VISION INSURANCE
Creative Sign Designs offers vision coverage through Guardian. The Vision PPO Plan allows you to use in-network or out-of-network benefits. If out-of-network vision providers are used, you will be responsible for paying the difference between Guardian’s allowed amount and what the provider may charge, also known as “balance billing”.
Vision Davis/Full Feature – Designer B
In-Network
Out-of-Network
Routine Eye Exams
No Charge
Up to $50 reimbursement
Standard Lenses: $48 - $126 reimbursement, depending on lens type
Standard Lenses: No Charge
Lenses *
Additional costs apply for specialty materials and/or lens coating*
Additional costs apply for specialty materials and/or lens coating*
Up to $150 allowance, plus 20% off balance over $150, plus an additional $50 allowance if purchased at Vision Works
Frames
Up to $48 reimbursement
Contact Lenses Fitting & Follow-up Exam
Included, when contacts are purchased
Not Included
Conventional Lenses: Up to $150 allowance, plus 15% off balance over $150 (copay waived)
Elective
Up to $105 reimbursement (Copay waived)
Medically Necessary:
No Charge (Copay waived)
Up to $210 reimbursement (Copay waived)
Frequency Exam
• Lenses, Frames & Contacts are limited to either one pair of contacts or frames/lenses per calendar year.
Once every 12 months
Lenses or contact lenses
Once every 12 months
Frame
Once every 24 months
* Please refer to your plan document for specific details.
Employee Contributions (Bi-Weekly)
Vision
Employee Only
$ 2.88 $ 5.54 $ 5.08 $ 8.31
Employee + Spouse
Employee + Child(ren)
Family
6
Made with FlippingBook - professional solution for displaying marketing and sales documents online