Pilot Bank 2019 Benefits

VISION INSURANCE

Pilot Bank offers vision coverage through MetLife. The MetLife vision network consists of optometrists, ophthalmologist opticians and optical retailers. You have the option of visiting any provider, however by choosing a participating provider, you receive the highest level of benefits.

Vision VSP Network

In-Network

Out-of-Network

Routine Eye Exams

$10 Copayment

Reimbursed up to $35

$15 Copayment $30-$100 allowance $15 copay Up to $55 allowance $15 copay Up to $120 allowance

Lenses*

$15 Copayment

$15 copay Up to $120 allowance

Frames

$15 copay Up to $120 allowance (elective) 100% after copay (necessary)

Contact Lenses

Frequency Exam

Once every 12 months

Lenses or contact lenses

Once every 12 months

Frame

Once every 24 months

• Covered lenses include single vision, bifocal, trifocal and lenticular. • Lenses, Frames & Contacts are limited to either one pair of contacts or frames/lenses per calendar year.

Employee Cost Semi-Monthly

Employee Only

$3.46 $6.92 $7.12 $9.86

Employee + Spouse

Employee + Child(ren)

Family

7

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