Page 7 - MIG Management - Benefit Guide 2018 Final 12.8.17

Benefits

Vision Insurance

Anthem | PPO Vision Plan
The Anthem 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 Anthem.

Anthem
Plan Name PPO Plan

Network Name Blue View Vision Non-Network
Vision Benefits
Copay
- Examination $20 Copay $42 Reimbursement
- Materials $20 Copay N/A

Lenses
- Single Vision 100% $40 Reimbursement
- Bifocal 100% $60 Reimbursement
- Trifocal 100% $80 Reimbursement
Frames $130 Benefit $45 Reimbursement

Contact Lenses In Lieu of Frames and Lenses
- Cosmetic / Elective $130 Benefit $92 Reimbursement
- Medically Necessary 100% $210 Reimbursement
Laser Vision Correction Discounts Apply Not Covered
Frequency
- Examination Every Calendar Year
- Lenses Every Calendar Year
- Frames Every 2 Calendar Years
- Contact Lenses Every Calendar Year

Finding a Vision Provider
Go to www.anthem.com or call (866) 723-0515. Refer to the Blue View Vision network when prompted.

Employee Assistance Program

The Employee Assistance Program (EAP) through Mutual of Omaha 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 counseling sessions per person, per problem, per year.

Accessing the EAP
To access EAP benefits, go to mutualofomaha.com/eap or you may call (800) 316-2796 to be immediately
connected to an EAP counselor.

7