Page 12 - ECV Benefit Guide 2020

BENEFITS

VISION INSURANCE

VSP | PPO Vision Plan
The VSP 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 use a non‐network provider, you will be
responsible for paying all charges at the time of your appointment and will be required to file an itemized claim with VSP.

VSP Note: VSP has the
PLAN NAME PPO largest network of
private-practice eye
Network Name Choice Non-Network care doctors in the
Vision Benefits industry. VSP’s
network includes
Copay 50,000 access points
- Examination $10 Copay N/A nationwide. VSP also
- Materials $25 Copay N/A contracts with Costco
Optical, Visionworks,
Examination (Every 12 Months) 100% $45 Reimbursement
and other affiliate
Lenses (Every 12 Months) retail providers.
- Single Vision 100% $30 Reimbursement Please note, benefits
- Bifocal 100% $50 Reimbursement may vary at affiliate
- Trifocal 100% $65 Reimbursement locations.
Frames (Every 12 Months) $130 Allowance $70 Reimbursement

Contact Lenses (Every 12 Months) In Lieu of Frames and Lenses
- Cosmetic / Elective $130 Allowance $105 Reimbursement
- Medically Necessary 100% $210 Reimbursement
Laser Vision Correction Discounts Apply Not Covered

Finding a Vision Provider
Go to www.vsp.com or call (800) 351-7500. Refer to the Choice network when prompted.

DISABILITY INSURANCE

Reliance Standard | Short Term Disability Insurance
Elements Corporate Ventures offers you Short Term Disability (STD) to provide income replacement if you become disabled due to
accident, sickness or pregnancy, through Reliance Standard. If you experience a temporary disability, benefits begin on the 8th day
after the start of your disability and will continue as long as you remain disabled up to a maximum of 8 weeks. STD works with state
disability programs, Social Security, and any other group disability coverage, to provide you with a combined monthly benefit equal
to 60% of your pre‐disability earnings up to a maximum benefit of $2,500 per week.

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