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.comfor 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.comor 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