Page 9 - PLM Benefit Guide 4-2018 Final

Vision Benefits | Employee Assistance Benefits

Anthem | PPO Vision Plan

The Anthem 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.

Anthem
PPO Plan
Blue View Vision Network Non-Network

Vision Benefits
Examination (Every Calendar Year) $10 Copay $42 Reimbursement

Lenses (Every Calendar Year)
 Single Vision $25 Copay $40 Reimbursement
 Bifocal $25 Copay $60 Reimbursement
 Trifocal $25 Copay $80 Reimbursement

Frames (Every Calendar Year) $130 Allowance $45 Reimbursement
Contact Lenses (Every Calendar Year) In Lieu of Frames and Lenses
 Cosmetic / Elective $130 Allowance $92 Reimbursement
Laser Vision Correction Discounts Apply Not Covered

Finding In-Network Vision Providers
Go to www.anthem.com/ca or call (866) 723-0515 and refer to the Blue View Vision network when prompted.

Mutual of Omaha | Employee Assistance Program

The Employee Assistance Program (EAP) through Mutual of Omaha 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
To access EAP benefits, go to mutualofomaha.com/eap or you may call (800) 316-2796 to be immediately
connected to an EAP counselor.

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