Vision Insurance Thomas College offers a vision plan from Northeast Delta Dental. The network is Eyemed. You can go to any vision provider that you want, but if you receive services from a participating provider, you will receive a higher level of benefits. Benefits In-Network Out-of-Network Examinations Routine eye exam (Once every 12 months) $10 Copay Up to $35 Eyeglass Lenses (in lieu of contact lenses—once every 12 months)
Up to $ 25 Up to $ 40 Up to $ 55
Single Vision Bifocal Trifocal
$25 Copay $25 Copay $25 Copay
Contact Lenses (in lieu of eyeglass lenses—once every 12 months) Fit and Follow-up Exams Up to $ 55
No benefit
Up to $1 8 0 ; 15% off balance
Elective
Up to $1 44
Non-elective Lenses (Medically Necessary)
Covered in full
Up to $2 00
Eyeglass Frames (once every 24 months)
Frames
Up to $1 80; 20% discount on balance
Up to $ 90
Per Pay Period $4.50 $8.77 $8.51 $13.28
Tier Employee Only Employee + Spouse Employee + Child(ren) Family
This Guide is for illustrative purposes only and is not a legal contract, contract of employment or guarantee of coverage. Any benefits payable will be subject to the terms and conditions of the insurance policy issued by the insurance company and relevant plan document.
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