Page 10 - Roll-A-Shade Ben Guide 6-2020

Benefits

Vision Insurance

United Healthcare | PPO Vision Plan
The United Healthcare 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 United

United Healthcare
VL008 PPO

Network Name UHC Vision Network Non-Network
Vision Benefits
Copay
- Examination $10 Copay N/A
- Materials $25 Copay N/A

Examination 100% Up to $40 Reimbursement
Lenses
- Single Vision 100% Up to $40 Reimbursement
- Bifocal 100% Up to $60 Reimbursement
- Trifocal 100% Up to $80 Reimbursement
- Lenticular 100% Up to $80 Reimbursement
Frames Up to $100 Benefit Up to $45 Reimbursement
Contact Lenses In Lieu of Frames and Lenses

- Cosmetic / Elective Up to $105 Benefit Up to $105 Reimbursement
Laser Vision Correction Discounts Apply Not Covered
Frequency
- Examination 12 Months
- Lenses 12 Months
- Frames 24 Months
- Contact Lenses 12 Months

Finding a Vision Provider
Go to www.myuhcvision.com or call (800) 638-3120.

Life and AD&D Insurance

Reliance Standard | Basic Life and AD&D Insurance
Life insurance protects your family or other beneficiaries in the event of your death while you are still actively employed with the
company. Roll-A-Shade pays for coverage, offered through Reliance Standard, in the amount of $25,000. If your death is due to a
covered accident or injury, your beneficiary will receive an additional $25,000 through Accidental Death and Dismemberment
(AD&D) coverage.

You may update your beneficiary designation at any time throughout the year on Ease (see page 11).

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