Page 10 - Teacher Created Materials EE Guide 09-18 - CA

Benefits

Vision Insurance

VSP | PPO Vision Plan
The VSP vision plan provides professional vision care and high-quality lenses and frames through a broad network of optical
specialists. You will receive richer benefits if you utilize a network provider. If you use a non‐network provider, you will be
responsible for paying all charges at the time of your appointment and will be required to file an itemized claim with VSP.

VSP Note
Plan Name PPO VSP has the largest
network of private-
Network Name VSP Choice Non-Network
practice eye care
Vision Benefits doctors in the
industry. VSP’s
Copay network includes
- Examination $20 Copay N/A 50,000 access points
- Materials $20 Copay N/A
nationwide. VSP also
Examination (Every 12 Months) 100% $45 Reimbursement contracts with
Costco Optical,
Lenses (Every 12 Months) Visionworks, and
- Single Vision 100% $30 Reimbursement other affiliate retail
- Bifocal 100% $50 Reimbursement providers. Please
- Trifocal 100% $65 Reimbursement note, benefits may
- Polycarbonate (children) 100% Not Covered
vary at affiliate
Frames (Every 24 Months) $130 Allowance, $70 Reimbursement locations.
then 20% Discount
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
- Contacts $130 Allowance $105 Reimbursement
- Contact Lens Exam (Fitting/Eval) $60 Copay Not Covered

Finding a Vision Provider
Go to www.vsp.com or call (800) 877-7195. Refer to the “VSP Choice” network when prompted.

Employee Assistance Program

Cigna | Employee Assistance Program
The Employee Assistance Program (EAP) provides you and your household members with free, confidential assistance to help with
personal or professional problems that may interfere with work or family responsibilities and obligations. Services are available 24 hours a
day, 7 days a week via a toll-free nationwide number. For face-to-face assistance, you have three sessions available to you and your
household members. Call Cigna to request a referral.

Accessing the EAP
Go to www.cignabehavioral.com/cgi.com or you may call (800) 538-3543 to be immediately connected to an
EAP counselor.

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