Page 19 - Work Life and Benefits Booklet 2020 SW

EyeMed Vision Plan
ShipWorks provides vision coverage through EyeMed Vision through the Select network. You can see an EyeMed in-network provider or an out-of-network provider,
however, your costs will be lower if you visit an in-network provider. If you visit and in-network provider you will be responsible for a copayment at the time of your
service. If you receive services from an out-of-network doctor, you’ll pay all costs at the time of service and submit a claim for reimbursement.

You will receive a separate vision ID card.

PLAN NAME EYEMED PPO

NETWORK NAME SELECT NETWORK NON-NETWORK

Exam
Once Every 12 Months $0 Copay Up to $35 reimbursement

Lenses
Once every 12 months Additional Discounts Available
Single Vision $25 Copay Up to $35 reimbursement
LASIK and PRK Benefit: You are entitled to a 15%
Bifocal $25 Copay Up to $49 reimbursement discount on the usual and customary fees for LASIK
Trifocal $25 Copay Up to $74 reimbursement and PRK procedures, or a 5% discount on any
promotional pricing, whichever is the greater benefit,
Frames through the U.S. Laser Network.

Once every 24 months $130 Allowance Up to $65 reimbursement Continued Eyewear Savings: After your initial visits
have been utilized, you are able to receive ongoing
Contact Lenses (in lieu of glasses) discounts on additional eye wear purchases at
Once every 12 months $130 Allowance Up to $96 reimbursement EyeMed provider locations, which result in discounts
up to 40% off the retail price of eye wear and
accessories.

Contact Lens by Mail Program: You may order
FINDING A VISION PROVIDER replacement contact lenses at competitive prices via
Go to www.eyemedvisioncare.com to find a provider near you. Refer to the Select the internet by visiting www.eyemedcontacts.com.
network when prompted. This service is for replacement contact lenses only.
Your initial pair of contact lenses must still be
The EyeMed network includes access to independent ophthalmologists and purchased from your eye care provider to ensure
optometrists, as well as LensCrafters, Target Optical, Sears Optical, JCPenney proper fit and follow up care.
Optical, and most Pearle Vision retail stores.