VISION INSURANCE
VISION PLAN INFORMATION
65%+ FTE FACULTY 75%+ FTE STAFF
ELIGIBILITY
VISION CARE SERVICES
PLAN INFORMATION
OUT OF NETWORK REIMBURSEMENT
IN NETWORK MEMBER COST
$25 COPAY; $130-$150 ALLOWANCE; 20% OFF BALANCE OVER ALLOWANCE; $70 COSTCO FRAME ALLOWANCE INCLUDED IN RX GLASSES CO-PAY INCLUDED IN RX GLASSES CO-PAY INCLUDED IN RX GLASSES CO-PAY $55-$175 CO-PAY
FRAMES (EVERY OTHER CALENDAR YEAR)
UP TO $70
SINGLE VISION BIFOCAL TRIFOCAL STANDARD PROGRESSIVE LENSES
UP TO $30 UP TO $50 UP TO $65 UP TO $50
CONTACT LENS FIT AND EVALUATION
UP TO $60
NOT APPLICABLE
CONTACT LENSES (IN LIEU OF GLASSES)
$60 COPAY
UP TO $105
$3.82 EMPLOYEE ONLY
$8.18 EMPLOYEE + CHILD(REN)
EMPLOYEE CONTRIBUTION
$13.08 EMPLOYEE + FAMILY
$7.74 EMPLOYEE + SPOUSE
PLAN ADMINISTRATOR
VSP
FOR MORE INFORMATION ON VISION BENEFITS: https://mailuc.sharepoint.com/sites/HR-Benefits/SitePages/Vision-Insurance.aspx
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