Page 19 - Work Life and Benefits Booklet 2020 SS

EyeMed Vision Plan
ShipStation 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
Single Vision $25 Copay Up to $35 reimbursement Additional Discounts Available
Bifocal $25 Copay Up to $49 reimbursement
Trifocal $25 Copay Up to $74 reimbursement LASIK and PRK Benefit: You are entitled to a 15%
discount on the usual and customary fees for LASIK
and PRK procedures, or a 5% discount on any
Frames promotional pricing, whichever is the greater benefit,
Once every 24 months $130 Allowance Up to $65 reimbursement through the U.S. Laser Network.

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

FINDING A VISION PROVIDER Contact Lens by Mail Program: You may order
Go to www.eyemedvisioncare.com to find a provider near you. Refer to the Select replacement contact lenses at competitive prices via
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.