Page 16 - Remita Guide 2020 - NonCA FINAL

Cigna | PPO Vision Plan
The Cigna 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 Cigna.
Cigna
Plan Name PPO Plan
Network Name Network Non-Network
Vision Benefits
Copay
- Examination $10 Copay N/A
- Materials $25 Copay N/A
Examination (Every 12 Months) No Charge $45 Reimbursement
Lenses (Every 12 Months)
- Single Vision No Charge $32 Reimbursement
- Bifocal No Charge $55 Reimbursement
- Trifocal No Charge $65 Reimbursement
Frames (Every 12 Months) $130 Benefit $71 Reimbursement
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
- Cosmetic / Elective $130 Benefit $105 Reimbursement
- Medically Necessary No Charge $210 Reimbursement
Laser Vision Correction Discounts Apply Not Covered

The Cigna Vision network includes access to independent ophthalmologists and optometrists, as well as JCPenney
Optical, Pearle Vision, Sears Optical, Visionworks and Target Optical retail stores.

Finding a Vision Provider

Cigna: Go to www.cigna.com or call (800) 244-6224.

Additional Discounts Available

While the plan does not cover LASIK eye surgery, discounts may apply. Please inquire with Cigna
or your vision provider.

Continued Eyewear Savings: After your initial visits have been utilized, you are able to receive
ongoing discounts on additional eye wear purchases at a network provider, which result in
discounts up to 40% off the retail price of eye wear and accessories.