Page 19 - 2021 Willett Engineering Benefits Guide
P. 19

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            Your eyesight plays an important role in your overall wellness.
            In addition to measuring your vision, regular eye exams help
            identify early signs of certain chronic health conditions.




            Your Blue View Vision Plan At-A-Glance


              VISION CARE SERVICES                                IN-NETWORK                OUT-OF-NETWORK
              Routine eye exam                                    $10 copay, then covered in full  $42 allowance
              Once every 12 months

              Eyeglass Frames                                     $130 allowance            $45 allowance
              Once every 24 months

              Eyeglass Lenses (Standard)
              Once every 12 months
              •  Standard plastic single vision lenses (1 pair)   $20 copay                 $40 allowance
              •  Standard plastic bifocal lenses (1 pair)         $20 copay                 $60 allowance


              Contact lenses
              Once Every 12 months
              •  Elective conventional lenses                     $130 allowance            $130 allowance
              •  Elective disposal lenses                         $130 allowance            $130 allowance
              •  Non-elective conventional lenses                 Covered in full           Covered in full





            2021 Rates


              VISION PLAN                                         COVERAGE                  MONTHLY RATE

                                                                  Single                    $7.36
                                                                  Employee + Spouse         $12.86


                                                                  Employee + Child(ren)     $13.96
                                                                  Family                    $21.30





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