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2015—2016 Benefits Guide
10
VISION INSURANCE
VSP Voluntary Vision
Benefit/Service
In-Network
Out-of-Network
Benefit
Examination
$10 Co-pay
$45 reimbursement
Frequency of Service:
Exam
Every 12 months
Lenses
Every 12 months
Frames
Every 24 months
Lenses:
$25 Co-pay then:
Reimbursement:
Single
100%
$30
Bifocal
100%
$50
Trifocal
100%
$65
Frames
$25 Co-pay, then
covered 100% up to
$130 Retail (20% off
amount over
allowance)
$70
Contacts:
Reimbursement
Necessary
Covered at 100%
$210
Cosmetic
$130 Allowance
$105
2015—2016 Employee Vision
Contributions
Vision Employee Cost
2015
Employee
Monthly
Cost
2015
Employee
Per
Paycheck
Cost
Employee
$6.19
$3.10
Employee & Spouse
$9.90
$4.95
Employee & Child(ren)
$10.11
$5.06
Employee & Family
$16.29
$8.15
VSP vision members have access to
one of the nation’s largest vision
networks.
If you are considering Lasik Surgery,
there is a discount available. The
average discount is 15% off the
regular price or 5% off the
promotional price at contracted
facilities.
Form more information or to find a
provider in your area, please go to
www.vsp.comor call 800-877-7915.
There are no ID cards needed for this
benefit. When you make your
appointment simply tell the provider
you are a VSP member.