VISION INSURANCE
Electronic Data, Inc. offers vision coverage through United Healthcare. The United Healthcare vision network consists of optometrists, ophthalmologist opticians and optical retailers. You have the option of visiting any provider, however by choosing a participating provider, you receive the highest level of benefits.
Vision United Healthcare V1001
In-Network
Non-Network
Routine Eye Exams
$10 Copayment
Up to $40
$10 Copayment Includes:
Single Bifocal Trifocal Lenticular
Up to $40 Up to $60 Up to $80 Up to $80
Lenses*
$10 Copayment $130 allowance, plus 30% discount
Frames
Up to $45
Contact Lenses
Elective Medically Necessary
$105 allowance (less applicable copay) Covered in Full (less applicable copay)
Up to $105 Up to $210
Frequency Exam
Once every 12 months
Lenses or contact lenses
Once every 12 months
Frame
Once every 12 months
• Lenses, Frames & Contacts are limited to either one pair of contacts or frames/lenses per year.
Employee Contribution 2018 – 2019 Coverage Year
Employer Paid Benefit Amount Monthly
Employer Paid Benefit Amount Annually
Employee Only
$0.00 $0.00 $0.00 $0.00
$ 5.42 $10.29 $12.02 $16.95
$ 65.04 $123.48 $144.24 $203.40
Employee + Spouse
Employee + Child(ren)
Family
6
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