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Vision Benefit Summary:
The following table outlines your Vision Benefits and Benefit Allowances. All
benefits are based on Reasonable and Customary.
Eye Exams (Every 12 months)
Lenses (Every 12 months)
Frames (Every 12 months)
Contact Lenses (Every 12 months)
Co-payment Amount: no co-payment for exams, prescription glasses, or
contacts
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Eye Exams
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Covered in Full
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Lenses
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Single Vision, Bifocal, or Trifocal covered in full
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Frames
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Frame of your choice covered up to $130.00. Plus, 20% off any out-of-pocket
costs.
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Contact Lenses
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Medically necessary contacts are covered in full. Allowances of $130 are paid
toward the cost of elective contact lenses.
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In addition an employee who visits an in-network doctor will be entitled to:
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Laser Vision Correction
Discounts
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Up to 20% savings on lens
extras such as scratch resistant and anti-reflective coatings and
progressives
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20% off additional
prescription glasses and sunglasses
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15% off cost of contact lens
exam (fitting and evaluation)
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Exclusive pricing on annual supplies of popular brands
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Eye Exams
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$50
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Single Vision Lenses
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$50
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Bifocal Lenses
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$75
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Trifocal Lenses
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$100
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Frames
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$70
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Contact Lenses
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$105
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