MicroLumen 2018 Benefits Guide

VISION INSURANCE

MicroLumen offers vision coverage through Sun Life. Sun Life uses the VSP network. To search in-network providers vision www.VSP.com . You have the ability to see in and out of network providers. If using an out of network provider you pay expenses at the time of service and file a claim for reimbursement. Below is a list of the reimbursement schedule.

To find an in-network provider go to www.VSP.com . When searching make sure to indicate your network is the “Signature” network.

Vision VSP Signature Network

Out-of-Network 1

In-Network

Routine Eye Exams

Every 12 months

$10 Copay

Reimbursed up to $52

Lenses

Every 12 months

Single Vision Lined Bifocal Lined Trifocal Lenticular

Reimbursed from $55 to $125, depending on type of lenses

$25 Copay

Frames 2

Every 24 months

$20 Copay provides, $130 Allowance PLUS 20% off the overage

$57 allowance

Contact Lenses (in lieu of glasses)

Every 12 months

$130 allowance

Reimbursed up to $105

1 Reimbursable amount, less applicable copay. 2 Get 30% off additional glasses and sunglasses, including lens options, from the same VSP doctor on the same day as your exam. Or get 20% off from any VSP doctor within 12 months of your last exam.

Employee Cost (Semi-Monthly)

Employee Only

$ 3.06 $ 6.12 $ 5.82 $ 9.14

Employee + Spouse

Employee + Child(ren)

Family

5

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