.47
Employee + 1 $3.27
Employee + 2 + $9.41
Your coverage includes
access to popular new
retail locations like
Costco, Cohen’s Fashion
Optical, and Visionworks.
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