Page 12 - California Eye Management EE Guide 2020

Vision Benefits

As an Ophthalmologist Group, California Eye Specialists will be providing the benefit of an
annual eye exam to employee, spouse and children from the age of seven and up. Frames,
lenses and materials will be provided at manufacturing cost. Reimbursement of frames,
lenses and materials to be paid to employer at the time of purchase by the employee/
spouse.

United HealthCare | Voluntary Vision Plan

In addition to the company vision perk listed above, you may also purchase the United HealthCare vision plan. This voluntary
vision is available to you and your family and works like a standard vision insurance plan, however you can submit your out
of pocket expenses to United HealthCare and get reimbursed for the out of pocket expenses. 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 HealthCare.

Plan Name United HealthCare
PPO Plan
Network Network Out-of-Network
Vision Benefits

Copay
- Examination $10 Copay n/a
- Materials $25 Copay n/a

Examination (Every 12 Months) 100% up to $40
Lenses (Every 12 Months)
− Single Vision 100% up to $40
− Bifocal 100% up to $60
− Trifocal 100% up to $80

Frames (Every 24 Months) $130 Allowance up to $45

Contact Lenses (Every 12 Months)
− Cosmetic / Elective $130 Allowance up to $130
− Medically Necessary 100% up to $210

Laser Vision Correction
Discount Available N/A

Finding In-Network Vision Providers
Go to www.myuhcvision.com or call (888) 679-8925

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