Page 12 - 2018-19 Optimas Enrollment
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2018–19 BENEFITS ENROLLMENT
VISION
We partner with VSP to offer you and your family members vision insurance.
Please note: the frames/
contacts allowance is reduced We offer a base and buy-up option to meet a variety of needs. Please note,
to $70 in the Base Plan and $100 ID cards are not needed with VSP. You will simply identify yourself as
in the Buy-Up Plan when you a VSP member and your doctor will do the rest! If you prefer to have an
purchase frames or contacts ID card, you can access your card on vsp.com or from your smartphone at
from Walmart, Sam’s Club, or mobile.vsp.com.
Costco.
Find an In-Network Provider
Visit in-network providers to receive the deepest level of discount on your
services. To find a participating in-network provider, go to www.vsp.com or
call 800.877.7195.
VSP
Base Plan Buy-Up Plan
In-Network Out-of-Network In-Network Out-of-Network
Exam $20 copay Reimbursed up to $45 $20 copay Reimbursed up to $45
Materials $20 copay Varies $20 copay Varies
Lenses
Single $20 copay Reimbursed up to $30 $20 copay Reimbursed up to $30
Bifocal $20 copay Reimbursed up to $50 $20 copay Reimbursed up to $50
Trifocal $20 copay Reimbursed up to $65 $20 copay Reimbursed up to $65
Frames
$20 copay; up to $130 Reimbursed up to $70 $20 copay; up to $180 Reimbursed up to $70
allowance, 20% off of allowance, 20% off of
balance over allowance balance over allowance
at participating at participating
providers providers
Contacts
Elective Up to $130 allowance Reimbursed up to $105 Up to $150 allowance Reimbursed up to $105
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu 12 months
of glasses)
Frames 24 months 12 months
This is a high level summary of your benefit coverage. Full coverage details are available in your summary plan description (SPD). In
the event there is a discrepancy between what is reflected in this guide and what is communicated in your SPD, the terms of your
SPD will prevail.
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VISION
We partner with VSP to offer you and your family members vision insurance.
Please note: the frames/
contacts allowance is reduced We offer a base and buy-up option to meet a variety of needs. Please note,
to $70 in the Base Plan and $100 ID cards are not needed with VSP. You will simply identify yourself as
in the Buy-Up Plan when you a VSP member and your doctor will do the rest! If you prefer to have an
purchase frames or contacts ID card, you can access your card on vsp.com or from your smartphone at
from Walmart, Sam’s Club, or mobile.vsp.com.
Costco.
Find an In-Network Provider
Visit in-network providers to receive the deepest level of discount on your
services. To find a participating in-network provider, go to www.vsp.com or
call 800.877.7195.
VSP
Base Plan Buy-Up Plan
In-Network Out-of-Network In-Network Out-of-Network
Exam $20 copay Reimbursed up to $45 $20 copay Reimbursed up to $45
Materials $20 copay Varies $20 copay Varies
Lenses
Single $20 copay Reimbursed up to $30 $20 copay Reimbursed up to $30
Bifocal $20 copay Reimbursed up to $50 $20 copay Reimbursed up to $50
Trifocal $20 copay Reimbursed up to $65 $20 copay Reimbursed up to $65
Frames
$20 copay; up to $130 Reimbursed up to $70 $20 copay; up to $180 Reimbursed up to $70
allowance, 20% off of allowance, 20% off of
balance over allowance balance over allowance
at participating at participating
providers providers
Contacts
Elective Up to $130 allowance Reimbursed up to $105 Up to $150 allowance Reimbursed up to $105
Frequency
Exam 12 months
Lenses 12 months
Contacts (in lieu 12 months
of glasses)
Frames 24 months 12 months
This is a high level summary of your benefit coverage. Full coverage details are available in your summary plan description (SPD). In
the event there is a discrepancy between what is reflected in this guide and what is communicated in your SPD, the terms of your
SPD will prevail.
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