Page 18 - Skyline Windows | 2022 Benefits Guide

Vision Benefits
Administered by EyeMed
Vision Benefits:
Effective 1st of the month following 30 days of employment.
Regular eye examinations can not only determine your need for corrective eyewear, but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone, therefore regular eye exams are recommended. All benefits eligible employees may elect to enroll in the voluntary vision plan offered by EyeMed. Employees pay the full cost of this plan offered at group rates, through payroll deductions.
VISION BENEFITS DETAILS
Eye Exam
Single Vision
Bifocal
Trifocal
Lenticular
Frames Any available frame at provider location
Member Cost
$10 copay $0 copay
$0 copay
$0 copay
$0 copay
$0 copay; $150 allowance 20% off balance over $150
Out-of-Network Reimbursement
Standard Plastic Lenses
Contact Lenses (Contact lens allowance includes materials only)
$40
$30
$50
$70
$70
Up to $105
$130
$130
Up to $210
Conventional
Disposable
Medically Necessary
Examination
Lenses or Contact Lenses
Frames
$0 copay; $130 allowance, 15% off balance over $130
$0 copay; $130 allowance, plus balance over $130
$0 copay, paid in full
Once every 12 months
Once every 12 months
Once every 12 months
You are in the Insight Network!
Frequency
18
2022 BENEFITS GUIDE YOUR WINDOW OF OPPORTUNITY