Page 15 - Premier EE Guide 01-20 - CA- Updated 01.03.2020

BENEFITS

VISION INSURANCE

EyeMed | PPO Vision Plan
The EyeMed 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 EyeMed.

EyeMed Note
Plan Name PPO EyeMed’s network

Network Network Non-Network includes access to
more than 44,000
Vision Benefits providers and
provider locations
Copay
- Examination $20 Copay N/A including
- Materials N/A N/A independent
ophthalmologists
Examination (Every 12 Months) No Charge after copay Up to $40 Reimbursement and optometrists, as
well as
Lenses (Every 12 Months) LensCrafters®,
- Single Vision No Charge Up to $30 Reimbursement Target Optical, and
- Bifocal No Charge Up to $50 Reimbursement
most Pearle Vision
- Trifocal No Charge Up to $70 Reimbursement
retail stores.
Frames (Every 24 Months) $130 Allowance, 20% Up to $91 Reimbursement

Contact Lenses (Every 12 Months) Lenses or Contact Lenses
- Cosmetic / Elective $130 Allowance Up to $130 Reimbursement
- Medically Necessary No Charge Up to $210 Reimbursement

Laser Vision Correction Discounts Apply Not Covered

Finding a Vision Provider
Go to eyemed.com or call (866) 804-0982. Refer to the “Insight” network when prompted.

EMPLOYEE ASSISTANCE PROGRAM

Mutual of Omaha| EAP
The Mutual of Omaha Employee Assistance Program (EAP) 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 for each concern, face-to-face or as an online session.

Accessing the EAP
To access EAP benefits, go to www.mutualofomaha.com/eap or you may call (800) 316-2796 to be
immediately connected to an EAP counselor.

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