Community Action for Improvement, Inc. - 2023-2024 Benefits…

Vision Coverage

The vision plan covers routine eye exams and also pays for all or a portion of the cost of glasses or contact lenses if you need them. To get the most from your benefits and reduce out-of-pocket costs, choose an in-network provider by utilizing our large national network. Your vision plan is through Aetna and offers “in and out-of- network” benefits. You can find vision providers at aetna.com/findvision

Insurance Carrier:

Aetna Vision Insurance

Plan Type:

Premier

In-Network $10 Copay $10 Copay $10 Copay $10 Copay $10 Copay

Out-of-Network

Exam Copay

$25 Reimbursement

Lenses - Single lined Lenses - Bifocal lined Lenses - Trifocal Lenses - Lenticular

Up to $20 Up to $40 Up to $65 Up to $65 Up to $65

Frames

$ 130 Allowance; then 20% off

Elective Contact Lenses (in place of lenses & frame) Medically Necessary Contacts

$115 Allowance; then 15% off

Up to $80

$10 Copay

Up to $200

Frequency for Exam / Lenses / Frames Employee Semi-Monthly Deduction Employee Only

12 months / 12 months / 24 months

$1.04 $1.97 $2.08 $3.05

Employee + Spouse Employee + Child(ren)

Family

15 COMMUNITY ACTION FOR IMPROVEMENT, INC. 2023 BENEFITS GUIDE

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