Page 11 - CW Driver Benefit Guide 2019 MAIN

VISION

The Anthem Blue Cross 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 Blue Cross Vision.

Plan Features PPO Vision Plan
Network Name Blue View Vision Non-Network
Deductible
- Examination $10 Copay N/A
- Materials $25 Copay N/A
Examination 100% $49 Reimbursement
- Frequency 12 Months 12 Months
Lenses
- Single Vision 100% $35 Reimbursement
- Lined Bifocal 100% $49 Reimbursement
- Lined Trifocal 100% $74 Reimbursement
- Frequency 12 Months 12 Months
Frames $130 Allowance + $50 Reimbursement
20% Off Remaining Balance
- Frequency 24 Months 24 Months
Contact Lenses In Lieu of Frames and Lenses

- Conventional / Elective $130 Allowance + $92 Reimbursement
15% off remaining balance
- Frequency 12 Months 12 Months

BASIC LIFE AND AD&D EAP

Life insurance protects your family or other beneficiaries in The Employee Assistance Program (EAP) through Anthem
the event of your death while you are still actively employed Blue Cross provides you and your household members
with the company. C.W. Driver pays for Basic Life and AD&D with free, confidential assistance to help with personal or
coverage, offered through Hartford Insurance, in the amount professional problems that may interfere with work or family
of 1 times your annual base salary to a maximum benefit of responsibilities and obligations. Services are available 24
hours a day, 7 days a week via a toll-free nationwide number.
$250,000. An additional $25,000 of Basic Life and AD&D is Also included is up to three face-to-face emotional or worklife
provided through Anthem Blue Cross. counseling sessions.

If your death is due to a covered accident or injury, your To access the EAP, go to www.resourceadvisorca.anthem.
beneficiary will receive additional amounts through Accidental com (Program Name: ResourceAdvisor) or call (888) 209-
Death and Dismemberment (AD&D) coverage. 7840 to be immediately connected to an EAP counselor.

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