Page 8 - PPP Guide
P. 8
Vision
Vision benefits are essential towards maintaining your overall health and well-being, which is why we are proud
to offer vision coverage.
Beneit Description Copay
Your Coverage with a VSP Doctor
X Focuses on your eyes and overall wellness
WellVision exam $10
X Every 12 months
Prescription Glasses $25
X $130 allowance for a wide selection of frames
X $150 allowance for featured frame brands
Frame Included in prescription glasses
X 20% savings on the amount over your allowance
X Every 24 months
X Single vision, lined bifocal, and lined trifocal lenses
Lenses X Polycarbonate lenses for dependent children Included in prescription glasses
X Every 12 months
X Standard progressive lenses $55
X Premium progressive lenses $95–$105
X Custom progressive lenses $150–$175
Lens enhancements X Average savings of 20-25% on other lens
enhancements
X Every 12 months
X $130 allowance for contacts and contact lens exam
(itting and evaluation)
Contacts (instead of glasses) X 15% savings on a contact lens exam (itting and $0
evaluation)
X Every 12 months
Glasses and Sunglasses
X 20% savings on additional glasses and sunglasses, including lens enhancements, from any
VSP doctor within 12 months of your last WellVision exam
Retinal Screening
Extra savings X No more than a $39 copay on routine retinal screening as an enhancement to a WellVision
exam
Laser Vision Correction
X Average 15% off the regular price or 5% off the promotional price; discounts only available
from contracted facilities
Vision Provider Search
Monthly Vision
Contributions 1. Go to www.vsp.com 3. Insert your zip code
Employee $6.67 2. Select “Find a VSP 4. Enter remaining search criteria
Employee/spouse $13.34 doctor”
Employee/child(ren) $14.29
Family $22.82 VSP Doctor Network: VSP Choice
8
2015 Benefit Guide
Vision benefits are essential towards maintaining your overall health and well-being, which is why we are proud
to offer vision coverage.
Beneit Description Copay
Your Coverage with a VSP Doctor
X Focuses on your eyes and overall wellness
WellVision exam $10
X Every 12 months
Prescription Glasses $25
X $130 allowance for a wide selection of frames
X $150 allowance for featured frame brands
Frame Included in prescription glasses
X 20% savings on the amount over your allowance
X Every 24 months
X Single vision, lined bifocal, and lined trifocal lenses
Lenses X Polycarbonate lenses for dependent children Included in prescription glasses
X Every 12 months
X Standard progressive lenses $55
X Premium progressive lenses $95–$105
X Custom progressive lenses $150–$175
Lens enhancements X Average savings of 20-25% on other lens
enhancements
X Every 12 months
X $130 allowance for contacts and contact lens exam
(itting and evaluation)
Contacts (instead of glasses) X 15% savings on a contact lens exam (itting and $0
evaluation)
X Every 12 months
Glasses and Sunglasses
X 20% savings on additional glasses and sunglasses, including lens enhancements, from any
VSP doctor within 12 months of your last WellVision exam
Retinal Screening
Extra savings X No more than a $39 copay on routine retinal screening as an enhancement to a WellVision
exam
Laser Vision Correction
X Average 15% off the regular price or 5% off the promotional price; discounts only available
from contracted facilities
Vision Provider Search
Monthly Vision
Contributions 1. Go to www.vsp.com 3. Insert your zip code
Employee $6.67 2. Select “Find a VSP 4. Enter remaining search criteria
Employee/spouse $13.34 doctor”
Employee/child(ren) $14.29
Family $22.82 VSP Doctor Network: VSP Choice
8
2015 Benefit Guide
