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VISION INSURANCE

VSP VISION | PPO VISION PLAN

The VSP Vision 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 utilize a non-
network provider, you will be responsible to pay all charges at the time of your appointment and will be required to
file an itemized claim with VSP Vision. Your vision benefits may be accessed by giving your provider your name, date
of birth, and the last four digits of your social security number (you will not receive an ID card in the mail).

VSP
VISION

NETWORK Choice Non-Network
VISION BENEFITS
Examination (Every 12 Months) $10 Copay Up to $45 Reimbursement
Lenses (Every 12 Months)
• Single Vision $10 Copay Up to $30 Reimbursement
• Bifocal $10 Copay Up to $50 Reimbursement
• Trifocal $10 Copay Up to $65 Reimbursement
Frames (Every 12 Months) $180-$200 Allowance Up to $70 Reimbursement
Elective Contact Lenses (in lieu of frames and lenses)
• Cosmetic / Elective Up to $60 Copay, $150 Allowance Up to $105 Reimbursement

VSP has the largest network of private-practice eye care doctors in the industry. VSP’s network includes 50,000 access
points nationwide. VSP also contracts with Costco Optical, Eye Care Centers of America / Visionworks, and other affiliate
retail providers. Please note, benefits may vary at affiliate locations.

FINDING A VISION PROVIDER:
Go to www.vsp.com or call (800) 877-7195 and refer to the ‘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. You and your household
members can receive up to 3 face-to-face counseling sessions per person, per year.

ACCESSING THE EAP:

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

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