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17

2017 Stantec

Benefits Guide

Vision Care

Our vision plan from VSP helps you save money on eye exams, contact lenses, glasses, Lasik

and more. Visit

vsp.com

for details on these extra savings. The

VSP Signature Network

is used

for vision providers.

Vision Benefit Highlights

Frequency

Copayment

Coverage from a

VSP Preferred

Provider

Non-preferred Provider

(Also Known as Out-Of-Network)

Reimbursement

Exam

12 months

$20

Covered in full

Up to $50 allowance

Prescription

eyewear

You may choose glasses or contacts. Remember, if you choose contacts, you will not be

eligible to receive glasses (lenses and frame) in the same service period.

Lenses

12 months

$20

(applied to lenses

and frame)

Single vision, lined

bifocal, and lined

trifocal lenses are

covered in full.

Single vision: up to $50

allowance

Lined bifocal: up to $75

allowance

Lined trifocal: up to $100

allowance

Frame

12 months

Up to $150

allowance

Up to $70 allowance

$80 allowance at Costco

Contact lenses

12 months

None

Up to $150

allowance

Up to $105 allowance

Note:

ID cards are not required or issued for vision benefits. To access your benefits:

• Log in t

o vsp.com

or call the VSP at (800) 877-7195 to locate an in-network eye doctor.

• Contact your VSP Preferred Provider to schedule an appointment and give them this information:

∙∙ Insurance Name:

VSP

∙∙ Group Number:

12280290

∙∙ Your Social Security Number:

last four digits only