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.
Your PPO vision plan is through Unum and offers “in and out-of-network” benefits.
To find an in-network provider, visit unum.com/employers/employee-benefits/vision-insurance
Insurance Carrier:
Unum Vision Insurance
Plan Type:
EyeMed
In-Network
Out-of-Network
Exam Services
$10
up to $40 up to $30 up to $50 up to $70 up to $70
Lenses - Single lined Lenses - Bifocal lined Lenses - Trifocal Lenses - Lenticular
$25 Copay $25 Copay $25 Copay $25 Copay
$150 retail allowance; then 20% off remaining balance
Frames
up to $105
Elective Contact Lenses (in lieu of lenses and frames)
up to $105, Medically necessary up to $210
$150 allowance
Frequency for Exam / Lenses / Frames
12 months / 12 months / 24 months
Employee Bi-Weekly Deduction Employee Only
$2.87 $5.74 $5.45 $8.56
Employee + Spouse Employee + Child(ren)
Family
9 Horizons Diagnostics, LLC. 2022 Enrollment Guide
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