Vision Coverage
Keep your vision clear with regular eye exams.
Vision is administered through Vision Service Plan (VSP).
VSP’s network has over 20,000 vision providers in the United States. The amount you pay for vision services depends upon whether you visit an in-network or out-of-network provider. Provider doctors can be found at www.vsp.com (VSP Choice Network) or call 800-877-7195.
You can choose between two plans, the Core or Buy-Up Plan. The Buy-Up allows you to purchase frames every 12 months instead of 24 months. The frame allowance is increased from $120 to $150. You can also purchase a second pair of eyewear (frame & lenses), or you can receive additional contacts for a $10 copay.
Vision Benefits
| Benefit | In-Network Core | In-Network Buy-Up | Out-of-Network | |||
|---|---|---|---|---|---|---|
| Exam | $10 Copay | $10 Copay | Up to a maximum reimbursement of $45 | |||
| Hardware/Materials | $25 Copay | $25 Copay | N/A | |||
|
Frequency Exam Lenses Frames |
12 months 12 months 24 months |
12 months 12 months 12 months |
12 months 12 months 24 months Core/12 Months Buy-Up | |||
| Frames | Covered 100% up to $120; 20% off balance over $120 ($140 for featured brands) |
Covered 100% up to $150; 20% off balance over $150 ($170 for featured brands) |
Max reimbursement up to $70 | |||
|
Lenses Single Vision Lenses Bifocal Lenses Trifocal Lenses |
Covered in Full after $25 copay |
Covered in Full after $25 copay |
Up to a maximum reimbursement of $30 Up to a maximum reimbursement of $50 Up to a maximum reimbursement of $65 | |||
| Elective Contact Lenses in Lieu of Glasses |
Covered up to $120 allowance |
Covered up to $150 allowance |
Max reimbursement up to $105 | |||
| Medically Necessary Contact Lenses |
100% after $25 copay |
100% after $25 copay |
Max reimbursement up to $210 | |||
| 2nd Pair (Lenses & Frame or Contacts) |
N/A | $10 Copay, Covered up to $150 allowance |
Frames: $70 Lenses: $30/$50/$65 Contacts: $105 | |||
Using Your VSP Benefit is easy.
- Create an account at www.vsp.com. Once your plan is effective, review your benefit information.
- Find an eye care provider who’s right for you. To find a VSP provider, visit www.vsp.com or call 1-800-877-7195
- At your appointment, tell them you have VSP. There is no ID card necessary. If you’d like a card as a reference, you can print one at www.vsp.com.
That’s it! We will handle the rest – there are no claim forms to complete when you use a VSP provider.
Employee Contributions
| Bi-Weekly Vision Contributions | ||||
|---|---|---|---|---|
| Core | Buy-Up | |||
| Employee | $0.56 | $7.13 | ||
| Family | $1.21 | $15.35 | ||
VSP Vision Benefit Summary
VSP Reimbursement Form
