Page 9 - Tender Greens Benefit Guide Sample

VISION

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. 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.

Plan Features VSP PPO

In-Network Non-Network
Examination $10 Copay up to $40

Lenses
- Single Vision 100% up to $30
- Lined Bifocal 100% up to $50
- Trifocal 100% up to $65
- Frequency 12 months 12 months

Frames up to $140 up to $70
- Frequency 2 pairs per 12 months* 2 pairs per 12 months*

Contact Lenses 100% Comprehensive Exam
- Cosmetic up to $105 up to $130 (both eyes)
- Medically Necessary 100% up to $125 (per eye)
- Frequency 12 months 12 months
*First frame $10 copay, second frame $20 copay

Assurant | 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.

You and your household members can receive:
• Up to 3 face-to-face counseling sessions with a licensed mental health practitioner per person, per problem, per year
• 24/7 phone consultations with licensed mental health professionals and referrals to supportive resources
• Online programs to offer something different than traditional counseling
• Access to quick and confidential help from legal and financial experts

Accessing the EAP
Go to www.ndbh.com or you may call (800) 624-5544 to be immediately connected to an EAP counselor.

9