Vision Coverage

Get the Most From Your Vision Benefits

Need glasses or contacts? The Vision Plan can help.

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What the Plan Covers

EyeMed Vision
You Pay:
EyeMed Vision
Plan Pays Up To:
In-Network Out-of-Network
Exams (Once every 12 months)
$15 copay $40
Glasses1
Single Vision Lenses
$20 copay $25
Bifocal Lenses
$20 copay $40
Trifocal Lenses
$20 copay $65
Standard Progresive Lenses
$20 copay $55
Premium Progresive Lenses
$20 copay, then anything over $120 you receive a 20% discount $65
Lens Options
UV Treatment, Tint (Solid and Gradient), Standard Plastic Scratch Coating
$0 $8
Standard Polycarbonate — Adults and kids under 19
$0 $20
Standard Anti-Reflective Coating
$45 copay N/A
Polarized
20% off retail price N/A
Other Add-Ons
20% off retail price N/A
Frames1
$0 Copay; $130 Allowance (you receive a 20% discount on amount over $130) $65
Conventional and Disposable Contact Lenses1
$0 Copay; $130 Allowance (you receive a 20% discount on amount over $130) $104
Medically Necessary
$0 $200
Contacts – Fittings
Standard
$0 $40
Premium
$0 Copay; $55 Allowance (you receive a 20% discount on amount over $55) $40
LASIK/PRK Procedures
You receive a 15% discount on usual and customary fees at LCA-Vision locations or a 5% discount on promotional pricing, whichever is greater You receive a 15% discount on usual and customary fees at LCA-Vision locations or a 5% discount on promotional pricing, whichever is greater

1. Lenses or contacts once every 12 months. Frames once every 12 months.

What the Plan Costs (Biweekly)

You – $3.30

You + Spouse/Domestic Partner –  $6.24

You + Child(ren) – $6.60

You + Family – $8.62

1. By law, the cost for domestic partner benefits cannot be paid pre-tax, and the “value” of Team Member and employer-provided domestic partner contributions is taxable.

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