Page 11 - Arktura EE Guide 12-17 - Final Sent 11.3.17

BENEFITS

VISION INSURANCE

EYEMED | PPO VISION PLAN
The EyeMed 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 EyeMed.

EYEMED
PLAN NAME PPO

Network Name Insight Non-Network
Vision Benefits
Copay
- Examination $10 Copay N/A
- Materials $20 Copay N/A

Examination (Every 12 Months) 100% Up to $40 Reimbursement
Lenses (Every 12 Months)
- Single Vision 100% Up to $30 Reimbursement
- Bifocal 100% Up to $50 Reimbursement
- Trifocal 100% Up to $70 Reimbursement

Frames (Every 24 Months) $130 Allowance Up to $91 Reimbursement
Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses

- Cosmetic / Elective $130 Allowance Up to $130 Reimbursement
- Medically Necessary 100% Up to $210 Reimbursement
Laser Vision Correction Discounts Apply Not Covered

FINDING A VISION PROVIDER
Go to www.eyemed.com or call (866) 804-0982. Refer to the Insight network when prompted.

EMPLOYEE ASSISTANCE PROGRAM

HARTFORD | EMPLOYEE ASSISTANCE PROGRAM
The Employee Assistance Program (EAP) through Hartford 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
Go to www.guidanceresources.com (Organization Web ID: HLF902; Company Name: ABILI) or you may call
(800) 964-3577 to be immediately connected to an EAP counselor.

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